Your first plan – be prepared!
This blog post is going to focus on how you can be prepared to have your bladder and bowel related needs adequately met within the NDIS.
A bit of lingo.
Bladder and bowel issues are known as “continence”;
Any equipment, community nursing or nursing consultancy needs you have in relation to continence management is grouped together within the NDIS ‘Core’ supports category; and
Continence aids (products) under the NDIS are referred to as ‘assistive technology’.
Currently majority of people living within the community with a permanent disability and has continence needs receive their products and equipment via government programs e.g. the Medical Aids Subsidy Scheme (MASS) in QLD and Enable in NSW. State government programs have been restrictive in what they will provide to clients. Standardised application forms have often been churned out every few years by publicly funded clinicians with high workloads to ensure the ‘box is ticked’.
Programs to date have been to the detriment of a person with a disability having choice & control over the products they use to manage their continence.
During the NDIS planning phase we have learnt that you are eligible (& encouraged) to request a formal continence assessment. During a continence assessment, the nursing consultant works with you on reviewing your continence program and provides advice to you in identifying your true needs. Under the NDIS you decide on your supplier/s for your continence products. For the first time for most people, you will need to know the value i.e. the price for your products. Once your true continence needs are known then a value can be calculated.
The Continence Foundation has prepared the following list of questions to prepare people with continence issues for the NDIS. Ask yourself:
Which products do I use now?
Are the products that I am currently using manage my incontinence effectively?
Should I have a continence assessment to make sure I am managing my incontinence effectively?
Should I have a continence review to determine if my needs have changed since my last assessment?
Is my incontinence preventing me from achieving my goals? If so, what can be done to improve the situation?
Can my incontinence be better managed?
Do not be swayed in your NDIS Planning meeting to allow the assessor - who is an administration person with no clinical background; to ask you to guestimate your needs.
An example of a value comparison for a person who has been performing intermittent self-catheters, reusing basic Nelaton catheters and experiencing regular UTI. On assessment, a single use hydrophilic Nelaton is recommended. Annual cost for the reusing program (including related products): $1,180.53 vs. cost for evidence based single use practice with hydrophilic Nelaton: $5,119.96.
With the NDIS there is no change to the PQ PBS arrangement.
A continence assessment provided by a Nursing Consultant may also identify future episodic specialist nursing services you may require (particularly if you are having continence issues) and these services should then be included in your Plan.
Once you NDIS Plan is finalised, if you receive the Continence Aids Payment Scheme (CAPS) we believe this payment will cease as your plan should provide sufficient funding to provide you with all your continence aids.
If you have a compensation payout for your acquired disability you may be eligible for the NDIS.
A few tips of what you are looking for in a Nursing Consultancy/Advisory service. A Nursing Consultant practices at an advanced level and holds a Bachelor of Nursing (or equivalent) + post graduate study related to specialty (average 6 – 8 years’ study); is 5 – 10 years’ post registration; and has a minimum 5 years’ clinical experience in area of specialty.
Community Nursing Services provide generalist registered nurses and these services are used if you have an indwelling/supra pubic catheter that requires an RN to change it at regular intervals.