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Overuse of Incontinence Pads in place of regular toileting identified in some N.I. Care Homes

Posted Mar 09 2012 3:55am

Some nursing homes in Northern Ireland are sedating residents long-term without reviewing whether they still need it, a Human Rights Commission report said. The commission also called for better guidance for the use of wheelchair straps, tables placed in front of residents to discourage movement and even more subtle commands to sit down.

It also identified practices such as forcing people to use incontinence pads, lack of adequate access to liquids and 17-hour gaps between the serving of dinner and breakfast. The report said: “In Northern Ireland, the absence of a statutory definition of restraint and the lack of appropriate guidance that draws on international human rights standards remains a serious concern.

“The commission is concerned that regular or long-term use of sedation without appropriate review may lead to residents being over-sedated or sedated for an extended period of time. This impacts on a person’s liberty and may affect their ability to participate fully in everyday life.”
A total of 25 residents from four homes were sampled from a variety of health trusts run by different organisations for the report – In Defence of Dignity.

Twenty-two were receiving a drug either explicitly for sedation or at high risk of causing sedation, including night sedation, anti-depressants, anti-psychotic drugs and dementia medication. All drugs were prescribed at appropriate doses and time intervals. The report added: “The prescribing of sedating drugs, including those with a high risk of a sedating effect, should be limited to that which is proportionate and their use should be regularly reviewed. In addition, the reasons for, and reviews of, the use of sedation should be clearly documented.”

A spokesman for the Independent Healthcare Providers group said it was dedicated to upholding the dignity and rights of residents in care homes and to ensuring the highest standards among members. The group called for adequate funding. “The Human Rights Commission’s investigation examined 188 complaints about care homes. Nine of these were deemed serious enough to refer on to the relevant statutory bodies for further consideration,” it said.

Although selection of the correct incontinence pad is important to a person’s quality of life, these are always there just as a back up to regular toiletting which should be maintained wherever possible to keep the urinary and bowel systems functioning properly.

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