Continuing our celebration of OT Week 2020 we showcase the role of Jo Smith. Jo is a part time community OT for South Tees NHS Foundation Trust. She graduated from the University of Teesside in 2003 and worked for many years in medicine/surgery, residential rehabilitation and her current role is as a continence OT. According to RCOT and Bladder and Bowel UK there are only two OTs in the country working in adult continence services.
What is your current role?
I am a member of a community continence team comprising of nurses and healthcare assistants working over five days. Referrals are encouraged to be via health professionals ensuring that first line treatment has been trialled before secondary care can take place.
Pad usage and costs can be reduced through good continence care. The monthly costs of pads is estimated at: daytime £34-73, night time £43-64. It is estimated that the NHS spends around £80 million per year on product costs.
Examples of referrals include patients who have continence issues, urinary and faecal or both, and who are diagnosed as having functional incontinence – where a person’s function affects their continence – lack of mobility, cognitive impairment and reduced dexterity. An assessment of a person’s level of function and identifying the toileting issues can devise a treatment plan. Areas of intervention include cognitive assessment, personal care, mobility accessing social activities, giving confidence to access local communities, including using toilet finder applications, the Radar Key scheme and accessing changing facilities within toilets.
Describe a typical day…
Once a client has seen a specialist continence nurse and has been assessed to establish which type of urinary incontinence they have – a patient may have functional incontinence, so a home assessment can then be carried out to assess a person’s functional ability to transfer on/off bed, chair, toilet and how they mobilise. A person-centred treatment plan using a compensatory method is devised and carried out. Provision of toileting programs and toileting equipment including; urinals, urine directors, male external devices (sheaths/penis pouches), commodes, bespoke toilet chairs, raised toilet seats, bio bidets and bottom wipers, as well as signposting to any other services.
For example, a client following a stroke was unable to get to the toilet in time due to hemiparesis. Provision of a urinal, commode and raised toilet seat along with fluid advice (avoiding caffeine, sweeteners and alcohol) were offered. This allowed the client to empty their bladder in time, stopped urinary accidents and prevented the patient from wearing pads. Pads cost the NHS billions of pounds per year and will continue to increase. Therefore it is about compensatory treatment and pads are not necessarily the answer.
It is beneficial to have an occupational therapist assessing the mental health, wellbeing, function and long-term goals of patients, to maintain patients’ independence and keep them at home longer, reducing costs to other healthcare settings.
What’s the best part of your job?
Being able to talk and assist people, making a difference about an embarrassing topic and giving patients the confidence and freedom to enable them to live their lives again.
If you would like to share your role with The OT Magazine for OT Week or to publish in a future issue please contact email@example.com.
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