How can we as nurses preserve the dignity of patients when all that we strive to do to maintain this is taken away in an instant without thought of the patient?
A recent news story concerned the dignity of a celebrated former prima ballerina. She was told by the country’s most senior judges that the State has no duty to provide her with a helper so she can live with dignity in her own home. This Lady had a stroke in 1999 which had left her with limited mobility and a small neurogenic bladder which meant that she needs to urinate 2-3 times a night. Her care package included night time carers to ensure she was able to get to the toilet during the night. This was unfortunately withdrawn by the local Council to save money (£22,000) and she was supplied with pads for the night although she was not incontinent!!
She went to the Supreme court to appeal this judgement but all the Judges except one said she had no right to demand a helper and that social workers were within the law when they withdrew the carer
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She stated that ‘I have the right to live with dignity, and for me that means to be able to go to bed knowing that I have the help I need to go to the toilet in the middle of the night. Having night-time care would give me the freedom not to worry all day about what will happen at night.’
This lady will now become incontinent as she will have no other option if there is no help to get her to the toilet at night. This, as we know, could lead to serious complications such as incontinence associated dermatitis leading to skin breakdown and possible pressure sores. Urinary infections which if then treated with antibiotics could make her faecally incontinent! Insertion of a catheter with all the associated risks! Need I go on! It’s much more than just her dignity that has been taken away from her and I wonder how many other people this is this happening to that that are not able to appeal their case in court.
The RCN (2008) suggests that “when dignity is present people feel in control, valued, confident, comfortable and able to make decisions for themselves. When dignity is absent people feel devalued, lacking control and comfort. They may lack confidence and be unable to make decisions for themselves. They may feel humiliated, embarrassed or ashamed”. I would suggest that this lady and many others like her have gone from the beginning of the statement to the end overnight!
Obviously I am only aware of what I heard and read about the case and don’t know the full facts but it does highlight the issue of making people incontinent when they don’t need to be! Undoing all the hard work that we do to ensure that people either regain their continence or prevent them from becoming incontinent therefore promoting rather than diminishing their dignity.
Wendy Ness, Association for Continence Advice.
- Reference Daily Mail online 7th July 2011 http://www.dailymail.co.uk/health/article-2011868/Former-ballerina-Elaine-McDonald-loses-Supreme-Court-battle-overnight-care.html