education series: reference guide to incontinence
DESCRIPTION
A great resource for nurses, case managers and caregivers on the types of incontience, how to have open conversations about the issue and the best products to use.TRANSCRIPT
Educational
Seminar
INCONTINENCE
Quick Reference
Guide
Presented by
SURFMED &
CARING HOME CARE
Experts in LTC Services
BETTER OUTCOMES
The focus is always on Better Outcomes
Increasing Patient Satisfaction
Save Insurers Money
Cost Containment Measures
Save Case Manager Time
Incontinence is a BIG DEAL
40 million Americans are 65 or older and 3.65 million
more turn 65 each year.
Currently, over 25 million people in North America
experience incontinence. Rates of incontinence
increase above age 65.
Many will eventually require long-term care (LTC) or
home healthcare (HHC), and the majority of people in
LTC are incontinent.
In Florida over 100,000 people are in Long Term Care
and most need help managing incontinence.
Your knowledge of this subject will have a profound
impact on their lives
.
Incontinence Types There are six basic types of Urinary incontinence:
Stress Incontinence: an involuntary loss of small amounts of urine during a cough, laugh, lift or exercise. It can be caused by multiple
vaginal births, enlarged prostate, loss of pelvic muscle tone.
Urge Incontinence: inability to control urinating once one feels the need to void. They may feel the need to urinate but cannot wait to
get to the bathroom. It can be caused by Alzheimer's, Parkinsonism,
enlarged prostate, spinal cord injuries or urinary tract infections.
Reflex Incontinence: This is frequent loss of urine with no warning. This is due to spinal cord injuries, brain tumors or strokes.
Overflow Incontinence: Leakage when the bladder is full. i.e dribbling, frequency, urgency and bladder distention. It is most
commonly caused by diseases that cause a U tract blockage.
Functional Incontinence: incontinence caused by factors outside the urinary tract, such as immobility or cognitive impairment. These
individuals would be continent if there were no external factors.
Mixed Incontinence: a combination of forms of incontinence, such as "mixed stress urge incontinence.“
Voiding Fecal incontinence happens when you are unable
to control bowel movements or gas and includes liquid and/or solid stool. Fecal incontinence can
vary by degree, from only a small amount of liquid
waste to entire solid bowel movements. It can be
caused by neurological diseases, musculoskeletal
disorders, or injuries to the pelvis.
Talking Incontinence -TIPS Incontinence is an extremely personal issue. Speak with
Sensitivity - Openness - Responsiveness
Remember that it's normal for patients to feel uncomfortable
discussing something as private as incontinence. Urinary incontinence
is a challenging exchange, but here are some tips to get it started:
Take an empathetic approach. If the person becomes defensive, remember that they may feel embarrassed – if they are angry it is
due to the problem, not to you.
Take a team approach and make it clear that you want to work together to find a solution; reinforce that they are not the only
person with these symptoms and help you begin the conversation.
Encouraging them talk about severity, the symptoms, changes
over time, and impact on daily activities.
Assure them that there are multiple products that can help them, if and only if they are clear with you about their situation.
The correct product can help them continue to lead a more
comfortable and healthy life.
What difference a product
makes…. Selecting the improper product can have serious consequences - :
Leakage and embarrassment can be the result of improper fit. The right fit goes a long way to ensure containment and increase personal self-confidence.
Skin breakdown can occur due to urine wetness against your skin. Products should quickly capture voids and lock them in the product core to keep skin healthier.
Odors can occur when urine is held against your skin. Quality products feature specially treated fibers to change the chemistry of urine to reduce growth of odor-causing bacteria.
Selecting a proper product can prevent serious complications.
Pads, Guards and Liners
These are the least intrusive
incontinence products but also the least
absorbent.
Products are often used in combination
with other products.
They come different sizes to
accommodate different body types.
Protective Underwear, AKA Pull-Ons or Pull Ups
Higher levels of absorbency from regular
to heavy.
After pads, these are the most discreet
option and the overwhelming favorite
among adult ambulatory incontinence
users.
Briefs – AKA Diapers
Two basic backings – cloth like or plastic vinyl
like backing, with single or multiple tape tabs.
The absorbent polymer packed padding
down the center is what does the work.
From Moderate to Severe absorbency – the
primary choice for sedentary users.
All sizes available from pediatric to bariatric
Underpads-
Underpads are an insurance policy, filling
in when a diaper, for example during a
change, fails to offer full coverage.
Under pads or liners are some times used
to add extra absorbency when needed.
For example night time use.
REUSABLE PADS
How Does One Judge Quality?
Size and Weight – Bariatric
Acquisition Speed
Rewet
Capacity
Leakage Prevention
Remember Bundling
Smart Ordering Assures Delivery and Reduces Costs
Save Case Manager’s Time
A Resource to your Case Managers
Easy Access Catalogue
Web Based Order Processing
24 Hour Order and Tracking
Continuity Concerns
Transitioning Medicaid Waiver Patients
and Diversion clients have some
limitation regarding LTC supply selection.
Verify items against the new fee schedule.
.
CODES & MODIFIERS
When choosing an item, reference the
code schedule, as many codes are
similar.
Modifiers are essential as they help
identify a specific size or description.
Learn from Our Experience in Early Roll Out Regions
T5999 T5999 Miscellaneous Code usage
can only be for specific purposes.
Do not abuse.
MUST be approved by supervisor.
PROCESSORS
CMs have limited interaction with
CSRs. Processor Interaction is
important. Assure you can be
reached.
Learn from Our Experience in Early Roll-Out Regions
Must Include in Authorizations Client Name
Address / Phone
Emergency Contact Phone
MEDICAID IDENTIFICATION NUMBER
Case Manager Name
Region /Phone / Email
Processor - Name
Phone /Email
Product
Description Code
Frequency
MODIFIERS
Customer Service Tips
Complete addresses (apartment #s/trailer #s/ efficiencies/rear units) - Little detail = delayed orders.
Special delivery needs (blind, deaf, bed ridden) – we need to know if items need hand delivery.
Know your products and sizes– help the client chose by giving patient advice (pull-up verses briefs).
Specify a Flavor – We send vanilla nutrition unless specifically ordered.
Patient Condition –(Inform CSRs about bariatric, complicated cases, ambulatory verses bed bound, etc.) – this helps understand your client.
Mobility – (walker/wheelchair/crutches)
Bundling Bundling Bundling
To assure speedy delivery, we suggest
Our Services Medicaid Patient Transition
Sample Program
Guaranteed Next Day Delivery
Hand Delivery available
Coding Assistance
Trained Customer Service Staff
Experts in complicated cases
Designated Customer Service Representative
Trained, bilingual delivery technicians
Wheelchair Rehab
SURFMEDPRO , an on-line resource for product information and pricing.
(888) 201-7873
FAX 305 865 6255
Customer Service Supervisor:
Lizane Lopez ext. 4511 [email protected]
Director of LTC Operations:
Georgeanne Calleiro ext. 4510 [email protected]
Executive Vice President of Operations:
Rudy Hernandez , ext. 4545 [email protected]
CONTACTS