Mailbox Response

The question was submitted Tuesday, 18 November 2008

Subject: What rights do you have in a nursing home?

My mum has dementia and is now totally dependant after suffering a stroke earlier this year and is now living in a dementia unit.

She needs assistance of a standing machine and a carer to be able to go to the toilet and is still continent and can say when she needs to go to the toilet.

They have her on a toileting program which entails being taken to the toilet every 3 hours regardless of whether she asks to go in between.

Sometimes she asks to go to the toilet an hour or two after she has been. I try to distact her and if successful I know she doesn't really need to go. When I can't distract her I ask the staff if she can go to the toilet. Some of the staff are great and will take her when I ask but there are a few that insist on adhering to the 3 hour routine. This makes my visit with her even harder than usual because she is just constantly asking me to take her to the toilet. I'm happy to take her myself and am quite competent with using the standing machine to transfer her but they won't let me.

What rights does she have about being taken to the toilet? What rights do I have about taking her? Surely if they won't take her and I'm happy to, I should be allowed to. If something happened to her while I was transferring her it would be my responsibility not there's.

Isn't it a basic human right to be taken to the toilet within a reasonable time period when requested? Shouldn't they be encouraging people to remain continent?

My visits with her are hard enough because she asks me to take her home every 5 minutes, without having her asking me to go to the toilet every 2 minutes. It's very upsetting that I can't even get her toileted when she asks, and as a result she gets even more agitated.

What can I do?

Answer from DementiaNet

You are correct; your mother has the right to be taken to the toilet when she wishes to. As her next-of-kin you should have some influence in determining how her care is provided.

Usually, a frank discussion with the director of nursing will resolve the issue. It may be that putting Mum in an all in one pad will be just as good at keeping her dry as the regular toileting regimen. Most nursing homes have a continence nurse specialist who can review the situation. If not, such a nurse can be asked to come in to see Mum.

There are standards that nursing homes have to adhere to. Refusing to allow a person access to the toilet is a breach of these standards. One would hope that a calm discussion with the staff will fix the problem. If the situation still does not resolve itself then you could contact the department of health and ageing and find out who to contact about making a complaint. The other option is to apply for a guardianship order in the hope that you can be appointed her legal decision maker. This would cover care needs.

The answer was published on DementiaNet Tuesday, 25 November 2008