We have now updated the useful links section of our website. It is now even easier to find useful information and support for people living with incontinence. You will also find a section dedicated to carers of people with incontinence and also a section dedicated to support groups for the older generation.
Why not click here and take a look!
We get lots of requests for information to help carers assist with managing incontinence. As well as the Carer’s section on our website, you can also request our printed leaflet online as well , just visit – http://www.allaboutincontinence.co.uk/carers-guide or click here – Allanda A5 Carers Guide.
The innovative TENA Shampoo Cap is now available from Allanda. The TENA Shampoo Cap is a non-rinse, comfortable alternative to washing hair with water – making it ideal for individuals and patients with limited mobility.
A gentle head massage while wearing the TENA Shampoo Cap leaves hair fully clean and conditioned. With no need to add water or rinse hair after use this product is ideal for those who are bedridden, fragile, immobile or terminally ill (or those who are afraid of water).
Each single-use pack contains the optimum amount of cleansing formulation for one hair wash, for enhanced comfort, you can heat the unopened TENA Shampoo Cap pack in the microwave (max. 30 seconds at 500W). Be sure to check the temperature before use.
The TENA Shampoo Cap is priced from £2.39 (inc. VAT) each, depending on quantity purchased.
Following customer feedback we’ve introduced a new smaller size of TENA Soft Wipes. The new 30 x 19cm size is just over half the size of the standard 32 x 32cm size. This new product may be smaller but they still offer the same excellent wet strength and softness in one handy cloth. These soft wipes are highly absorbent and lint-free, to use simply moisten them using warm water to attain a comfortable temperature. The ultra-soft feeling combined with high wet strength make them ideal for cleaning all body areas.
A recent study, commissioned by the Carers trust has revealed that more than 50% of carers looking after those with dementia have not been given relevant information about incontinence as well as other issues such as correct management or medicines or legal issues.
The study also showed that more than half of these carers had problems obtaining a diagnosis for the person for whom they cared, and and nearly 70% had not received training or information about how to deal with the agitated behaviours that can develop in the latter stages of the condition.
Other key findings included:
-Over half (52%) of carers in the survey reported difficulties in obtaining a diagnosis for dementia for the person they cared for
-More than half of carers (55%) questioned said that they had not been given information on legal issues and managing money. Many had learned about Lasting Power of Attorney too late
-Many carers, particularly those caring for someone in the later stages of the illness, felt ill equipped to deal with more agitated behaviours that might develop.
-More than two-thirds 68% surveyed said they had not received training or advice on this issue
-82% of carers questioned said that caring had adversely affected their ability to work
One person surveyed said she found it very difficult to deal with her husband’s double incontinence and felt un-suppoted by local policy as she was not to provided incontinence pants and wasn’t never given information about support options.
Thea Stein, chief executive of the Carers Trust, has said that it was clear that all professionals needed a checklist of all the information and advice carers needed. This should be reviewed regularly with carers at key points of the person with dementia’s illness.
The report highlighted 7 key points when carers most needed information and support:
-When dementia is diagnosed
-When the capacity of the person with dementia declines
-When the carer needs emotional support and/or a break from caring
-When the person with dementia loses their mobility
-When the carer has to cope with behaviour problems
-When the carer’s own circumstances change
-When the person with dementia becomes incontinent
The full report can be read online here.
People who have neurological conditions and also experience symptoms of lower urinary tract dysfunction should be offered detailed assessments, NICE has said.
The health body has issued the clinical guidance in a bid to minimise the distressing effects caused by incontinence and other urinary problems on those with conditions such as stroke, multiple sclerosis, and head or spinal cord injuries.
Under the guidance, healthcare professionals across England and Wales are advised to undertake thorough assessments of such patients, including obtaining information about their urinary tract and neurological symptoms, other health problems such as bowel or sexual problems, and their use of medication and therapies.
Factors such as mobility, hand function, cognitive function, social support and lifestyle should also be assessed, with the information gained used to inform the management of each patient’s urinary problem.
NICE says that these assessments should happen at least every three years, although individual circumstances – such as a patient’s age, diagnosis and type of management – may mean they need to be undertaken more frequently.
NICE’s director of the centre for clinical practice, Professor Mark Baker, said: “Incontinence is common in people who have conditions caused by damage to their brain, spinal cord or other parts of their nervous system. It can be particularly problematic when there is an underlying neurological condition because these people may have mobility, hand function and sight impairments and so may need extra support to manage the effects.”
He added: “Incontinence can have a huge impact on a person’s daily activities, and can increase demand on carers, such as partners and family members.”
1. Establish a culture that promotes continence, rather than just checking and changing incontinence products. This includes establishing teams of incontinence specialists, setting incident-reduction goals, raising awareness of a plan, periodically ensuring guideline compliance, benchmarking and establishing a staff competency program.
2. Develop a formal bowel and bladder programme. One of the best ways to decrease the incidence of incontinence in long-term care residents is having a clear bowel and bladder program that is in compliance with current clinical guidelines (e.g. NICE). Often suppliers of incontinence pads can supply such a programme.
3. Promote continence with broad staff education and training. Low incontinence incidents and positive survey results may lull many providers into a false sense of security, sometimes surveyors may overlook how the home is promoting continence and you might continue the same process that has contributed to higher incidents of falls, nosocomial infection or depression. Proper staff education and support on perineal care is essential to help eliminate skin breakdown or redness before it can occur as well.
4. Properly assess and identify vulnerable areas. Proper assessments include identifying the type of incontinence, and often the cause. The assessment should lead to the proper care plan and also the type of incontinence product and care that will best support the highest possible level of continence for each individual. A structured program can help identify and treat some very simple underlying causes of incontinence, such as medications, poor dexterity or mobility, anatomical defects or lack of appropriate staff.
5. Keep your eyes and ears open. It might seem simplistic, but many homes link cost with effectiveness when often a more expensive treatment or product will be more effective and reduce overall costs through such areas as reduced treatment of skincare issues or laundry bills. There are undoubtedly many treatments available for incontinence, but the best treatment is simply to pay vigilance and attention to each individual clients situation.
6. Be mindful of the total cost of incontinence. Incontinence pads represent only a fraction of care costs. Consider other metrics such as change rates, cost of laundry, nursing time, medications or ointments, falls and cost of skin injuries.
7. Understand that it’s more than just a physical problem. Preserving the dignity of the resident is paramount. Staff can help residents emotionally by making them feel confident, and by providing quality support products that reduce the incidence of embarrassing leakage.
8. Provide easily identifiable products. Make it as easy as possible for staff to identify the proper supplies, including undergarments and topical treatments, e.g. through using products where the packaging means that names can be read from across the room and also colour-coded packs and products. Staff can are often be overworked, so different products can be quickly identified can help when staff are busy.
Some Mistakes to avoid are:
– Using outdated continence management policies or guidelines.
– Assuming a good survey and few incontinence incidents mean you are managing the problem well.
– Skipping an initial assessment of vulnerable areas of the body.
Nursing homes that foster an environment in which workers feel they are valued contributors to a team of caregivers provide better care to their residents. That is the conclusion of a study out this month in the journal Health Services Research.
“We know from other fields of medicine that teamwork – the relationship between co-workers that facilitates decision making and care co-ordination – plays an important role in the quality of care,” said Helena Temkin-Greener, Ph.D., lead author of the study. “Our body of work in this area demonstrates that, while many nursing home managers may contend that they have teams in place to coordinate care, it is only when staff perceives that they are part of a cohesive unit that the quality of care is improved.”
The study’s authors used data on over 45,000 residents in 162 nursing homess. They measured the quality of care by examining the incidence of incontinence and pressure ulcers, conditions that, while highly prevalent in nursing homes, can frequently be prevented from occurring. In nursing homes, the prevalence of these two conditions may be exacerbated by poor staff communication, inadequate hand-offs during shift changes , and inefficient coordination of care.
The authors surveyed 7,418 nursing home staff providing direct patient care at these facilities to measure perceived staff cohesion, defined by the extent to which staff share common goals, values, responsibility for care delivery, and group identity. Answers to survey questions were used to construct a numerical score (ranging from 1 to 5) that represented “staff cohesion” at a given nursing home.
The authors then examined the association between staff cohesion and prevalence of pressure ulcers and incontinence in that facility, adjusting for other patient characteristics. They found that less than 0.25 point improvement in a facility’s staff cohesion score was associated with a 4.5 percent decrease in the prevalence of pressure ulcers and a 7.6 percent decrease in incontinence, representing a significant improvement in both these health outcomes.
“This study empirically demonstrates that better work relationships between staff, as measured by staff cohesion, are associated with better outcomes for nursing home residents,” said Temkin-Greener. “Nursing home managers have the tools to encourage good patient care but they have to work at it and encourage practices that promote better cohesion, communication, and teamwork in their facilities. If they do this, the quality of care will improve.”
Brunel University is holding a free one day training event giving advice to health professionals on how to tackle incontinence in older people.
The training day is being held on Wednesday 13 June by TACT3, the UK’s largest collaborative research programme, focussing on older people and continence difficulties.
Eleanor van den Heuvel, principal investigator for TACT3, from the Brunel Institute for Ageing Studies, said: “We believe that care professionals working in the frontline with older people should have the opportunity to benefit from our work so we are putting on a free one day training event (refreshments and lunch included).
“The event is aimed at health and social care professionals but informal carers and people with an interest in continence research are also welcome.”
The day will include:
•The latest continence promotion workshop
•The stigma of incontinence
•Continence services as experienced by professionals and service users
•Demonstrations of prototypes of two new continence management technologies
•An exhibition with the interactive “Great British Toilet Map”
The aim of TACT3 is to reduce the impact of continence difficulties for older people by:
Improving toilet provision for older people – by investigating the problems older people have locating and using toilets when they are away from home and exploring why older people do not like or use the new automatic conveniences.
Improving understanding of continence treatment services – by exploring patient, family and professional viewpoints when people seek help for continence difficulties from the health services.
Providing assistive devices to help people with continence disability – by developing two products that have been requested by continence pad users to help older people to feel more confident and manage their condition better. The first product is a urine odour detector that will warn the continence pad user that their pad needs changing before any odour is detected by the human nose. This simple colour change device will be in the form of a small card or a piece of jewellery or other items requested by users. The other product is smart underwear that will detect a pad leak immediately and warn the wearer or carer before the leak spreads to outer clothes or furniture.
About 50 per cent of women over 40 will suffer some symptoms of urinary incontinence, with the number increasing with age; about half as many men are affected. Faecal incontinence is present in about one per cent in the general population, rising to 17 per cent in the very old and as high as 25 per cent in nursing homes.
People wanting to attend the event should call 01895 266921 or register online at www.brunel.ac.uk/bib/tact3/events, the programme for the day can be viewed at http://www.brunel.ac.uk/__data/assets/pdf_file/0007/187261/Meeting-the-Challenge-programme-Final.pdf