ARE WE READY? ……Managing the complexities of dementia within stoma care

Mrs Michaela Parker1
1Salts Healthcare Ltd, Aston , United Kingdom

Dementia is a broad term used to describe a range of neurological disorders, that cause a progressive decline in a person’s function. Even though public awareness and involvement is increasing, there are still significant misunderstandings within society that may affect management of this group of patients.

In the UK, approximately 850,000 people live with this condition, with numbers predicted to rise to over 1 million by 2025 and 2 million by 2051 (Dementia UK). In Australia, dementia is the single greatest cause of disability in people over the age of 65 and the second leading cause of death (Dementia Australia). Without a medical breakthrough, this healthcare challenge is set to increase significantly on a global scale and governments worldwide are now, supporting and promoting initiatives to meet this major challenge

Ostomists with dementia require diverse and creative support. Moving forward, Stoma Care Nurses should proactively seek to form key partnerships with specialists in dementia to enhance care provision and consider the impact of this patient group on future services. Training, development and any planning of care is critical and should influence clear strategies that reflect best practice

This presentation aims to identify the key challenges that may become evident whilst supporting the care of someone living with dementia and then focus on the main areas for consideration and vital future developments.


Michaela Parker Is currently a clinical nurse specialist in research and development for Salts Healthcare Limited

Experienced in colorectal, gastrointestinal and urology nursing in Nottingham, United Kingdom before becoming a stoma care nurse in 2004. Her stoma care role has allowed her to work in both the hospital and community settings and more recently with industry

Michaela has presented at conferences at a national and international level and lectured to a wide variety of health care professionals on the subject of stoma care. She has also published work in relation to the vulnerable adult with a stoma

A new way to treat urinary tract infections

Ms Loreto Pinnuck1
1Monash Childrens, Clayton, Australia

Urinary tract infections are the most common nosocomial infection worldwide. Catheter acquired urinary tract infection represents a significant proportion of this group. The increasing risk of antibiotic resistance and persistence of biofilms have necessitated the search to find alternative forms of both treatment and prevention of urinary tract infections.

Children with neurogenic bladder are often required to perform clean intermittent catheterisation up to five times a day. Many of these children develop multiple urinary tract infections and some also develop antibiotic resistance.

Microdox is a solution  containing hypochlorous acid (0.009%) with broad-spectrum antimicrobial activity against multi-drug resistant organisms and established biofilms. This is instilled as a bladder rinse for both symptomatic urinary tract infection treatment and prophylaxis.

Discussed will be our experience of children requiring clean intermittent catheterisation and developing recurrent urinary tract infections with a focus on the impact of using the instillation of Microdox.


Loreto has worked for more than 30 years as a stomal therapist/wound consultant and more recently a urology clincincal nurse consultant

“On the verge of residential aged care” a continence management case history

Mrs Claire Dobson1
1SWSLHD, Peakhurst, Australia

Caring for a loved one with incontinence can be difficult. Add to the mix a client with dementia and it increasingly becomes a challenge emotionally, physically and financially. The issue often leads to clients being placed prematurely into residential aged care as carers do not have the coping tools and mechanisms to be able to manage the incontinence. Often they are unaware of local Continence services that can assist in the management of the condition and the burden of caring and the stress on the carer can be profound

However, help is available via Continence Advisory Services in most metro, regional and rural areas

I would love to present a heart-warming case history where a carer nearly placed his wife into residential aged care. With carer support, proper assessment and continence management strategies, this was avoided and a positive outcome was achieved


UK trained RN

Worked in Urology at Westmead Hospital, Urodynamics at Royal North Shore Hospital and set up the Continence Service at Bankstown in 1992.

Bankstown Continence CNC from 1992 -1998 then private sector as Continence Educator for 9 years before returning to Bankstown as Continence CNC in 2008.

Graduate Certificate in Continence Management in 1990  Graduate Diploma in Health Science Education Sydney University 1997.

CNC role:

–              a clinical component to clients over the age of 65

–              an education component, 4th year medical students, nursing staff and community groups

–              research and Quality Improvement

–              -health promotion

Neobladder support group

Mrs Kavita Sharma1
1Perth Urology Clinic, , , 2Sjog Murdoch Hopital, ,

A neobladder support group was established in Perth with the assistance of Stomaltherapy nurse and business practice manager of the urology practice.

Neobladder patients were reporting a sense of isolation following their neobladder surgery and they had varied levels of satisfaction or dissatisfaction following the surgery.

Patients who have neo bladder surgery report ongoing problems:

  • Varied experiences with level of continence.
  • Constipation
  • Urinary tract infection
  • Mucous in urine
  • Consumption of alcohol reduces night time continence
  • Possible residual cancer
  • Varied experiences with chemotherapy
  • Erectile dysfunction

There is small numbers of patients having neo bladder surgery and no support organisation so these patients feel isolated. It was recognised that a support group was needed for this vulnerable group of patients.

At St John of God Murdoch patients had been put in contact with other neobladder patients when requested and if a willing contact was available. Support needed to be larger than a couple of individuals.

It was hoped that the support group could assist to:

  • Reduce the sense of isolation amongst neobladder patients
  • Allow sharing of information that may benefit other individuals
  • Provide support for prospective neobladder patients
  • Information from invited guests


The initial meeting was held in in August 2018 with patients attending who had had their surgery up to 12 years previously. 15-20 neobladder patients and family members or support person attended. The lead of the group was a neobladder patient. It is expected that the neobladder patients will take over the administration of the group in time.


Continence Nurse/ Stoma Nurse

Urology Practice Nurse

Incontinence in Australia by numbers

Ms Donna Heggie1
1Continence Foundation Of Australia In Nsw Inc., Newington, Australia

One in three women who have ever had a baby…..

3-12% of children aged 5-17 years…..

20,000 to 60,000 of children aged 13-18 years…….

Over 4.8 million Australians over the age of 18…….

The Deloitte Access Economics report “The economic impact of incontinence in Australia” explores the current prevalence and economic impact of incontinence in Australia, and provides an outline of the future projected growth of this burden.

As quoted from the Continence Foundation of Australia website (

This presentation will give an overview of Incontinence in Australia and who it effects in our community. Statistics and data will be quoted from the most recent research available.

Over 70% of people who seek help can be improved or cured


Donna Heggie RN, STN, Grad Cert Clinical Teaching, Continence Management Certificate.  Centre Manager, Continence Foundation of Australia in NSW Inc.

Donna has a long nursing career specialising in Stomal Therapy and Continence/ Colorectal Nursing at Royal Prince Alfred Hospital, Sydney. Currently she manages the CFA in NSW Inc. Office in Newington. A position held since February 2015. Donna is also a member of the CFA National Bladder Bowel Collaborative Steering Committee.


This conference is proudly hosted by the Australian Association of Stomal Therapy Nurses:

One of the Association's major objectives is the promotion of quality care for a wide range of people with specific needs. These needs may be related to ostomy construction, urinary or faecal incontinence, wounds with or without tube insertion and breast surgery.

Patients/clients across the life span are provided with preventative, acute, rehabilitative and continuing care as required. Another objective is the maintenance and improvement of professional standards in relation to Stomal Therapy Nursing Practice to the highest degree possible. Recognition of the need for and encouragement of the development of specialist expertise in the field of Stomal Therapy Nursing underpins the Standards for Stomal Therapy Nursing Practice.

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