Continence Assessments Explained for NDIS Participants |

Continence, the ability to control bladder and bowel function, is something many people take for granted. For NDIS participants who experience continence difficulties due to their disability, the impact on daily life, dignity, and wellbeing can be significant. The good news is that the NDIS can fund both the assessment of continence needs and ongoing management support, and a thorough continence assessment is the essential starting point.

This article explains what an NDIS continence assessment involves, who conducts it, how it’s funded, and what happens after the assessment.

What Is a Continence Assessment?

A continence assessment is a comprehensive clinical evaluation of a participant’s bladder and bowel function, conducted by a qualified health professional, typically a registered nurse with specialist continence training, or a physiotherapist or occupational therapist with relevant continence expertise.

The assessment goes beyond simply identifying that a continence problem exists. It aims to understand the nature and severity of the problem, identify contributing factors, and develop a personalised management plan that addresses the participant’s specific circumstances.

What Does a Continence Assessment Cover?

History and Background

The assessment begins with a thorough history, including the participant’s disability, relevant medical history, current medications (many of which can affect bladder and bowel function), fluid and dietary intake patterns, and a detailed account of their current continence difficulties.

Bladder Assessment

Bladder assessment may include a bladder diary (a record of fluid intake and voiding patterns kept over several days), post-void residual measurement (assessing how much urine remains in the bladder after voiding), and clinical assessment of bladder function. This information helps identify the type of bladder dysfunction present, whether overactive bladder, underactive bladder, stress incontinence, mixed incontinence, or another presentation.

Bowel Assessment

Bowel assessment covers bowel habit, stool consistency, diet and fluid intake, physical activity, and any existing bowel management strategies. For participants with neurogenic bowel dysfunction, common in people with spinal cord injury, multiple sclerosis, or other neurological conditions, specialised assessment of bowel transit and reflex function is also relevant.

Environmental and Functional Assessment

The assessment also considers practical factors, the participant’s ability to access the toilet, transfer to and from the toilet, manage clothing, and use continence aids. Environmental modifications or assistive equipment may be recommended as part of the management plan.

Review of Current Continence Products

If the participant is already using continence products, the assessment includes reviewing whether these are appropriate for their needs, the right product type, absorbency level, and fit.

Who Conducts NDIS Continence Assessments?

Continence assessments under the NDIS are typically conducted by: continence nurses (registered nurses with specialist continence qualifications), physiotherapists with continence specialisation, or occupational therapists assessing functional aspects of continence management.

For complex presentations, such as neurogenic bladder or bowel dysfunction, a urologist or gastroenterologist may also be involved in assessment and treatment planning.

What Happens After the Assessment?

Following the assessment, the practitioner develops an individualised continence management plan. This may include: a bladder training program, pelvic floor exercises, dietary and fluid modifications, a bowel management regime, recommendations for continence products, referral to specialist services, recommendations for environmental modifications or assistive equipment, and a schedule for follow-up and review.

The management plan is shared with the participant, their support coordinator, and relevant members of the treating team.

How Is a Continence Assessment Funded Under the NDIS?

Continence assessments are typically funded under the Improved Health and Wellbeing capacity building budget or the Core Supports budget, depending on how the support is framed in the plan. The NDIS also funds continence consumables, products such as pads, pull-up pants, and drainage systems, under the Consumables budget.

To access continence assessment funding, the support should be in your NDIS plan. If it’s not currently included, speak with your GP, specialist, or support coordinator about the evidence needed to include it at your next plan review.

Frequently Asked Questions: Continence Assessment and the NDIS

Is a continence assessment only for people who are incontinent?

No. A continence assessment is appropriate for any participant who experiences difficulties with bladder or bowel management, including those who manage currently but are at risk, those who use continence products without a formal assessment, and those whose disability affects their ability to manage continence independently.

Can continence products be funded through the NDIS?

Yes. Continence consumables can be funded under the NDIS Consumables budget, provided they are included in the participant’s plan. A continence assessment report is often required to support the inclusion of consumable funding at planning meetings.

What is neurogenic bladder and can the NDIS fund support for it?

Neurogenic bladder refers to bladder dysfunction caused by damage or disease affecting the nervous system, common in people with spinal cord injury, multiple sclerosis, Parkinson’s disease, or acquired brain injury. The NDIS can fund both the assessment of neurogenic bladder dysfunction and ongoing management supports, including catheterisation and specialist nursing.

How long does a continence assessment take?

A comprehensive continence assessment typically takes between 60 and 90 minutes, including history-taking, clinical assessment, and discussion of the management plan. Follow-up appointments may be shorter, focusing on progress review and plan adjustment.

Can I request a continence assessment even if my current plan doesn’t mention it?

If your plan includes funding that could reasonably cover a continence assessment, such as Improved Health and Wellbeing capacity building or nursing support, it may be possible to access an assessment within your current plan. If not, your support coordinator can help you request a plan variation or include it at your next plan review.

Will my family or carer be involved in the continence assessment?

With the participant’s consent, yes. Family members or informal carers can be involved in the assessment process, particularly where they assist with continence management. Their observations and input can be valuable to the assessment.

What is the difference between a continence assessment and a bladder scan?

A bladder scan (post-void residual measurement) is one component of a comprehensive continence assessment, it measures residual urine in the bladder after voiding. A continence assessment is the broader clinical process that incorporates the bladder scan along with history, diary analysis, functional assessment, and management planning.

Conclusion

A comprehensive continence assessment is the foundation of effective continence management, and for NDIS participants in Brisbane with bladder or bowel difficulties, it can open the door to meaningful improvements in health, dignity, and daily independence.

Our team includes registered nurses with specialist continence expertise who provide assessments and ongoing management support for NDIS participants across Brisbane. Get in touch to learn more.