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Fears 'shameful' incontinence ruling could set example


Community nurses may increasingly find their patients left to sleep in their own urine after the Supreme Court backed a council decision to deny a stroke patient social care at night.

The court, the highest court in the UK, backed a local authority ruling not to provide night time care to a woman left “practically incontinent” after a stroke, telling her instead to use incontinence pads.

The ruling sparked fears the case would be used as an example to deny more people of care.

Former ballerina Elaine McDonald’s appeal against the Royal London Borough of Kensington and Chelsea was dismissed by a four to one majority in court.

Following a stroke Ms McDonald needs to use the toilet two or three times a night. The council said it would not provide her with a night time care and she should use incontinence pads or special sheeting since it is dangerous for her to use the toilet on her own.

Association for Continence Advice chair Debbie Yarde told Nursing Times she feared the practice could be “widespread”.

“Needing to go to the toilet in the night is a basic human need. There are serious implications for quality of life and dignity,” she said. She warned the case would be “used as an example” by other public bodies to justify similar decisions.

Age UK charity director Michelle Mitchell called the decision “shameful”. She said: “Older people have a fundamental right to dignity and forcing someone to sleep in their own urine and faeces could not be more undignified.

“This judgement opens the door to warehousing older people in their own homes without regard to their quality of life.”


Readers' comments (17)

  • Shameful is the least you could say about this. Disgraceful is nearer the mark. The judges who made this decision must think they'll never be left like this when they are old.

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  • He won't be. On a judges salary and pension he can afford a team of carers at home. One rule for the rich-another for the poor, or not so rich.

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  • I cannot believe that this is the Britain i grew up in, and such attitudes make me very ashamed. One wonders why there are nurses and why we bothered with all the training and all the study, research and CPD we do or why one is compassionate and caring at all in such a society where we constantly seem to be fighting a losing battle to provide our services at a decent level, and now this!

    This is not the attitude and behaviour of a civilised human nation no matter who the individual concerned is. I am sure that even the poorest and most primitive societies on this planet would not treat their elderly in this way and with such indignity.

    has the Mr. judge also considered the avoidable costs of care and untold damage to the quality of life of this individual, and other more far reaching consequences, when they develop infected sores, resultant mental health disorders and possibly has a fall as they try to get out of bed regardless to go to the wc and sustains multiple fractures or dislocations, including a hip?

    I just cannot imagine any human being purposelessly being left during the night and until a carer arrives sometime the next day (who might be delayed or not turn up for a variety of reasons) in a supposedly modern, civilised western European country which boasts of being one of the eighth richest countries in the world and who fritters taxpayers money away on many far less worthy projects without any regard for the importance of the basic needs and rights of its most vulnerable citizens.

    It further proves the attitude of many that the elderly are worthless, unneeded, are a burden to society and are costly and can be ignored until they are forced into care or die. What a way to end end a life with so little respect for dignity.

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  • Very pertinent points made by both Debbie Yarde and Michelle Mitchell. And I agree, this is a shameful decision.

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  • Appalled and Ashamed....The judges that made this decision, in their obvious WISDOM, should be feeling this way. How can this happen in a so called CIVILISED society? What has happened to treating people with dignity? It isn't enough that resources are being further and further squeezed, we now have to contend with this kind of decision being made IN COURT. Have these judges read the NMC Code of conduct? is not one of the main concepts of this code to treat people with dignity? Care should be focused on the needs of the individual, not on the whim of the courts.

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  • why is the Supreme Court involved in decision making of the nocturnal habits of the elderly and who should wear incontinence pads? these are decisions that can only be taken by the individuals concerned and healthcare experts.

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  • It is preached that privacy, equity and dignity are a priority, until it comes to cost it seems. This patient could be continent given the intervention needed. This can't be an isolated case by any means.

    This may seem extreem (then not really), but I would like this judge to be given gallons/litres of water, and denied the toilet until someone came to allow them to use it - see how they like either wearing pads or laying in a wet bed....and like a previous blog mentioned, help maybe delayed or not even turn up (due to mostly short term problems).

    Needless to say they maybe his skin conditions to tend to then and the prescribed abo's for a UTI, OMG I hope they suffer, which sadly goes against all my hopes and dreams of being a nurse.

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  • As you say above, this can't be an isolated case but it will surely set a precedent for many future cases unless these suggestions of such appalling and inhumane treatment can be stopped right now!

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  • michael stone

    It is shameful.
    But the problem the judge would have had, is there is always a 'yin and yang' test of 'reasonable balance' built in to the guidelines people work with. In this case, the council will have argues that it has to balance money it spends in one area, with the inability ot spend the same money elsewhere: the test for the judge, will be restricted to 'did the council undertake the appropriate consideration'. The judge will not ahve been ruling, on whether the decision the council arrived at, was right or wrong.
    BUT IT IS SHAMEFUL STATE OF AFFAIRS - the problem, is it isn't so easy when you try to work out who to actually balme for it !

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  • it is not a question of seeking out and blaming someone. it is a question of this person and others getting the care they need and not suffering through lack of care. until people get this culture of blame out of their heads nothing will improve. even if guilty it is too easy to find and blame somebody else which is what many of the guilty do.

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