Abstract
Purpose: Problems with continence are common in people with an acquired brain injury (ABI). This project aimed to investigate, review, and trial assistive devices to support people with an ABI to toilet more independently, improve quality of life, and reduce the cost of care.
Methodology: This mixed-methods project used a sample of 16 clients with ABI and continence/toileting issues receiving community-based rehabilitation for brain injury at two Brightwater rehabilitation sites. Data collected on client outcomes included: estimated care hours, cost of care, cost of consumable products (e.g., continence pads), independence in daily living activities, and quality of life. These data were collected at the start of the study (Time 0) and three months after assistive devices were implemented (Time 3). Practices in continence care were examined using qualitative observation and surveys of 24 staff directly involved in clinical care at participating rehabilitation sites.
Results: Between Time 0 and Time 3, weekly care hours required for toileting/continence declined by an estimated 4.3 hours per client, which translated to an estimated weekly cost reduction of $633.29 per client. The average daily cost of consumable items reduced by $9.91 per client after intervention. Significant improvements in client independence were also found, with observed improvements in total as well as cognitive and motor independence. Despite these improvements, client-reported quality of life declined over the study period; however, this was not statistically significant. Qualitative observations showed limitations of current practices in continence management. Staff surveys revealed gaps in staff knowledge and practice around continence care and the need for improvedinterdisciplinary communication.
Conclusions: Managing continence-related problems in the ABI population with assistive devices is
effective at reducing the need for staff intervention and cost, as well as improving functional independence, wellbeing and dignity. Consistent with previous research, current practice in continence management can be improved to provide client-centred and evidence-based care using a multidisciplinary team approach. The findings have wide-ranging policy implications and should be taken into consideration when planning treatment and rehabilitation services, and in the preparation and funding of care plans.
Methodology: This mixed-methods project used a sample of 16 clients with ABI and continence/toileting issues receiving community-based rehabilitation for brain injury at two Brightwater rehabilitation sites. Data collected on client outcomes included: estimated care hours, cost of care, cost of consumable products (e.g., continence pads), independence in daily living activities, and quality of life. These data were collected at the start of the study (Time 0) and three months after assistive devices were implemented (Time 3). Practices in continence care were examined using qualitative observation and surveys of 24 staff directly involved in clinical care at participating rehabilitation sites.
Results: Between Time 0 and Time 3, weekly care hours required for toileting/continence declined by an estimated 4.3 hours per client, which translated to an estimated weekly cost reduction of $633.29 per client. The average daily cost of consumable items reduced by $9.91 per client after intervention. Significant improvements in client independence were also found, with observed improvements in total as well as cognitive and motor independence. Despite these improvements, client-reported quality of life declined over the study period; however, this was not statistically significant. Qualitative observations showed limitations of current practices in continence management. Staff surveys revealed gaps in staff knowledge and practice around continence care and the need for improvedinterdisciplinary communication.
Conclusions: Managing continence-related problems in the ABI population with assistive devices is
effective at reducing the need for staff intervention and cost, as well as improving functional independence, wellbeing and dignity. Consistent with previous research, current practice in continence management can be improved to provide client-centred and evidence-based care using a multidisciplinary team approach. The findings have wide-ranging policy implications and should be taken into consideration when planning treatment and rehabilitation services, and in the preparation and funding of care plans.
| Original language | English |
|---|---|
| Publisher | Brightwater Care Group |
| Commissioning body | Insurance Commission of Western Australia |
| Number of pages | 103 |
| ISBN (Electronic) | 978-0-9954235-3-4 |
| Publication status | Published - 2019 |
| Externally published | Yes |