Damaging ‘pad culture’

An ingrained practice of “pad culture” in the management of incontinence on hospital wards is having a damaging impact on the dignity and independence of people with dementia, an in-depth study has found.

Conducted by the University of West London’s Geller Institute of Ageing and Memory, the study of six wards in three hospitals identified the “everyday and routine” use of continence pads as a precautionary strategy for people with dementia, even if they had no history of incontinence.

These practices mean that people who are continent at admission are at “significant risk” of developing incontinence during their hospital stay, the study suggests, with an irreversible impact on the ability, dignity and identity of individuals and their families.

“Continence care is a hidden problem – the elephant in the room of hospital dementia care,” said Professor Katie Featherstone, who co-led the study.  “It is often regarded as ‘low status’ work, but we must recognise that it is at the heart of dignified quality care.  Managing routine bathroom habits is a major part of being independent and retaining control over your body.”

Funded by the National Institute for Health and Care Research (NIHR), the study is entitled Understanding how to facilitate continence for people with dementia in acute hospital settings.