Patients left in pads, even when not incontinent, study finds

Staff caring for hospital patients with dementia report routine use of incontinence measures due to overstretched resources
Incontinence pants

Staff caring for hospital patients with dementia report routine use of incontinence measures due to overstretched resources

Picture: iStock

Hospital patients with dementia are being made to use incontinence pads regardless of need as nurses struggle to provide dignified care, according to a new study.

Nursing and other ward staff told researchers they felt alone and invisible as they strived to care for large numbers of people with dementia, contributing to a ‘pad culture’ becoming the norm.

Devastating impact on patients’ dignity and identity

The year-long study by the University of West London Geller Institute of Ageing and Memory looked at approaches to continence care on six wards at three hospitals in England and Wales. It found incontinence pads were used routinely for patients with dementia as a precautionary measure, regardless of whether they were incontinent or not.

This could have a devastating impact on patients’ dignity and identity and meant those who were continent when admitted were at significant risk of becoming incontinent during their hospital stay, says the report.

Nurses and healthcare assistants told the research team they wanted to provide high quality care but felt unsupported by their hospitals and senior staff.

Continence care ‘at heart’ of dignified, quality treatment

Helping patients to use the toilet is often not seen as a priority, especially when wards are hectic or short-staffed, the report says.

It also documents the physically draining aspects of providing continence care, with nurses carrying full bedpans considerable distances and dragging heavy bags of soiled bedding along corridors.

Report co-author and Geller Institute director Katie Featherstone says continence care for hospital patients with dementia is ‘a hidden problem’.

‘It is often regarded as “low-status” work, but we must recognise that it is at the heart of dignified, quality care,’ says Professor Featherstone.

A neglected practice area that needs greater recognition

The report calls for more training for staff and a greater recognition of the importance of continence care by managers.

Co-author and nurse Karen Harrison Dening, director of research and publications at Dementia Care UK, says: ‘Staff not only require targeted education on the specific ways they can promote an individual’s independence, but healthcare organisations should be mandated and responsible for maintaining an older person’s autonomy.’

Continence specialist nurse Karen Logan, who leads the continence service at the Aneurin Bevan Health Board in Wales, says continence care is a neglected area of practice and she hopes the study will drive improvements.

In other news