Memorandum by Help the Aged
Help the Aged is an international charity fighting
to free disadvantaged older people from poverty, isolation and
neglect. Our vision is of a future where older people are free
from the disadvantages of poverty, isolation and neglect, so they
can live with dignity as valued, respected and involved members
of society. Our mission is to secure and uphold the rights of
disadvantaged older people in the UK and around the world. Working
with them, we will research their needs, campaign for changes
in policy, and provide services to alleviate hardship today and
prevent deprivation tomorrow.
RESEARCH AND
EVIDENCE
Help the Aged (HtA) provides much of this response
from two key pieces of HtA research:
— Nowhere to go:[3]
an survey 1000 older people on their views on public toilet provision
in their local area in August 2006.
— Incontinence and Older People: is
there a link to social isolation? Hta-commissioned qualitative
interviews with 20 older people with incontinence.[4]
SUMMARY: WHY
PROVISION OF
PUBLIC TOILETS
IS VITAL
FOR OLDER
PEOPLE
1. As we age, we are more likely to need to
use the toilet frequently and often due to conditions such as
incontinence, urgency and prostate cancer.
2. Older people say they do not find it easy
to find public toilets or they are not open when they are needed.
3. The closure of public toilets can cause or
exacerbate isolation and contribute to ill-health.
4. Many older people see a decline in the quality
of the public toilets which do remain open. Older people want
accessible, well-designed toilets with adequate number of cubicles,
hand washing and disposal facilities which are well maintained.
5. HtA is a sponsor of the Loo of the Year Awards
and has influenced the inclusion of age-friendly criteria which
are used in the judging of what constitutes a "good"
toilet.
WHAT HELP
THE AGED
CALLS FOR
— The creation of a national mapping
of public toilet facilities to highlight where there are gaps
in provision and work to improve standards.
— The provision of accessible and well
designed toilets with adequate number of cubicles, hand washing
and disposal facilities which are cleaned regularly and are well
maintained.
— Hospitals trust to provide a high
standard of toilets and toilet facilities on wards and to involve
older people in monitoring standards.
RESPONSE TO
INQUIRY QUESTIONS—ADDITIONAL
DETAIL
1. The need for public toilets
We are more likely to suffer from conditions
such as incontinence, urgency and prostrate problems as we age.
It is estimated that urinary incontinence affects around 6 million
people in the UK; more than half are over 65 and the majority
are women. They rely on the availability of public toilets so
they can go out without fear of accidents. Many say public toilets
have become more important to them as they aged and developed
health problems such as prostate problems or urgency.
We are also more likely to be living with one
or several disabilities as we age. There will also be those who
do not consider themselves disabled but for whom even slight changes
in the built environment would be of enormous benefit for example
hand rails or raised toilet seats.
Many older people say that using the toilet
should be a private experience and do not want to ask someone
for a key or access because their need is urgent; public toilets
should be provided, should be accessible and free or inexpensive
to use. However, certain schemes such as that run by RADAR are
perceived to have uses.
Lack of provision:
1.1 Increases isolation and reduces quality
of life: In Nowhere to go, 52% of respondents agreed that the
lack of public toilets in their area stopped them from going out
as often as they would like.
1.2 Causes humiliation: We have stories of older
people carrying jugs or jars so that they can pass water if there
is no public toilet available. Many people "plan" trips
around the availability of public toilets.
1.3 Increase health risks: If people feel they
cannot leave their homes, they can't keep physically active. Some
older people say they ration what they drink when going out so
they won't need to use a public toilet; this can exacerbate health
problems including urinary tract infections. Being socially isolated
may lead to depression.
2. The image of public toilets
2.1 Cleanliness: Hundreds of people informed
us that public toilets can be hugely off-putting if they are dirty,
smell or feel unsafe. 74% said they are frequently disturbed by
the lack of cleanliness of their local public toilets. Cleanliness,
good lighting and security are important.
2.2 Promoting good toilets: HtA has successfully
negotiated the inclusion of age-friendly criteria in the judging
criteria for Loo of the Year Awards (LOYA) to influence best practice
of public toilet provision. These criteria are based on the views
and opinions collated by Help the Aged from research and small
focus groups; issues such as lighting, safety and large locks.
The Charity is also sponsoring a national award for the best "age-friendly"
toilet.[5]
2.3 More public toilets: Evidence from the Spotlight
Survey 2007[6]
found that of the people who said they did not lead as full and
active a life as they would like, 11% said they would be more
active if there were more public toilets.
3. Who pays?
A large proportion of those surveyed said they
would be happy to pay a nominal amount to have public toilets
staffed, clean and in a good state of repair.
4. Opening hours and accessibility
4.1 Access: A number of people felt that using
the toilet should be private and anonymous; they didn't feel comfortable
with having to ask to use the facility or to go into a pub for
example, to explain their need was urgent. Cards scheme such as
"Just can't wait" was useful for those who carried the
card but many older people do not consider themselves incontinent
so don't take part.
4.2 National Key Scheme (NKS): Offers independent
access to disabled people to around 7,000 locked public toilets
around the country.
4.3 Opening hours: Respondents said they did
not find it easy to find a public toilet and 78% said that public
toilets are not open when needed.
5. Security and Attendants
Having toilets staffed by an attendant was a
popular suggestion. 79% said that safety concerns make public
toilets unappealing to use.
6. Who should provide?
Attitudes vary to the provision of public toilets
by other than local authorities. While 84% of respondents felt
that shops and businesses should make more effort to provide toilet
facilities for the public to use, others felt this potentially
compromised their anonymity, dignity and privacy. Too often new
shopping developments are built without any consideration for
toilet facilities. Transport systems that include toilet facilities
are also needed.
The scheme operated by the London Borough of
Richmond was popular with some people because signs advertised
the business's toilets, some toilets had disabled access and there
were business staff about making it feel safe. Many people felt
very strongly that there should be a duty placed on local authorities
to provide adequate public toilets for the community.
7. Dignity and Behind Closed Doors: Using
the toilet in private[7]
in hospitals
The aim of this work is to raise awareness that
people, whatever their age and physical ability, should be able
to choose to use the toilet in private in all care settings including
hospitals. There are many reported instances of poor and undignified
care of older people when it comes to toilets; being given a bed
pan rather than being taken to the toilet and curtains not being
drawn around someone using the commode.
The campaign emphasises the importance of the
environment, as well as care practices. It provides commissioners,
chief executives and inspectors with a measure of good practice
and clinical governance. It has produced a number of resources
to support local people and practitioners to improve the quality
of toilet facilities on wards.
3 Nowhere to go :public toilet provision in the UK
from: http://policy.helptheaged.org.uk/healthyageing Back
4
Incontinence and Older People: is there a link to social isolation?
from: http://policy.helptheaged.org.uk/healthyageing Back
5
Loo of the Year Awards. For more information, visit www.loo.co.uk Back
6
The Spotlight Survey 2007 ordered from Help the Aged publishing
on 020 7239 1946. Back
7
Behind Closed Doors is a dignity campaign led by the British Geriatric
Society, Help the Aged and other organisations to improve standards
of toilets on hospitals wards. www.bgs.org.uk/campaigns/dignity.htm Back
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