Carter Williams, early advocate for restraint-free nursing homes, dies at 97

Mrs. Williams was the widow of Dr. T. Franklin Williams, a leader in geriatric medicine who was a longtime professor of medicine at the University of Rochester and served as director the National Institute on Aging from 1983 to 1991.

Mrs. Williams traced her interest in elder care to her youth, when she was raised amid aging relatives in Virginia’s Tidewater Region after the death of her father.

After many years as a homemaker, and working as an activist for civil rights and education causes, Mrs. Williams became an independent nursing home consultant in 1974 and a few years later ran an infirmary for the elderly in Rochester. It was an era of massive nursing home expansion, thanks to the creation of Medicare in 1965, and many properties were corporate-owned.

Mrs. Williams grew concerned by the common practice of restricting the movements of nursing home patients by binding them to beds or wheelchairs with straps or belts. Many suffered from senile dementia or other debilitating conditions, and the intent was to protect them from injury in accidental falls.

But it came at a high cost. Some patients injured themselves struggling to get free of restraints. A few accidentally strangled themselves. Many found the practice to be oppressive and demoralizing.

“It’s like Vietnam, where we destroyed villages to save them,” Mrs. Williams told the St. Petersburg Times. “We are saving people, but we are destroying them in the process.”

She once described a nursing home visit in which she found an 89-year-old woman with heart disease slumped over and tied to a wheelchair, wanting only “to get out of this place.”

Many such patients, she said, felt they had no control of their lives. “Often you can’t even control what’s on the bedside table, and then to be tied down is the final straw,” she recounted to the Times.

She helped watchdog groups such as the National Citizens’ Coalition for Nursing Home Reform, which advocated changing the basic mission of nursing homes.

Instead of a model of clinical medical care with fixed timetables, schedules and procedures, they championed a more flexible model aimed at providing a meaningful and varied quality of life to its residents. This included opportunities to bathe and have meals on their own schedules, and the freedom not to be tied down in a bed or wheelchair.

Mrs. Williams “brought the person back into view [and] individualized care to the forefront,” Barbara Frank, a former associate director of the National Citizens’ Coalition for Nursing Home Reform, wrote in an email.

In articles as well as speeches at nursing homes, health-care organizations and societies for the aging, she argued the case for nursing home reform and was among the leaders of a national movement to improve and personalize the nursing home experience for hundreds of thousands of Americans.

She was consultant to a panel working on nursing home assessments for the 1987 Nursing Home Reform Act, which effectively prohibited the use of physical restraints on nursing home patients.

Only in an emergency — and for a short time with orders from a doctor and the consent of the patient — did the act permit use of physical restraints on nursing home patients. In addition, the nursing home had to have executed a rigorous documented-care planning process.

In 2013 the Virginia legislature commended Mrs. Williams in a resolution as “a true hero for the cause of pioneering new techniques and practices in long term care” for elderly people. She also received honors from the American Society on Aging and the National Council on Aging.

Catherine Mott Catlett was born in San Antonio, Tex., on Sept. 2, 1923. Her father, an Army aviator, was killed two years later in an airplane accident near Honolulu. Her mother took her to live with relatives in her family’s ancestral home in Gloucester, Va. Catherine’s middle name was soon changed to Carter, in honor of the middle name of her late father.

She graduated in 1945 from Wellesley College in Massachusetts and received a master’s degree in 1949 at the Simmons School of Social Work in Boston.

In 1951 she married Williams, whom she had met while he was a student at Harvard Medical School, and accompanied him to Chapel Hill when he joined the medical school faculty at the University of North Carolina, and her family attended civil rights protests.

They returned to Rochester in 1991, and Mrs. Williams later relocated to Gloucester. She continued her advocacy for nursing-home improvements.

Her husband died in 2011. Their son Landon Carter Williams died in 1960, shortly after birth. In addition to their daughter, of Gloucester, survivors include a son, Thomas Nelson Williams of Rochester; six grandchildren; and three great-grandchildren.