Valerie Yules Letters

March 26, 2015

CONTINENCE of the Aged – a major problem

Filed under: Aged, ageing and dying, future problems, research needed — Tags: , , , — valerieyulesletters @ 3:01 am

CONTINENCE  of the Aged – a major problem

One of the ten most important problems in the world for research to solve is continence of the elderly. People dont recognise this until they are old or involved with the old. The old are getting more numerous, so the matter is getting urgent

When there are more old people, there is more employment but it is mainly in looking after them – and what does looking after them mean?

In the past when there were fewer elderly, the term ‘continence’ was related to chastity. Now it refers to the capacity to be toilet-trained.

Most of the employment of the young in care for the old is caused by incontinence. This is primarily work in toileting the elderly. This is not something that the young would particularly relish as a form of employment, and it is consequently relegated as much as possible to untrained immigrants. The elderly don’t like this either.

As well as providing direct employment in keeping the aged clean and dry, incontinence in the aged is a source of other employment younger people may care to consider.

There is the design, making and marketing of nappies for old people, and the measures taken to dispose of them in landfill – because they are not recyclable at all. They take up an inordinate amount of space, together with the disposal of their mattresses that once wet or soiled are quickly not re-usable. Carpets may require a future in landfill.

There is the problem that many old people could look after themselves if it were not for their incontinence. It causes them to cease being independent, and it is also hard for relatives to care for them. Their homes become smelly. The various stages of nursing home are often calibrated by the degree of incontinence.

Incontinent people lose the will to make themselves independent, and so more of them are relegated to nursing homes.

They are able to get about less, and they stop going to previous social and political occasions because of anxiety and embarrassment.

Up to the 1950s old people in government ‘homes’ for the elderly, such as Willsmere, were often lined up on concrete floors, to be hosed down. What happened to old people cared for at home is hard to find – women did the looking after and did not have the means to record what they did.

When my daughter as a holiday job looked after the elderly at Willsmere in the 1960s, they were no longer hosed down, but changing the sheets was a random occurrence, so that old people often lay in their own filth for considerable periods. It depended on the carers what happened.

When my grandson as a holiday job twenty years later looked after the elderly in a commercial nursing home, the problem was time. He had to get so many people up and toileted and fed and dressed in a limited time. It was hard to do. The old people often screamed at being hustled to get everything done quickly. My grandson hated the job, and did not last long.

Training courses for carers became essential. A 2011 report by the Productivity Commission called Caring for older Australians found that many private training organizations (RTOs) were often inadequate, with the trainers themselves without practical experience, and the certificates meaning little. Still today poorly trained carers graduate with these nationally accredited qualifications which advertise that they take little time to qualify. Caring for the incontinent remains a doubtful vocation.

Immigrants are welcome because they will take this low-paid unpleasant job, but often they have not enough English or ways of personal contact with the old people they are prepping as if they were objects they had to look after.

People who attend clinics for the incontinent see doctors who take all their details, and nurses who give instructions that can help some but not all. Research needs to become a national priority.


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