managing incontinence within a reasonable time period
There is a brief reference to a reasonable time period and Activity 5 in MF v SSWP (2015 UKUT 554), is anyone aware of any other decisions?
Basically, client had ileostomy and reversal operations that went wrong and will require further surgery but this can’t be done for another 12 months. In the meantime he is left with a leaking bag that causes acid burns to the skin around it. Due to nerve damage he has no sensation around the operation site so does not always realise he is being burned by the acid leaking out, particularly at night. Due to various complications, managing the bag and cleaning up leaks takes him a considerable amount of time. He was awarded 5b for an aid or appliance.
1) I am putting together the MR and want to argue that although in reality he manages his incontinence himself, he does not do so within a reasonable time period and in order to do so he would require assistance. This would get him 5e. Does this sound viable?
2) Leaking at night soils his bedding and part of the time taken is dealing with this. The Regs refer to “clean oneself afterwards” so on the face of it this would seem to exclude changing bedding. This seems a bit rough on my client though as it is a constant chore and is part of the process of managing his incontinence. Any thoughts?
3) Any thoughts on how to address the ‘safely’ aspect of managing incontinence, i.e. the acid burns and infection risk?
I did an appeal last year involving similar issues and we got 5(e).
I don’t know the degree of detail you have already obtained from your client but it is my understanding that ileostomy pouches are not re-usable, so that if one leaks, it has to be replaced. That is not a short process. Couple that with the need to change one’s nightclothes and to shower and you are certainly into the terrain of the activity taking more than twice as long….
Changing soiled bed sheets (and, if necessary, mopping flooring which has become soiled on the walk to the bathroom) is certainly dealing with the immediate aftermath of incontinence/toilet needs. It is unconscionable that it could be considered that a person needs to shower, change their ileostomy pouch and change their nightclothes in order to deal with incontinence - but is then expected to return to sleep in soiled bedding.
In terms of the safety aspect, presumably the risk only arises because he doesn’t wake? - i.e. once awake he is able to clean himself to an acceptable standard/to a standard that avoids the risk of infection? If that is the case, maybe it is reasonable that he uses an alarm clock to wake himself periodically to check? Or at least, more reasonable than having someone present to check on him periodically. Of course, that might mean that he is, as a consequence, very tired/exhausted during the day - but with the potential for additional point scoring.
Thanks PC, good to know that we seem to be on the right path.