Reframing continence care in care-dependence

Abstract

International guidelines promote active investigation and treatment of incontinence; however, these guidelines do not fully accommodate the psychosocial aspects associated with providing continence care i.e. the caregiving dynamics. The author developed a new framework that aims to support nurses and care workers in their efforts to identify and meet the continence care needs of individuals with complex health conditions who are dependent on another person for assistance to manage incontinence or to maintain continence. The framework is underpinned by two core concepts: 'dignity' and 'care', and is characterized by a focus on: empathic continence care; personhood in dementia; therapeutic communication; authentic partnership in continence care; acknowledging stigma, social taboos and courtesy stigma; and the need for a foundational continence assessment. This paper describes the Dignity in Continence Care Framework and suggests strategies for its use in the future education of nurses and care workers about continence care.

Keywords: Dementia; Dignity; Education; Incontinence; Nursing care; Nursing homes; Personhood.