Violations against dementia patients in the UK

Heather Lawrence was shocked when she went to visit her mother, Violet, 90, at a hospital in Manchester, England.

Heather told the BBC: “Bed diapers and incontinence soaked in urine. The door was wide open, and she wasn’t wearing underwear. She was also in a mixed men’s and women’s room.”

“There were other people who could see her like that. My mother didn’t want to be seen like that.”

Violet, who suffered from dementia, was transferred to Tamside General Hospital in May 2021 after suffering a fall.

Violet’s health deteriorated in the hospital: she developed a sore groin and a rash that extended from that spot to her stomach, due to prolonged exposure to urine.

She died a few weeks later.

“I feel her dignity has been taken away from her,” Heather says. “This happens to a lot of people with dementia. I think they stop caring about them, and they feel unimportant – which is not true.”

Violet’s case is not unique to the UK NHS public health system.

A new report released exclusively on the program 4 . file From BBC Radio 4 he found that other dementia patients had received similar treatment, which the authors deemed “inappropriate”.

‘They need help’

For a year, researcher Katie Featherston, of the Geller Institute on Aging and Memory at the University of West London, analyzed incontinence care for dementia patients at three hospitals in England and Wales.

The study was funded by the National Institutes of Health and Care Research, and health research agencies in the United Kingdom.

In the report, she says she found patients who were not helped to go to the bathroom – and who were left wet and dirty, exposed to their own droppings.

“We have identified a widespread practice: the daily use of diapers or incontinence diapers in the care of all people with dementia, regardless of their ability to retain urine or not,” Featherston explains.

It also found that most patients were well treated on the NHS, but the pressure and understaffing meant that many caregivers had to use nappies or sanitary pads as an ‘alternative’.

When 86-year-old Bessie was taken to Rotherham General Hospital in 2019 after falling home, she was still able to go to the bathroom on her own.

Despite this, her daughters Janine Ward and Susan Norden say, the team did not respond when Bessie asked to go to the bathroom.

Unbeknownst to the girls, the hospital also placed incontinence bandages. “It wasn’t possible for my mom to go to the bathroom,” Janine says.

“She knew what she was doing. She would make a big fuss 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 had to be referred to an incontinence team at a special NHS unit in the area.

Then Janine and Susan felt that their mother’s ability to go to the bathroom on her own, along with her shaky movement, were factors that put her at risk of falling again 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 more caregivers, toilets, and incontinence pads (although this never happened).

On Bessie’s first night, Janine was with her when their caretakers 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 put my mom in that ‘bath’ with the curtains open, why didn’t you close them?” ”

Contacted by BBC News, the Rotherham Trust and Council, the body that runs hospitals in the Rotherham area, apologized to Bessie’s family and said patient care “later improved”.

Featherston says that people with dementia often forget how to go to the bathroom when they are forced to use nappies 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 just using sanitary pads and the practices that surround it can mean that people start losing the ability to go to the bathroom when they need to,” he says.

“And that can have real implications for people later on. It can make it more difficult for families to care for someone if they also have to deal with incontinence. And it can result in these elderly people being transferred to nursing homes and nursing homes.”

It should be well evaluated

Professor John Andrews, who has worked in dementia care for more than 30 years, says rigorous incontinence assessments are necessary to avoid guesswork.

“I see documents in which a family member asks whether the patient has incontinence or not,” she says. “And that was all that was done to assess the situation.”

“It is absolutely essential that families know how to ask if an assessment for incontinence was conducted and who produced that analysis,”

Karen Harrison Denning, director of research and publication at Dementia UK and co-author of the study, has been critical of the care provided to dementia patients in NHS hospitals.

“People, regardless of their underlying conditions and age, never go to the hospital to get out of it with incontinence,” he says.

“Not only do staff need specific training on how to promote individual autonomy, but healthcare organizations must have an obligation and responsibility to maintain the autonomy of an older person.”

– The text was originally published in https://www.bbc.com/portuguese/geral-61918480