Fear and overprotection in Australian residential aged care facilities: the inadvertent impact of regulation on quality continence care

Aim: Most residents in residential aged care facilities are incontinent. This study explored how continence care was provided in residential aged care facilities, and describes a subset of data about staffs' beliefs and experiences of the quality framework and the funding model on residents' continence care. Methods: Using grounded theory methodology, 18 residential aged care staff members were interviewed and 88 hours of field observations conducted in two facilities. Data were analysed using a combination of inductive and deductive analytic procedures. Results: Staffs' beliefs and experiences about the requirements of the quality framework and the funding model fostered a climate of fear and risk adversity that had multiple unintended effects on residents' continence care, incentivising dependence on continence management, and equating effective continence care with effective pad use. Conclusion: There is a need to rethink the quality of continence care and its measurement in Australian residential aged care facilities.