Severely brain injured adult grabs at caregiver's clothing, towels
while being showered, at own clothing while being dressed. Grip is
very strong, not sure if this action is voluntary. Is there any
product on the market that would restrain the hands when required. 
Would prefer if this product were a physical product rather than
medication, but will look at all alternatives.

Hello, sun8-ga,

 I have not found anything specific online for hand restraints, but I
did come up with a few references that might help.

 The article, "Utilizing Increased Response Effort To Reduce Chronic
Hand Mouthing." Journal of Applied Behaviour Analysis. 1998.at
http://www.envmed.rochester.edu/wwwrap/behavior/jaba_articles_exp/1998/jaba-31-03-0375.pdf
mentions that the Murdoch Center's Special Protective Device Clinic
had constructed some special arm restraints for their particular study
of preventing "hand mouthing" in two disabled individuals. The same
article mentions various types of mittens used over the hands as well.

"We thank the members of Murdoch Center's Special Protective Device
clinic for their efforts in theconstruction and modifications of the
arm restraints utilized in this study."

You can read about the design of the arm restraints under the section
"Apparatus."

 I understand that the hand gripping you are experiencing with your
patient is far more severe than the "hand-mouthing," but it seems as
if something like the arm restraints described might be the ideal
solution in certain situations like showering or bathing. Of course,
you would then need some type of solid, possibly rubberized mitten
over the hand to prevent grip in other situations.

The Murdoch Foundation web page is at
http://www.murdochfoundation.org/. Though I do not see any references
to their clinic on the site, it would be worth calling them for a
referral to the clinic that made the devices in the above study. They
might be able to make a customized restraint that fits your particular
situation.I noticed from the web search that they have various clinics
throughout the country, so the foundation would be the logical place
for information.

Contact:
http://www.murdochfoundation.org/CONTACTS.htm

=====

Lesch-Nyhan Syndrome, which involves patient self-mutilation, is one
condition where various types of restraints are used to protect the
individual from injury.

"The general approach for dealing with Lesch-Nyhan self-injurious
behaviors is employing protective devices. Using protective devices
with this syndrome is different than the use of physical or chemical
restrains with other conditions. Individuals with Lesch-Nyhan desire
the use of protective devices because they do not want to injure
themselves or others, but they know they will if they are not
restrained. When left unrestrained,these individuals become upset and
fearful. Well-engineered protective devices are enabling to
individuals with Lesch-Nyhan because they allow them to carry on
constructive activities."

From the Eric Clearinghouse on Disabilities and Education at
http://ericec.org/faq/lesch-ny.html


It may be worth contacting one of the associations that deals with
such rare disorders to see if they can offer you some advice. A list
of organziations may be found at the National Organization for Rare
Disorders at:
http://www.rarediseases.org/search/rdbdetail_abstract.html?disname=Lesch%20Nyhan%20Syndrome
 
I will continue to look and let you know if I find anything else, but
for the time being, I certainly hope this provides a direction for you
to pursue.

My best to you!

umiat-ga 

Google Search Strategy
+disabilities +hand restraints
Murdoch Center
+protective +arm +restraints brain injury
Lesch-Nyhan Disease organization

---

Request for Answer Clarification by sun8-ga on 02 Mar 2003 09:26 PST

I could not get picture of the arm restraints from your link.  I think
I am looking for something that will immobilize the fingers like some
type of hand splint that can be easily taken off and on and is
comfortable to wear.

---

Clarification of Answer by umiat-ga on 03 Mar 2003 07:08 PST

sun8-ga,

 No, there are no pictures of the restraints in the article. As I
mentioned, it would be best if you contacted the Murdoch Foundation
directly at:

Murdoch Center Foundation 919-575-1000  

and asked for contact number for the "Murdoch Center's Special
Protective Device Clinic."

 The clinic made the splints for the research article and I am sure
they would be willing to give you advice, work to make you something
suited to your needs, or point you to a source where you could buy
something suitable.

 Other than that clinic, I have found no special devices for sale.
However, I also ran across a chat forum for caregivers of patients
that have a problem with biting their hands. There are several
suggestions from that string that may work for you.

http://www.rettsyndrome.org/digests/00174.htm

 Some examples:

"You can wrap a hand towel around her wrists (the long way) then twist
it beyond her fingers and fold it back over her hand a second time.
Secure this with a strong rubber band, once around the wrist then
twist it over the bulky end piece. Angie has never bitten through the
rubber bands, but that might be a potential problem if you use thin
bands."

 Is there a brain injury clinic near you? Or a hospital rehab center
that works with brain-injured patients? I am sure you are not the only
caregiver experiencing these types of problems. I would contact them
as well.

 My last suggestion would be a pair of mittens, or a wrap you make
yourself to go around the hands and secure tightly with velcro. That
way, the arms are mobile but their is no ability to grasp.

 However, my first suggestion is to call the Murdoch clinic.

 Hope this helps.

 umiat

I'm not a doctor but ...

I'm told that compulsive holding is symptomatic of autism.

When working with such patients, Nurses are advised to give them
something soft that they can hold onto ... like a cloth for each hand,
etc.

Just a thought.