Going to plan

A recent study suggests that continence telemonitoring could help return patients’ quality of life.

Early findings on the use of telemonitoring systems to augment continence assessment procedures in residential aged-care facilities are promising, says Barry Cahill, CEO of Continence Foundation of Australia.

“Any intervention that assists staff implement targeted and active approaches to prevent and manage incontinence deserve further consideration,” notes Cahill, although he cautions that further studies into the use of telemonitoring systems are needed before they become more commonplace.

“The advantage of using telemonitoring systems to augment continence assessment for aged-care workers lies in their capacity to provide accurate information which can be used to develop targeted continence-care plans,” Cahill comments.

The University of Wollongong (UoW) study, undertaken over a 12-week period in a Melbourne nursing home with 120 older people, is one of only a few to explore the impact of telemonitoring systems in this area. Initial results published in the Journal of Clinical Nursing point to a positive impact of such systems on continence care.

One of the researchers, Victoria Traynor, associate professor, Rehabilitation, Continuing, and Aged Care at UOW, says generally the main problem with continence care within nursing homes, particularly for individuals living with dementia, is that it is extremely sporadic.

“There is no really rigorous approach to continence care, so you have to rely on the staff noticing that somebody needs to go the toilet or adhering to a care plan that has been developed from observation only,” says Traynor.

According to Traynor, the advantage of telemonitoring systems is that they provide an accurate pattern of a person’s continence needs. “It means that the care staff know exactly when the person normally goes to the toilet, as the device provides an accurate picture of this person’s continence pattern,” she said.

The UoW study results showed that introducing a telemonitoring system for urinary continence assessment and staff training improved staff awareness of continence needs. The SIM telemonitoring system, from Sydney-based Simavita, was used in the research. Over the period of the study, staff adhered to the care plan and the system reduced the number of times staff had to ask the person if they wanted to go to the toilet. It also increased the number of successful toileting events.

“[In addition], we found that less urine was voided into the continence aid, which means that the individuals living with dementia went to the toilet more often than they did prior to the device being implemented,” Traynor says. “It means they are actually urinating in the toilet rather than in their continence aid.”

However, the use of assistive technologies did not reduce contact between the older person and their caregivers in nursing homes.

Residential and home-care provider Arcare has introduced telemonitoring throughout their new homes, and Karen Carey, Regional Manager – Melb North East says she has seen some great results. She said that having validated toileting programs – as opposed to basing it on a manual system, which is really a guessing scenario – improved the resident’s quality of life.

“It’s accurate; we’re not basing it on guesswork any longer,” Carey says. “I think it’s a human right to try and assist anyone in being continent or to assist them to regain some sort of privacy or dignity.”

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