Today we look at the challenge of toilet accidents in church and find that it may not just be because the person living with dementia has developed incontinence. There can be many reasons why a person living with dementia may experience difficulties related with using the toilet. We should not just jump to the conclusion that they have become incontinent and can no longer attend church or a group.
If we start to see problems occurring, we need to be very sensitive and understanding towards the person. They deserve to be treated with dignity and love even when the challenges seem hard to us. Coming to church may be the only thing that the person living with dementia and their carer gets to do that allows them to leave the house. We cannot stress enough how important this is in helping them maintain their dignity, identity and ensuring that they don’t feel lonely.
When accidents start to happen it really helps if you are supportive and understanding. Don’t assume that the primary carer knows what to do. Church Leaders and Group Leaders obviously are not, and shouldn’t be, experts in dementia care but, a little bit of knowledge can be a real blessing.
The purpose of this blog today is to help church leaders have a bit of knowledge that can really help. The first thing to do (and encourage a carer to do) is to look to see if there is a reason why accidents are happening. There are several things that could lead to the person living with dementia experiencing problems using the toilet. These could include many things including the person might:
· no longer be able to recognise or remember where the toilet is
· not be able to get to the toilet in time because of mobility issues
· have difficulty in explaining that they need to go to the toilet
· be experiencing side effects from medication
· not be able to undo their clothing in time
· have a urinary tract infection or some other kind of physical problem
· experience difficulties with the stages of the process of successfully using the toilet
· have visual perception issues making using the toilet more challenging
· have given up trying to use the toilet because they haven’t got the help they need
As you can see above many of these may have simple things that you or the primary carer can do that could help prevent a perceived incontinence.
So what can we do?
Clear signage to the toilets in church buildings is so important. The direction to the toilet should be easily identified from anywhere in the buildings and then clear signage should be displayed on the toilet doors. It can also be helpful if the toilet doors are painted a different colour to all the other doors making them easily noticeable. Also remember that once they have been to the toilet they may need help finding their way back to where the meeting is being held. Simple signs really help.
Mobility problems can affect a person’s ability to get to the toilet quickly. It may help to discreetly check before meetings whether they need to go to the toilet and to think about where they sit in a meeting to ensure ease of access to the toilets.
Sometimes difficulties are caused by other health conditions. A urinary tract infection, for example, can result in urgent and frequent ‘calls to nature’ and a person may not be able to get to the toilet in time. It could be worth talking to the primary carer to encourage a visit to the doctor.
People with dementia can sometimes experience difficulties recognising things and their depth perception could be impacted. This can mean that, even though a person is able to see, they may be unable to recognise that a toilet is a toilet or make it out as separate from its surroundings. It’s much easier if the toilet seat is a different colour from its surroundings, and a black, dark blue or red seat is much more easily seen by those with perception difficulties.
It is possible that the person may be having difficulty with one part of the process of going to the toilet. For example, they may sit down on the toilet without pulling down their underwear or forget what to do with toilet paper. Knowing which parts of a task they find difficult could help the primary carer help them manage toileting leaving them with dignity and with privacy at the point they are competent. Whilst this would never be expected of someone in the church to manage, other than the primary carer, awareness of this issue could enable support for the primary carer. It is also possible that the primary carer may not have thought this through before and you could help them.
It is possible that a person is not able to tell you in words that they need to go to the toilet. In these instances, encourage the primary carer to learn any non-verbal signs the person may use. These could be a noise or a sign like them starting to pull at their clothing when they need to go to the toilet. If you notice this, it may be invaluable knowledge for the primary carer that they may not be aware of.
We have covered several different scenarios above but how do we know what are the causes? The answer may seem obvious but, the better we know the person, the easier it is to support them. For example, we may discover that one person usually needs to go to the toilet before a group or meeting to get all the way through. Providing a discreet prompt when they arrive may help to ensure they get through the whole meeting. Maybe add in a planned comfort break in a meeting will help take the embarrassment out for someone who may have to get up and find their way to the toilets.
It is important to do all we can to help people avoid embarrassment when they need to use the toilet in church. It’s such a private part of our lives and can be awkward when something goes wrong. If problems do occur, we need to be very sensitive and understanding towards the person. Usually it is possible to support people’s individual needs and help them to maintain their dignity with very little adjustment.
Don’t always assume that the primary carer knows what they are doing. Remember they are often a husband, wife, family member or friend and they will probably have little knowledge or training about dementia. Being able to share knowledge with them often is very welcome, especially in areas that make their life easier like toileting.