clinical focus
Out in the open a unit of competency in continence care . This omission along with the lack of awareness and stigma are clearly reasons for the high prevalence in aged care .
There is a solution to this . If we continue to build awareness , start conversations to reduce stigma and equip the workforce with more education and knowledge , we are sure to see better continence care and better health outcomes for not just the elderly living in aged care but all people .
The time has come to take incontinence seriously .
Rowan Cockerell interviewed by Conor Burke
Over five million Australians aged 15 years and over suffer with bladder or bowel control problems , a figure predicted to grow to 6.5 million by 2030 , and people with incontinence suffer long-term physical and emotional impact and rarely seek help .
In 2010 , total health system expenditure on incontinence in the Australian population was estimated at $ 271 million or $ 57 per person with incontinence , which was projected to rise to $ 450 million by 2020 .
While the total financial cost of incontinence , taking into account loss of productivity and carer costs among others was estimated to be $ 66.7 billion in 2010 .
Aged care alone contributes $ 1.6 billion to that figure .
In total , approximately 21 per cent of the community population have urinary or faecal incontinence , or both . That rate jumps to 70.9 per cent for aged care residents , and evidence from the royal commission suggests that this is a problem that is often untreated .
Aged Care Insite sat down with Rowan Cockerell , chief executive of the Continence Foundation of Australia to talk more about the issue .
18 agedcareinsite . com . au
ACI : The Royal Commission said in its final report that it heard 71 per cent of people in residential aged care have experienced incontinence . Why is this problem persisting ? RC : Incontinence is common across the Australian population and is prevalent in the elderly and consequently also among those living in residential aged care facilities . Unfortunately , there is a general lack of awareness that incontinence is a preventable and treatable condition . A lot of people think that it is a symptom of ageing and as such there isn ’ t anything that can be done . However , this is not the case and with proper support , people can improve and manage their incontinence .
There is also an element of stigma associated with incontinence . People don ’ t tend to raise it openly , even in a health care setting , so by the time they are entering aged care people are often resigned to their incontinence . We also know that once in aged care most incontinence persists and becomes worse .
Unfortunately , as evidenced within the Royal Commission , incontinence and continence care is not managed well in most residential aged care . Despite this , the Royal Commission ’ s final report only included one recommendation relating to incontinence . Recommendation 19 – calling for an urgent review of the Aged Care Quality Standards , to raise the bar in terms of best practice continence care , amongst other conditions .
Recommendation 78 , while not mentioning continence care , focused on workforce support and the lack of knowledge and training within the personal carer workforce which is fundamental in ensuring safe and effective continence care and incontinence management moving forward .
The Certificate III in Aged Care , which is the most relevant qualification for workers in the sector , does not currently include
What are we not doing , or doing wrong , that is causing this problem to persist ? The causes of increased incontinence in people living in residential aged care can be associated with a number of issues . These can include care management plans that promote the use of incontinence products only , rather than the provision of toileting assistance , a lack of specialised education and training , and a lack of staff resources and time . All of these contribute to containing the urinary and faecal incontinence rather than supporting that person to be as continent as possible .
A lack of specialised education and training also has a key role in perpetuating improper incontinence management . The Royal Commission ’ s recommendations for increased staff time per resident will help , but central to this is that care staff need to understand the importance of personcentred continence care and be able to deliver that care .
What physical effects can be caused by ignoring incontinence ? The physical effects of unsafe and ineffective continence care may include an increased risk of UTIs , incontinenceassociated dermatitis , pressure injuries , pressure injuries not healing , falls , depression and acceleration of functional decline .
What should we be doing to fix it ? Firstly , we need to prioritise continence care . There was a total of 148 recommendations in the Final Report , but only one relating to incontinence .
In its workforce submission to the Royal Commission , the Foundation recommended that all staff and health professionals working in the aged care sector should receive education about safe and effective continence care and incontinence management in their foundation courses ( VET and undergraduate courses ). There is a clear