Almost 70,000 New Zealanders are living with dementia today, but with our ageing population, forecasts suggest that is likely to rise to near 170,000 by 2050. Alarmingly, the numbers are increasing at a faster rate among Māori, Pasifika and Asian New Zealanders.
The situation is compounded by stressed District Health Boards, and COVID-19 impacting care at the coal face, with DHBs postponing or rejecting referrals, due to resources being targeted at the pandemic response. There is of course also increased strain on the workforce as staff are redeployed to care for the rising number of COVID cases.
Aged and disability care workers play a vital role in ensuring Kiwis with dementia can have a good quality of life, but this is made more difficult in the face of the stigma and embarrassment that this group face when also dealing with incontinence.
Continence NZ is a national charity that can support carers in this essential work.
“We help people with continence problems, caregivers, health professionals and the public, with information and education about bladder and bowel health,” says Continence NZ CEO Louise Judd.
“We are here to aid aged and disability care managers and staff with the advice and resources they need to provide effective continence care, helping ensure dignity and respect for those impacted.”
People living with dementia can become incontinent when their brain no longer sends or receives the messages that allow them to recognise the feeling of a full bladder or bowel. Incontinence episodes occur when the person with dementia doesn’t remember what they are supposed to do. For example, they may be able to get to the toilet but not be able to recall what they should do next.
Bladder incontinence usually happens first, with bowel accidents usually occurring long before true bowel incontinence happens. Bowel incontinence is less common, usually happening much later in life.
“It is important to be mindful of any chronic conditions that might impact on someone achieving continence,” says Continence NZ’s Continence nurse specialist Louise Mills, who has over 35 years nursing experience, with 20 years specialising and focusing on improving continence care within the community.
“It is important they have a regularly updated assessment and treatment plan in place, and that carers are working alongside other health professionals as needed.”
Mills says developing a routine that supports healthy bladder and bowel control can help through a toilet timing approach.
“Timers can be set for before or after each meal, coffee, and teatime, and before bed with the carer supporting the person, following the task through. Automatic reminders on phones can be a useful prompt too. When having a bowel motion, listening to music or talking with someone may help the person stay on the toilet long enough to focus.”
Mills says it’s worth considering and providing appropriate underwear which can catch any leakage on the way to the toilet, supporting the person’s self-respect and dignity. Discussing and providing good personal hygiene will also ensure the person living with dementia has less risk of a urinary infection.
“It is important for the person living with dementia, when able, to know and talk about what the choices are or how their health and happiness could be affected. It is also important to think about what supports are required to enable them to achieve continence.”
Continence NZ is currently developing an online course for health professionals covering dementia and continence that includes resources carers can use, together with tips that may be passed on to family carers.
Continence NZ also has a range of free resources available and a helpline that carers may call. The website www.continence.org.nz has a wealth of information and resources on the Continence Care for Adults page including specialist topics such as dementia and incontinence, caring for someone with incontinence, older people and incontinence.
There are also a series of resources available on our website specifically for aged care workers.
- Continence Assessment Form and Care Plan
- Continence Review Form
- Continence Screening Form
- Monthly Bowel Chart
- Seven Day Bowel Chart
- Continence Management Flow Chart
- Three Day Bladder Chart
Facilities and carers are welcome to join Continence NZ, which not only supports our work, but also entitles them to a quarterly copy of the Australia and New Zealand Continence Journal (ANZCJ) and the quarterly newsletter, access to our member portal, with webinars, copies of the ANZCJ, newsletters and other content, membership discounts to Continence NZ education days and after being a member for three consecutive years, there is the opportunity to apply for conference.
Continence NZ has a free helpline on 0800 650 659 which is available to all, including the health workforce, with Louise Mills one of our specialist continence nurses who answers calls.