Continence program improves quality of life for seniors

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Stigma silences many seniors into keeping their bladder and bowel control issues secret; however a Regional Continence Program for Seniors in the Mississauga Halton area is helping to end this silence.

According to Laura Robbs, a Trillium Health Partners Clinical Nurse Specialist and the Program’s Clinical Coordinator, the stigma of incontinence can negatively affect seniors so they stay at home and miss out on some of their favourite activities, which can lead to depression. The Regional Continence Program aims to battle this stigma.

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The Regional Program’s goal is to improve the health, wellness and quality of life for seniors by improving access to assessment and treatment of incontinence, including urinary and fecal incontinence and constipation. The Program applies a unique three-pronged approach – clinic visits, home visits and public education. It provides continence services for seniors with a range of needs – from those who are well to those with frailty and cognitive impairments. Clients are seen by a Nurse Continence Advisor (NCA) – a Registered Nurse who has advanced education in the conservative treatment of incontinence.

The Regional Program is part of an inter-professional Seniors Services team that enables NCAs to link seniors to other specialized professionals, such as geriatricians (physicians who specialize in caring for older adults), nurse practitioners, pharmacists, social workers and occupational therapists as well as to a  continuum of services (e.g. Falls Prevention Programs).

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The Regional Program’s five community-based continence clinics are located in Milton, Oakville, Mississauga and two in south Etobicoke. Continence home visits are provided across the Mississauga Halton LHIN area for seniors who are frail and unable to access a clinic; home visits require a referral from a physician or Community Care Access Centre. In both home and clinic visits, focused and specialized nursing assessment and conservative treatment are provided for seniors who are experiencing urinary incontinence, urinary frequency, nocturia, issues with urinary catheters, frequent bladder infections, fecal incontinence and constipation. There is no cost to the seniors for home or clinic continence visits.

Referrals to the Regional Program are encouraged from seniors themselves, their families and from health professionals. By calling one central number (416-521-4090), seniors who are 65 and older can book their own appointments at one of the five clinics.

The Nurse Continence Advisors also provide education for the public as other area residents need increased continence-related knowledge to improve their bowel and bladder function. Popular education sessions given at retirement homes, community groups and hospitals include topics such as, “Healthy Bladder Habits as We Age” and “Avoiding Constipation with Aging.”

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As part of the Regional Program’s first year evaluation, clients and health providers were surveyed. Data collected through pre and post questionnaires indicated that the Program has had a positive impact on the lives of seniors in the Mississauga Halton region. Evaluators found that incontinence-related psychological, emotional and functional quality of life significantly improved after treatment in the program. A pharmacist who responded to the survey commented, “I used to always recommend laxatives and alpha blockers for constipation, now I refer clients to the continence program to learn other strategies that are extremely effective to manage chronic constipation.”

Self-efficacy (i.e. how confident seniors attending the continence program feel in managing their incontinence under different circumstances) also significantly improved. As one health care professional shared, “A client was getting up every hour at night to urinate and he reported very poor quality of life as a result of lack of sleep.  The nurse was able to fit him with a condom catheter and this client now reports that he sleeps like he hasn’t been able to in years.  He is very happy.”

Lastly, seniors involved in the Regional Program have had statistically significant decreases in falls, emergency visits related to urinary tract infections, and hospital admissions related to both urinary tract infections and bowel problems. Thirty-one per cent of survey respondents reported that they visited the hospital’s emergency because of a fall and eleven per cent visited because of a urinary tract infection. Those numbers dropped to six and two per cent, respectively.

“Reaching a higher quality of life means the clinics are successfully helping seniors fight the stigma of incontinence,” concludes Robbs.

For more information on the Regional Continence Program for Seniors, please contact Clinical Coordinator, Laura Robbs at extension 905-848-7580 ext. 3267 or at laura.robbs@trilliumhealthpartners.ca.

If you live in the Mississauga Halton LHIN and would like to make an appointment at one of Program’s continence clinics, call 416-521-4090.