technology
telling me that we’re using far fewer incontinence pads. This was
borne out when we examined financial records. We saved more
than $2000 on incontinence products. So I think the staff members
were correct.
When we went back into a focus group at the end of the
feasibility study, the residents were saying: “It seems that the bidet
is encouraging people.” This was because, often, when you take
somebody who has a cognitive impairment to the toilet, you sit
there and nothing happens. The staff would run the bidet in what
was intended to be a clean, and that would prompt a void of
bladder or bowel, sometimes both. They might find they would
use the cleaning mode of the bidet up to three times, and not
only would they get a void on the first and second goes, they’d
get more of a void the second time. The third time they’d used to
clean the resident. People were emptying their bladder or their
bowels much more completely than they were doing previously.
Therefore, they weren’t getting as many episodes of incontinence.
This is borne out in some research. I have just two studies,
both from Korea, demonstrating that for people with spinal cord
injuries – they’ve lost the ability to consciously push to have a
bowel motion – a pulsed warm-water stream, directed at the
anal sphincter muscles, started up peristalsis. I have another good
case study from Japan that showed an 84-year-old gentleman,
who had an a-contractile bladder that was unresponsive both to
surgery and medication, started using a bidet himself, and found
that over four years he was no longer needing catheterisation
to empty his bladder, because the pulsing warm-water stream
seemed to start off the sympathetic nervous system and help the
bladder contract.
These are early results and this is a feasibility study; we still have
so much to learn. But [these are] positive adjunct ways of helping
people manage incontinence.
What is the message you hope to be able to send through
this research?
Awareness. Absolutely nobody – it doesn’t matter whether you
have severe dementia or not – finds the experience of somebody
[helping with their toileting] dignified. People who are elderly
and frail, living in nursing care or at home with community care,
deserve dignity. If possible, managing toileting themselves [helps
them remain] dignified.
I think [this kind of technology] is something that will give older
people [back that] dignity and, where possible, [will help] people
who have frailty, stroke, severe arthritis, and any number of other
physical conditions, if they can use the remote control for the bidet.
It may enable people to remain at home for longer. People who
otherwise would have to move into a residential care situation
simply because they can’t have somebody there 24 hours a day
every time they need to go to the toilet [may finally be able to]
manage those tasks themselves. n
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