‘The standard response is wear incontinence pads in bed – even if you’re not incontinent’

Social workers responding to Community Care's survey on care package cuts described the impact some reductions have had on people's lives

By Rachel Carter on September 19, 2017 in Adults

The findings of a Community Care survey, published today, highlight the difficult decisions adults’ social workers are having to make in the current financial climate. The survey asked social workers to share examples, from their professional experience, of where care packages have been cut and to describe how this had impacted on a person’s wellbeing.

It can be appropriate and safe to reduce a person’s care where, for example, their needs have decreased, and practitioners responding to the survey shared some positive examples of where reductions had helped people to regain independence, increase their wellbeing through moving to a more appropriate care setting, or build new social and community links.

However, social workers also shared the following stark examples of the human cost of social care cuts and the negative impact cutting a person’s care can have on their life.

“A common example is not allowing budget to be used for night care. The standard response is ‘wear incontinence pads in bed’ – even if the person is not incontinent!”

‘Reducing the social support in a care package for three brothers who live together. Each has either a mental health problem, physical or leaning difficulty. They have had a substantial care package for approximately 15 years, which kept them safe from financial abuse and enabled all three to continue to live together in the community. After reducing the care package, two of them went into residential care and died. The other was admitted to hospital with dehydration and hypothermia.”

“A person with hoarding issues and a tendency to eat rotten food had their shopping and housework call cut. This resulted in an admission to hospital with food poisoning.”

“I was moved off a case because the cost of the home care package was too high and I refused to ‘put’ the client in a care home against his wishes. He was incapacitated but his wife fought, the next case worker did the same thing and he went home. There were no support services for his wife, who provided most of the care and was frail emotionally, because it was ‘her choice’ to have her husband at home. She, and other professionals, were unhappy I had been removed from the case and I was not allowed to say the truth. I left not long after.”

“A husband and wife both with learning disabilities were no longer able to attend a day centre as the budget was stopped. They couldn’t afford to attend privately at £48 per day, so they lost some social relationships and meaningful activity.”

“A person who previously lived in a private rented house with a live-in carer was moved to a supported living service, which was cheaper because the core support hours were shared with the other tenants. The person was initially keen to live with others, but quickly realised they had lost a lot of choice, control and independence. The limited core support provision reduced the amount of activities that the person could do in the community and struggled to meet the wishes of all tenants. The person became low in mood and there were more self-harming incidents.”

“I worked with a woman who could strip wash but couldn’t reach her back and intimate parts of her body, so she had paid carers for years as part of her personal budget to help her. However, her budget was cut because she was deemed physically able enough to strip wash. This was devastating for her and she explained feeling like she was not being treated as a human but instead as a burden.”

“I work in mental health where many of the areas cut, such as shopping or accessing the community, are central to an individual’s need for support but there is little we can do as third sector services are dwindling and people can’t afford to self-fund. It feels as though in most cases the only funded support we can offer is with personal care.”

“I have had much experience of reducing care packages, allowing time only for essential tasks associated with risk. This amounts to carers only having time to dash in and wash, toilet and water those in need. The process can almost be automated and offers little opportunity to provide compassion or quality.”

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5 Responses to ‘The standard response is wear incontinence pads in bed – even if you’re not incontinent’

Rosaline September 21, 2017 at 3:56 am #

Deeply disheartened.
Tom J September 21, 2017 at 2:13 pm #

To quote our Prime Minster; ‘There is no magic money tree’

Unless of course you are the DUP or Trident.
the maz September 22, 2017 at 4:07 pm #

I have been asked to put a mental health client in pads, my concern was that he would no longer get up and go to the toilet and would hide the pads. The property is bad enough as it is. W e have worked with the gentleman concerned and given a lot of support and reassurance i can now say the problem we had a year ago is so much better. He is happier, im not saying he will never need to go into pads but now is not the time. Too many professionals see this as an easy option. Im honoured to work with the clients i work with, and would never belittle them.
LouiseM September 28, 2017 at 7:34 pm #

My mother, who is 91, and has dementia has bee waiting since Xmas for her domicilary care package to be put in place. She should be getting 4 visits daily, along with other care services we already pay for. At present, an enablement team provide two visits a day, but should have stopped this once the domicilary package was in place. My sisters and I are filling in the gaps as best we can. The carers who do come are generally so lovely, but they are contending with staff retention following privatisation and poor organisation, with some of them spending several hours a day on the road in a rural area. We are really just waiting for the inevitable crisis that will probably end up with an expensive and unwanted admission to hospital.
We surely can do better than this for our older citizens.
Reuben October 14, 2017 at 2:52 pm #

Well, as I’m fully incontinent for some time already I think I can relate to this issue. Wearing pads despite not being incontinent all the time whenever you are sleeping in your bed is probably the worst idea I have ever heard. Even people that are incontinent should avoid wearing pads/diapers for excessive amount of time, because they are getting used to it – they feel safer when they are wearing them on, which causes many issues leading to not improving your incontinence issues, but actually worsening them. I had a couple of friends, who were slightly incontinent, but yet they didn’t listen to me and they continued wearing diapers during sleep, work etc. Of course, they have been training kegels, they lost weight – so they put attention to improve their overall being, but still it worsened – why? Because you are subconsciously feeling safer and when your mind considers peeing into a diaper as a safe option, then your body does it and you can’t impact it really. You are just losing whatever bladder control you have before. It’s not the case with me as I’m fully incontinent so I wear diapers 24/7 as well, but there was not really a help for me anyway, so I had to settle for the worst and keep wearing them as I do – at least I order them in bulk pretty cheaply from hexa & co, but still if I had even a slight chance to recover from being incontinent I would do whatever I have to – I wouldn’t worry about people noticing that I’m urinating into a diaper, I wouldn’t care about it at all – I would just focus on proper diet, workout, kegels training and medications, but wearing diapers 24/7 is just a best way to destroy your bladder control not restoring it.