Pad cultures: an ethnography of continence care and its consequences for people living with dementia during a hospital admission

Northcott, Andy ORCID:, Boddington, Paula and Featherstone, Katie (2022) Pad cultures: an ethnography of continence care and its consequences for people living with dementia during a hospital admission. Dementia. ISSN 1471-3012

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There is little research examining how continence care is organised and delivered to people living with dementia across an acute hospital admission, despite the prevalence of this patient population and their vulnerability within these settings.

To explore how continence care is delivered to people living with dementia during an acute hospital admission.


Acute medical units and wards within three hospitals across England and Wales.

People living with dementia and ward staff (registered nurses and care assistants) on participating wards.

Ethnographic fieldwork collected over a period of 12 months (180 days of non-participant observation) focussing on the organisation and delivery of continence care to people living with dementia. Observations were supported with in situ ethnographic interviews (n = 562) with patients, visitors and staff within the six observed wards. Data collection and analysis drew on the theoretical sampling and constant comparison techniques of grounded theory.

The findings comprised of five overall themes: (1) visibility of continence; (2) rationales of continence care; (3) containment and contagion; (4) consequences of continence care and (5) supporting continence.

We introduce the term ‘pad cultures’ to refer to the established routine use of continence pads in the care of a wider group of people living with dementia (regardless of continence status and independence), with the rationale to provide safeguards, ensure containment and prevent ‘accidents’ or incontinent episodes. There was an expectation within acute wards that people living with dementia not only wear continence pads but that they also use them.

Item Type: Article
Identifier: 10.1177/14713012221116490
Additional Information: This project was funded by the National Institute for Health Research, Health Services and Delivery Research Programme (project number 13/10/80). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Keywords: dementia, continence, incontinence, acute care, hospital, ethnography, qualitative
Subjects: Medicine and health > Nursing > Nursing practice
Medicine and health
Social sciences
Related URLs:
Depositing User: Andy Northcott
Date Deposited: 18 Jul 2022 09:00
Last Modified: 06 Feb 2024 16:11


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