A study revealed that the excessive use of nappies and sanitary pads in the British public health system has undermined autonomy and violated the dignity of people in this condition.
Heather Lawrence was shocked when she visited her mother, Violet, 90, at a hospital in Manchester, England.
“The bed and incontinence diaper were soaked in urine. The door was wide open and she had no underwear. She was also in a mixed male and female room,” Heather told the BBC.
“There were other people there who could see her like that. My mother wouldn’t want to be seen that way.”
Violet, who suffered from dementia, was taken to Tameside General Hospital in May 2021 after suffering a fall.
Violet’s health deteriorated in the hospital: she developed inflammation in her groin and a rash that spread from that point to her belly, due to prolonged exposure to urine.
He died a few weeks later.
“I feel her dignity has been taken away from her. And that happens to a lot of dementia patients. I think they just stop caring for them, they feel insignificant – and that’s not true,” says Heather.
Violet’s case is not unique to the NHS, the UK’s public health system.
A new report, published exclusively on the program File on 4 from BBC Radio 4, found that other dementia patients had similar treatment, deemed “unworthy” by the authors.
‘They need help’
For a year, researcher Katie Featherstone, of the Geller Institute for Aging and Memory, West London University, analyzed the care of incontinence patients with dementia at three hospitals in England and Wales.
The study was funded by the National Institutes of Health and Care Research, a UK health research agency.
In the report, he says he found patients who were not helped to go to the bathroom and who were left wet and dirty, exposed to their own excrement.
“We have identified a widespread practice: the daily use of diapers or incontinence pads in the care of all people with dementia, regardless of their ability to retain urine or not,” explains Featherstone.
He also found that most of the patients were treated well in the NHS, but the pressure and understaffing meant that many healthcare workers were forced to use diapers or sanitary pads as a “workaround”.
When Bessie, 86, was taken to Rotherham General Hospital in 2019 after falling at home, she was still able to go to the bathroom on her own.
Despite this, her daughters Janine Ward and Susan Nurden say, the team did not respond when Bessie asked to go to the bathroom.
Unbeknownst to the daughters, the hospital also placed incontinence pads. “There was no way my mom could go to the bathroom,” Janine says.
“She knew what she was doing. She would make a big noise if she wanted to go to the bathroom, and if no one helped her, she would freak out and scream for someone to come.”
Bessie should have been referred to incontinence specialists at a special NHS unit in the region.
Later, Janine and Susan felt that her mother’s ability to go to the bathroom on her own, coupled with her fragile mobility, were two factors that put her at risk of another fall at home.
The daughters wanted their mother to move to a nursing home near the family, but the hospital and social services disagreed.
They said Bessie suffered from incontinence and came up with a care plan to provide extra assistants, toilets, and incontinence pads (although this never happened).
The first night at Bessie’s house, Janine was with her when the attendants arrived with a urinal.
Janine says, “They put her in the potty. The curtains in the room were still open. It was a big picture window. I can’t explain how I felt. I said, ‘You just put my mom in that’ bathroom ‘with the curtains. open, why didn’t you close it? ”
Contacted by BBC News, the Rotherham Trust and Council, the body that manages hospitals in the Rotherham area, he apologized to Bessie’s family and said patient care “has improved since then.”
Featherstone says people with dementia often forget how to go to the bathroom when forced to use diapers or sanitary pads.
“We know that many people with dementia who can go to the bathroom on their own leave hospitals with incontinence,” he says.
“So the simple act of using a sanitary napkin and the practices surrounding it can mean that people start to lose the ability to go to the bathroom when they need it,” she says.
“And that can have real implications for people later on. It can make it harder for families to care for someone if they are also facing incontinence. And it can bring these older people into nursing homes and nursing homes.”
it must be well evaluated
Professor June Andrews, who has worked in dementia care for more than 30 years, says rigorous incontinence assessments are essential to avoid guesswork.
“I see documents where someone has asked family members whether the patient is incontinent or not. And that’s all that was done to assess the situation,” he says.
“It is absolutely vital that families know how to ask whether or not an incontinence assessment was performed and who produced that analysis,”
Karen Harrison Dening, director of research and publication at Dementia UK and co-author of the study, criticized the care provided to patients with dementia in NHS hospitals.
“People, regardless of their underlying condition and age, don’t go to the hospital to get out with incontinence,” he says.
“Not only do employees need specific training on how to promote an individual’s independence, but health care organizations need to have a commitment and a responsibility to maintain an older person’s autonomy.”
– Text originally published in https://www.bbc.com/portuguese/geral-61918480
Source: Terra
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