Should Older Adults Have to “Hold it?”: This is What Happens When Seniors in Skilled Nursing Have to Go to the Bathroom.

If asked, many people would consider going to the bathroom as a fundamental human right. It is just part of what makes us human, and because of this, I think we all can sometimes take it for granted.

But what happens when you are no longer able to “go” on your own? When you become dependent on someone else to take you to the bathroom.

In the case that you do require assistance, should you have to wait to go to the bathroom until someone has the time and ability to take you? Or as a fundamental human right, should going to the bathroom take a precedent?

For those assisting others in going to the bathroom it does take time, and when there are many other “to-dos” on the care list, it’s easy to get in the habit of telling someone to “hold it.”

There are a lot of different ways I’ve heard staff handle the request to go to the bathroom over the years. Some of the most common are:

  • I just took you to the bathroom.
  • I’m helping someone else right now.
  • I don’t take you until 11:00 a.m.
  • You can go in your pad (or briefs).

Or sometimes, if they are already on the toilet, some people are left to sit there until the next available person is able to assist them back up.

While of course there is staff who take the need to go to the bathroom as a priority, and this doesn’t always happen, there is a persistent culture of “hold it” in caregiving, that seeks to get worse as care demands increase for our direct care workers.

Alzheimer’s Disease and Other Forms of Dementia

Frequent trips to the bathroom for individuals living with Alzheimer’s or other forms of dementia are common. Some may even ask to go to the restroom quite literally every five minutes. Understandably at such frequency, it is near impossible to take them each time.

Questions to consider:

  • Do they have a UTI?
  • Has a Doctor checked them for an overactive bladder?
  • Are they able to go to the bathroom safely and independently?
  • Are they drinking enough water?
  • Are they wearing briefs (pads)?
  • Are they on a bathroom schedule?

Feeling the need to go to the bathroom is a common occurrence of Alzheimer’s disease, and while not every instance may be a real need, some naturally still are, so we can’t discount their attempts to “go.”

What Can Be Done?

I think the first thing is awareness. Awareness and the acknowledgment that going to the bathroom is an earnest request, and not something someone can just put off until the next available person is able to take them.

The impression I’ve received is that many care homes don’t want to directly call out the “hold it” culture in care facilities. Which is understandable: Skilled Nursing Facilities wish to exhibit great care, and while they may be working on culture change, facilities around the country (and even the world) are faced with a growing shortage of care workers and an increasing number of residents. Which is notably affecting the ability to provide the highest quality of care.

The same goes for older adults in a hospital setting. While medical professionals may want to focus on medical care, it is vital that natural needs are still prioritized. “Holding it” can have its own adverse effects on the health of an older adult. In general, older adults are much more prone to Urinary Tract Infections – which in turn can cause a host of symptoms that demonstrate as Dementia.

Read More: Urinary Tract Infections Strike at Any Age… Keep an Eye Out for These 6 Signs.

“Holding It” shouldn’t have to be an option for older adults in need of our care. While yes, they may not always have to go to the bathroom when they say they do that doesn’t mean that their request should be ignored.

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