For the average person, going to the toilet is a very private affair, a breach of this privacy can feel undignified and may also be accompanied by feelings of embarrassment.
Our fundamental need to avoid things that we are uncomfortable with stems from the values that we hold, and being forced to act in a manner that goes against these values can diminish the way in which a person feels about themself.
Due to its nature, ‘continence’ is a topic that is talked about in whispers.
But for many of the elderly Australians who currently call a residential facility home, issues surrounding continence and continence pads are a reality that requires loud discussion and some ironclad answers.
HelloCare was recently approached by a reader whose grandmother is currently living in a residential facility.
And this person raised some serious ethical questions about the usage of continence pads in aged care facilities.
“My grandmother told me that the workers told her to go to the toilet in her pants,” she said.
“My grandmother is old, but she doesn’t have any issues with continence. She knows when she has to go, but she does require some assistance. And she has been forced on a number of occasions to go to the toilet in her pants and she hates doing it.”
“She told me she tried to hold on and wait to see if someone could help, but in the end she was forced to sit there in her own mess.”
Demoralizing
If you are treated well by people, you know that people value you as a person. This reinforces your own sense of importance and self-worth.
Sadly, elderly people within aged care facilities can become highly prone to feelings of depression and social isolation, and these feelings come through a lack of feeling valued.
Being asked to go to the toilet in your pants would be a nightmare for anyone without continence issues, and the fact that a person is elderly doesn’t change the way that they would feel about having to do that.
Being continually forced to do things that you feel are embarrassing or shameful has a devastating effect on your mental health, and shapes your opinion on how others feel about you, and ultimately, how you feel about yourself.
What Do The Experts Say?
Mrs Rowan Cockerell, CEO of the Continence Foundation of Australia, was kind enough to share her thoughts with HelloCare, on the issue of continent people being made to urinate in pads as opposed to being taken to the toilet.
“This type of practice compromises the duty of care, respect and dignity, that is a right of any person in an aged care facility. In addition to the emotional impact that this can cause, forcing a person to use continence pads when they do not have bladder or bowel control issues increases their risk of complications such as skin rashes.”
“It is important to understand that continence needs of each resident differ and continence care should to be tailored to the individual,” she said.
“Whilst we have no control over staff processes in aged care facilities, residents should be aware that they have the right to raise any continence care issues they are having with the care staff or management of the facility,” she said.
Why Does This Happen?
The overwhelming majority of aged care employees set out to do the best job that they can in providing care for elderly residents.
Unfortunately though, time restraints due to a lack of staffing has a number of negative consequences.
We have heard stories from a number of people who had previously worked in aged care facilities, but resigned out of the frustration that the current pressures and lack of staffing did not allow them to do their job to a level that they could live with.
Having continent people urinate into pads because staff do not have adequate time to take them to the toilet, is a prime example of how compromised care has become within the aged care sector.
A number of people who become aged care employees, do so with the sole intent of trying their best to ensure that elderly people experience as much joy and comfort as they possibly can in their remaining years.
And the fact that a number of great people have quit their job because they were unable to do this, is one of the strongest arguments for strict staffing-ratios that there is.
A person’s sense of dignity is a barrier between what they feel is morally right, and what they feel is morally wrong.
And neither the residents, or the employees, should have to compromise in order to live or work in an aged care facility.
Residents are entitled to lodge complaints with the Aged Care Complaints Commissioner and the Australian Aged Care Quality Agency (which will be amalgamated from 1 January 2019 as a new independent entity called the Aged Care Quality and Safety Commission). Complaints can be lodged by ringing 1800 550 552 or email at www.agedcarecomplaints.gov.au
The Continence Foundation of Australia is preparing a submission to the Royal Commission into Aged Care Quality and Safety and we invite anyone with continence care issues in aged care facilities to have their say by emailing us at advocacy@continence.org.au.
See what our readers are saying about this topic on Facebook.
It is NEVER okay to tell a resident to do it in their pants. My mother was non-ambulatory (as a result of complications from an operation) when she was placed into care and forced to wear pads due to length of time it took staff to answer her calls and get the lifter to her. She was also told to “do it in her pad”. She was left in urine & faeces soaked pads for so long that she had blood-filled blisters all around her groin. Apart from the indignity, she would cry from the pain whenever she needed to wee. Management was told but the situation never changed. In fact, it worsened after the complaint.
That is disgusting your poor nan.
I am sick and tired of hearing how people are getting treated bad in these aged care places .
Obviously it is never acceptable to refuse to take a resident to the toilet. Your article does explain the reason why this happens ( staffing issues) and I can confirm after 20 years as an RN in Aged Care that in any nursing home there is not a compliance rate of anywhere near 100%.
Nothing is mentioned however of the resident with cognitive issues who may have just been toileted and within a few minutes of being taken back to their room asks for toileting again. This is very very common and it is obviously impossible to continue to comply with these residents requests.
Some of these residents also display behavioural and attention seeking issues or have fixations with bladder and bowel that compel them to constantly ask for toileting.
Added to the above is that when a resident is immobile or requires 2 persons to toilet them this is very time consuming and staff cannot continually be spending all their time and attention toileting people unreasonably frequently to the detriment of other residents.
Again people need to actually work on the floor of a nursing home to understand ‘the real world’ of these places, just how complex it is to care for dependant elderly often confused people with nowhere near enough staff to actually fulfill every request.
In reality anyone with urge incontinence that needs to be toileted immediately on asking will become incontinent in a nursing home as during certain periods after hours there is often 2 staff only on the floor and if they are attending to a non ambulance resident it can take up to 15-20 minutes to attend. This is of course assuming that they are the only resident ringing for assistance and this is often unlikely!
This is a sad illustration of what is occurring our health care system and unfortunately it’s not isolated to residential Aged Care. An elderly mother of a friend of mine was admitted to an acute hospital to reset a broken arm. She was continent prior to admission but was placed in large pads and was told by a senior nurse
‘we don’t have the time nor the staff to take you to the toile’!
She was so humiliated that she rang her daughter to come and take her home.
For some people they don’t have the support to go home and as a consequence put up with poor care.
My father was chemically restrained with an antipsychotic sedative – multiple times, in an acute private hospital in Brisbane recently because he needed to use the toilet at night! He was incontinent – NOT PSYCHOTIC!!!
I know what is like to be a Slave to Incontinence Underwear having to wear them 24/7 sometimes i can make it to the Toilet to Peee other times i get little time to make a mad Dash to the toilet but when i go to sleep i don’t get any warning as it just happens … If i try to limit my intake of fluids i find myself getting a little dose as in little dose of confusion..so i try to not put a limit on how much liquid and food i consume … I some time a go, did a short time of working in a Nursing Home….. and i noticed that they limited the fluids of the Elderly as they did not have time to care about having to give the people a proper toileting that… they… the people, felt were urgent requests of their keeping a time in a need of to go to the toileting on time and were or just connected to incontinence bag they lost a lot of interaction with the staff or other people and spent a lot of time in isolation mostly just watching the sun come up or down and very little else and then lost interest in what was going on around them and were not even interested in eating their meals toward the end of their lives … Until there was just an empty shell left of Who…What …. They Were … Before ….
Disgusting.,,,against health requirements and personal pride…