I was driving on the motorway a couple of days ago counting the miles to the next services and regretting the second cup of tea I had before I set off.
Predictably the traffic ground to a halt. As minutes passed I went from mild discomfort, to anxiety, then panic as I held onto a full bladder.
So why share this with you?
This week, the supreme court was asked to rule on a case in which 68-year-old Elaine McDonald, who had had a stroke, wanted the council to provide a night-time carer to help her use a commode rather than supply her with incontinence pads.
Sadly this is not an isolated situation. Everyday, people in their own homes, care homes and hospital are required to use incontinence pads when they could be continent. They do this because of lack of time, lack of care or lack of knowledge on the part of those caring for them. This ruling is not the start of something new, but more worrying, it legitimises a system of care already in place.
Being allowed to defecate and urinate in a dignified way is a basic human right. It is difficult to imagine what it is like to sit in bed and have to make a decision to pass urine into a pad, when you know you are continent.
Rationing of continence products is already common in England.
Many nurses involved in assessing continence are concerned that their ability to provide care is hampered by restrictions on resources. In parts of the country cuts to pad budgets mean patients may not get the number or type of product they need. They either do without or top up themselves. Many do not have the financial resources to do this.
Functional incontinence should be carefully managed to maintain patient dignity and promote independence. But in so many cases it is easy to ignore the problem because patients have no voice and no one to speak out for them. This is truly shameful.
If you have problems accessing appropriate continence care for your patients I would be interested to hear about your experiences.