“In every interaction you have with a person, you have the opportunity and power to uphold or diminish their dignity.”
Prof Joan Ostaszkiewicz, National Ageing Research Institute (NARI).
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Model of Continence Care (MCC) is a best practice model of continence care which ensures older people receive evidence-based, person centred, clinically informed continence care that is responsive to their individual needs, safe, protective of their dignity and that optimises their functional ability.
The aged care workforce is largely untrained in safe and effective continence care and incontinence management. Current education programs do not adequately provide aged care staff with the necessary knowledge and skills for good continence care. Evidence supports increased physical activity in combination with being regularly reminded to go to the toilet and, having timely assistance to do so, can reduce leakage and prevent ‘accidents’, however, this is not always reflected in the aged care setting.
This disparity between current clinical practice and best practice in continence care needs to be addressed. The MCC has been developed to address a gap that has been identified for best practice continence care in the residential aged care sector. It delivers a comprehensive, targeted package to provide a substantial and measurable increase in the safety and quality of continence care in residential care.
Continence SMART Care is a model of best practice continence care, underlined by ten guiding principles and mapped to the Aged Care Quality Standards. It is shared between:
- Workforce through education
- Consumers through dignity and choice
- Providers through governance
This model is designed to be responsive to individual needs, involves person-centered and shared decision making, and is safe, protective of dignity and optimises an individual’s functional abilities.
Continence care is the subject of frequent complaints to the Aged Care Quality and Safety Commission and ‘terrible examples of substandard incontinence care’ were brought to the attention of the Royal Commission into Aged Care Quality and Safety in 2021. The Foundation believes now is the time to act and implement CSC, a model which will help transform the provision of safe, high-quality continence care within the aged care sector.
In 2019, the Continence Foundation of Australia commissioned the National Ageing Research Institute (NARI) to develop and test a best practice model of continence care for residential aged care. The result of their thorough research was the development of an evidence-based, person-centered, clinically informed model of continence care.
The Foundation’s MCC will have a significant impact on consumers and their families, the aged care workforce and aged care service providers.
MCC involves a three pillars approach to support the implementation of the model. Educational resources will support consumers, their families, carers, support workers, registered nurses, managers and quality assessors, education providers and aged care service providers.
1. Consumers through dignity and choice: SMART Continence Care means choosing the best care for the best you
2. Aged Care workforce through Education: SMART Continence Education means a skilled workforce to provide best care
3. Aged Care providers through governance and systems: SMART Continence Governance and systems means that all the checks and balances are in place for the best continence care