The Art and Science of Continence Caregiving
Joan Ostaszkiewicz (see full bio here)
Sunday, 17th October 2021
This presentation will illuminate the hidden world of continence caregiving. The objectives are:
- To develop and understanding of who performs continence care work, and how and where it is performed.
- To obtain insights into the challenges associated with continence caregiving.
- To learn about the strategies nurses and formal and informal carers use to deal with the challenges of providing continence care and the significance of this information for policy, education and practice.
Why this topic is important?
With 15% of the global population with a disability, it is highly likely that many of us will experience a disability at some stage in our lives causing us to rely on another person for help with bladder and bowel function. Incontinence and care-dependence go to the very heart of our fears as humans, so much so, that some people claim they would rather die than become incontinent or be care-dependent. Human reactions to incontinence and care-dependence vary considerably. These reactions manifest in care interactions with nurses and carers who must find a way to deliver care in a way that minimises the risk of psychological or physical harm and protects the person’s dignity. It is important that those of us in the caring professions get it right: that we know how to deliver safe continence care that protects a person’s dignity. This presentation brings together knowledges from the biosciences and the social sciences to describe the art and science of continence caregiving where the aim of care is dignity-protection.
• Ostaszkiewicz J, Dickson-Swift V, Hutchinson A, Wagg AS. (2020). A concept analysis of dignity-protective continence care for care dependent older people in long-term care settings. BMC Geriatrics. 20, 266 (2020). https://doi.org/10.1186/s12877-020-01673-x
• Ostaszkiewicz J. (2017). Reframing continence care in care-dependence. Geriatric Nursing. 38(6):520-526. http://dx.doi.org/10.1016/j.gerinurse.2017.03.014
• Ostaszkiewicz J, Dunning T, Dickson-Swift V. (2020). Translating dignity principles into practice for continence care for older people in residential aged care: A study protocol. Journal of Advanced Nursing. 76(11):3147-3154. http://dx.doi.org/10.1111/jan.14481
We asked Joan why the ICS is important for international advances and training in Nurses and allied health clinicians?
The last 20 years has seen a major advance in knowledge about bladder and bowel function and treatment and the ICS has been instrument in sharing this knowledge globally. However, these advances have focussed on interventions to minimise or alleviate symptoms, rather than caregiving interventions. Indeed, many continence care practices remain deeply rooted in tradition and routine and are rarely discussed, partially because of the misconception that they are based on feminine ways of knowing which are understood as emotional, natural, irrational, biased and inferior to masculine ways of knowing (which are considered to be rational, clinical, objective..). Moreover, there is almost a complete absence of guidance about continence caregiving in medical and/or nursing texts. As a leader in international advances and training for nurses and allied health clinicians, this presentation on the Art and Science of Continence Caregiving represents a new field of enquiry for the ICS.
We asked Joan what was the one important new finding all nurses and allied health clinicians need to learn about?
Although dignity is subjectively experienced, a concept analysis led by Dr Ostaszkiewicz reveals the key attributes of dignity-protective continence care are privacy, respect, autonomy, empathy, trust, and communication, in the caregiving encounter. An understanding of the essential attributes of dignity-protective continence care could allow caregivers and healthcare professionals to challenge practices that violate dignity, and recognize caring opportunities for protecting the dignity of vulnerable and care-dependent older citizens.