‘Every interaction is an opportunity to uphold or diminish a person’s dignity’ — Dr Joan Ostaszkiewicz
Ensuring dignified and effective continence care is a critical aspect of quality residential aged care. The Royal Commission into Aged Care Quality and Safety in Australia highlighted a significant gap between community expectations and the actual standard of continence management in aged care homes. Addressing incontinence and promoting continence is paramount to the health, well-being, and dignity of older residents.
Research underscores the prevalence of continence issues in aged care:
- Urinary incontinence affects 73% of residents.
- Faecal incontinence impacts 54% of residents.
- Constipation is experienced by 23-71% of residents.
Recognizing the urgent need for improvement, the Continence Foundation of Australia collaborated with researchers from NARI to develop and pilot a best practice model. This initiative resulted in The Best Practice Model of Continence Care in Residential Aged Care, a framework outlining the essential characteristics of high-quality continence care. This model serves as a vital tool for aged care facilities aiming to enhance their continence care practices.
This Best Practice Model is structured around ten core principles, each acting as a guideline for implementing effective continence tools and strategies:
- Person-Centred Approach: Emphasizing supported shared decision-making to ensure care aligns with individual needs and preferences.
- Clinically Informed Care: Utilizing thorough assessment processes to understand each resident’s specific continence challenges.
- Evidence-Based Practices: Grounding continence care strategies in the most current and reliable research findings.
- Dignity and Respect: Protecting and upholding resident dignity as a central focus of all continence care interactions.
- Functional Ability Optimisation: Implementing tools and techniques to maximise residents’ functional independence related to continence.
- Timely and Responsive Care: Ensuring prompt and appropriate responses to residents’ continence needs as they arise.
- Inclusive and Culturally Sensitive Care: Respecting and integrating residents’ diverse cultural backgrounds, identities, and life experiences into care plans.
- Safe Care Environment: Prioritizing safety in all aspects of continence care delivery and the use of continence tools.
- Trained and Skilled Workforce: Ensuring care is provided by staff with adequate training and expertise in continence management.
- Appropriate Resource Allocation: Providing sufficient resources to support the effective implementation of best practice continence care.
Download the Best Practice Model of Continence Care in Residential Aged Care
The Continence Foundation of Australia has translated this comprehensive model into Continence SMART Care, a practical resource designed to assist aged care providers. Continence SMART Care embodies the principles of the Best Practice Model, offering:
- Person-centred tools and approaches.
- Evidence-based strategies for effective continence management.
- Alignment with the Aged Care Quality Standards, ensuring facilities meet and exceed regulatory requirements.
The research underpinning the Best Practice Model has been widely recognised. In 2022, the team received the Barry Cahill Travel Scholarship for their work on resident expectations and preferences in continence care. Furthermore, in 2021, the International Continence Society acknowledged the model with a Best in Category Prize in Geriatrics/Gerontology at ICS2021. These accolades highlight the significance and impact of this research in advancing continence care tools and practices.
NARI extends gratitude to the Continence Foundation of Australia for their funding and to the Project Advisory Group and expert advisors for their invaluable contributions to the development of this essential model. The Project Advisory Group, chaired by Dr Susan Hunt, included individuals with lived experience and representatives from key organisations within the aged care sector.
For further information about these continence tools and resources, please visit the Foundation’s website: Continence SMART Care
For inquiries at NARI, contact: Dr Joan Ostaszkiewicz
Or reach out to the Continence Foundation of Australia for more details.
