Incontinence

is no fun. And I'm coming to see my own ability to "toilet" myself as a rather long blip on the screen. I've changed many an infant diaper by now, and have worked hard at potty-training my toddler. Now at work I help adults in various stages of losing, or, in the best case, attempting to regain, their abilities to (1) recognize when they need to use the bathroom, (2) get themselves there, (3) get themselves safely onto and off of the toilet, (4) get themselves cleaned and dressed afterward, and (5) wash their hands. Some just need supervision and reminding because they have epically short memories. Some, since they're hemiplegic, need help getting onto the toilet, or maybe just pulling their pants up. You try getting re-dressed sometime with just one arm. :/

It's a weird position to be in with adults, with whom I have normal conversations about normal things when we're not in the bathroom. It's infantilizing, and how I do my job can mitigate or exacerbate this dignity-robbing effect. The advice I was given back in NAC training was to be professional and matter-of-fact, and non-judgmental. This I have done, and it was good advice.

One hemiplegic client last week was on his way to the toilet, but the process of getting out of his too-big-to-fit-in-the-bathroom wheelchair and getting set up to use his cane to walk in took longer than it usually does, so he didn't make it. I spent a good 30 minutes getting him cleaned up and changed. He was mortified and apologized profusely. I was totally okay with it, in part because of the number of infant diapers I've changed, but that's not a comparison that would have made him felt better. Another client, who takes himself to the toilet without reminding or assistance, has now twice pooped--once on the floor, once on a chair--in the middle of group activities. He is the absolute _last_ client I would have predicted such of--no one else has done anything like this. It seems a little crazy. The second time he left the room without mentioning that it had happened, and someone had to point it out to me. I cannot imagine how incredibly embarrassing this must be for him.

A lot of our clients wear Attends or whatever other brand of disposable adult undergarment. This was the case in the nursing home where I did clinic. Unlike that home, however, we do not merely rely on changing these undergarments, bypassing the bathroom altogether. They still use the restroom. This seems so very important to me. Babies and toddlers don't go to the toilet by themselves, and to not encourage and assist adults' bathroom use communicates to them that they are children.