Post-acute care nurses are right on target with continence assessment and management, a new study finds. But their patients are largely unaware of these activities and think they’re going it alone, investigators say.
The researchers conducted interviews with 10 nursing staff and 10 patients in two geriatric units of a rehabilitation hospital. Perhaps not surprisingly, nurses and patients had very different experiences of incontinence care.
Care providers said that they considered continence management an important part of geriatric rehabilitation nursing. Their focus was on containment and regular toileting. Patients, by contrast, described experiences with incontinence as embarrassing. The problem made them feel dependent and recovering independence was seen as regaining control, they said.
“Patients had no sense of an overall plan to improve continence during rehabilitation and were left feeling done to, rather than being an active collaborator,” study lead Adrian Wagg, M.D., of the University of Alberta, in Canada, reported.
The patients said they would strategize on their own to avoid incontinence episodes. They would go to the bathroom before having therapy or treatments where they knew toilet access and assistance would be limited, for example.
The results highlight the need for continence care approaches that engage older persons during rehabilitation, Wagg and colleagues concluded.
The development of a routine assessment tool could encourage conversations with patients and support a continence care plan, encouraging a more “systematic and inclusive approach to continence care,” they wrote.
Full findings were published in Rehabilitation Nursing Journal.