Diaper use is common in nursing homes, especially among elderly residents with certain medical conditions or mobility issues. At NTUC Health Nursing Home (Jurong West), Nurse Manager Teo Ai Lian and Senior Nurse Clinician Pang Lingxia noticed that many residents were on diapers. They had a fear of urinary leakage and were not confident that they could reach the toilets in time.
Both Ai Lian and Lingxia were concerned about residents who were on prolonged use of diapers. These residents were at risk of bed sores, urinary tract infections and other diaper related skin conditions. Residents may not feel comfortable wearing diapers all the time, due to the warm and humid weather in Singapore. As such, they embarked on a journey to help NTUC Health Nursing Home residents wean off diapers.
“We wanted to help residents restore their normal bladder function so that they can manage their continence, regain their dignity and enjoy a better quality of life,” shared Lingxia. In April 2018, the team piloted a “NTUC Health Continence Management Programme” for 41 residents who were identified with the potential to wean off diapers. Using a multidisciplinary approach involving nurses, a doctor and allied health professionals, the team adjusted the residents’ diet, exercise routine, medication, and monitored each resident’s toileting habits, and encouraged residents to try going without diapers.
The team also designed a tracking sheet to chart the residents’ progress and keep them motivated. Nurse champions in the wards used the tracking sheet to help residents plan their schedules around two-hourly toilet breaks, and had regular one-on one engagements to offer residents their support, encouragement and reassurance.
The team also organised “graduation” ceremonies for residents who managed to wean themselves off diapers, and gifted them with tokens to purchase items at the Home’s “provision shop”. Some residents in the pilot programme were so pleased with their success that they became continence ambassadors, sharing their success stories and encouraging other residents to get on board. The programme officially took off in July 2018 and has seen 37 successful cases to date. The team has gone on to share their experience with other nursing homes.
Continence Management Team
NTUC Health Nursing Home
Recipient of the Singapore Health Quality Service Awards (SHQSA) 2020 Best Team Award - Clinical Practice Improvement Category (Intermediate and Long-Term Care)