Introducing a dignified approach to continence care in residential aged care

‘Every interaction is an opportunity to uphold or diminish a person’s dignity’ — Dr Joan Ostaszkiewicz

The Royal Commission into Aged Care Quality and Safety heard compelling firsthand evidence that the quality of continence care in Australia’s residential aged care homes does not align with community expectations. Managing incontinence and promoting continence in this setting is a significant issue, and vital to the health and wellbeing of individuals and their families.
Research has found that:

• 94.1% of individuals in residential aged care homes in Australia require support to manage incontinence
• Urinary incontinence affects 88.1% of individuals in this setting
• Faecal incontinence affects 51.5% of individuals in this setting
• 23-71% of individuals in this setting experience constipation.

In 2019, the Continence Foundation of Australia commissioned researchers from NARI to co-design, and pilot test, a best practice model to inform the delivery of continence care in Australian residential aged care homes. The Best Practice Model of Continence Care in Residential Aged Care articulates the characteristics of quality continence care for individuals with continence care needs in residential aged care homes. These characteristics are articulated in the following principles.

Continence care:

1. Is person-centred through supported shared decision-making
2. Is clinically informed through an assessment process
3. Is informed by the best available evidence
4. Protects a resident’s dignity
5. Optimises a resident’s functional abilities
6. Is timely and responsive
7. Is inclusive and respectful of a resident’s culture, diversity, identity and life experiences
8. Is safe
9. Is provided by an appropriately trained and skilled workforce
10. Is appropriately resourced.

Download the Best Practice Model of Continence Care in Residential Aged Care

Translated by the Continence Foundation of Australia into My Continence Care, the Model is:

• Person-centred
• Based on the best available evidence
• Consistent with the expectations of individuals with incontinence in residential aged care and their families.

In 2022, the team was awarded the Barry Cahill Travel Scholarship for their research about aged care residents’ expectations and preferences for continence care at the National Conference on Incontinence in Melbourne. They also received a Best in Category Prize in Geriatrics/Gerontology for their abstract and presentation at ICS2021 about the model from the International Continence Society in 2021.

NARI thanks Continence Health Australia for funding this project, and members of the Project Advisory Group, and expert advisors, who kindly and generously shared their expertise and were vital to the development of this model. Chaired by Dr Susan Hunt (Aged Care Consultant, Leisten Hunt Pty Ltd), the Project Advisory Group included people with the lived experience, and representatives from the Continence Health Australia, the Australian Government Department of Health, Alzheimer’s WA, the Australian Nursing and Midwifery Federation, Bolton Clarke, Carers Victoria, COTA Tasmania, and Edith Cowan University.

You can find out more about the model on the Foundation’s website here: My Continence Care

Contact at NARI: Dr Joan Ostaszkiewicz

Or contact the Continence Health Australia