Physiotherapist Stephanie Boadle intended to return to Melbourne after a four-month rotation in Alice Springs in September 2017, but she loved it so much she has decided to stay.
Working at the major hospital in Alice Springs is a unique experience with obstacles Stephanie didn’t face as a new graduate back in Melbourne.
“Being so remote, there are many challenges that we’re forced to grapple with in Alice Springs that aren’t normally an issue in the city - getting follow-up for our clients in remote communities, getting necessary equipment delivered on time and so on, but it keeps work interesting and there’s never a dull day,” said Stephanie.
Stephanie was one of 10 recipients of the 2018 National Conference on Incontinence Rural and Remote Scholarships. She’s seen the impact of incontinence and is passionate about continuing to help people in this area.
“While a dialogue around continence is improving in Australia, it has historically been a topic that has been surrounded with quite a lot of social stigma and shame.”
“The impact of incontinence on independence and social engagement can be really significant and I think a lot of women who experience incontinence feel deeply isolated at times,” she said.
As the top scholarship winner, Stephanie undertook an observation day at Royal Hobart Hospital in October. Her time at the Women’s Health Services in Hobart sparked lots of inspiration to take back to Alice Springs.
She hopes to use these ideas to develop a physiotherapy service for Women’s Health at Alice Springs Hospital. Stephanie strongly believes in the benefits that such a service could have for the Central Desert region.
“Being able to provide education and exercise programs for women can enable them to reinstate their confidence and can drastically improve their quality of life,” said Stephanie.
Overcoming the distance
People living in rural and remote areas of Australia often need to travel long distances or relocate to attend health services or receive specialised treatment. This creates ongoing challenges for Aussies living in the bush as well as health professionals working in the field of continence care. But it has also produced some innovative solutions.
In 2017, Dr Kate Gray started the first Mobile Incontinence and Urodynamics Assessment Clinic, run by a urologist, in Queensland. The clinic removes the geographical barriers to care for people living outside south-eastern Queensland.
Before the mobile clinic, Dr Gray had found that encouraging people to come for an assessment was difficult enough due to embarrassment and myths about incontinence. The challenge increased even more with the distance factor, which meant that patients were forced to take time from work, family and other commitments to travel.
Bathurst-based continence nurse practitioner Louise Linke, who works in remote and rural New South Wales, said poorer access to health professionals and services meant greater difficulties for carers.
“In rural areas there is a lack of specialised continence services, GPs and allied health workers to help manage people with incontinence. This often means these people can miss out on a continence assessment and management strategies that can help improve their incontinence and quality of life.”
“Simple steps such as managing constipation, reviewing medications and monitoring fluid intake can often help. Just ‘padding up’ is not the only solution to managing incontinence,” Ms Linke said.
Developments in technology now mean virtual and telehealth consultations are possible from anywhere with an Internet connection.
A 2016 study of women with incontinence conducted in rural West Australia found that telehealth may be an effective solution to the lack of health professionals in rural areas. The research found that benefits of telehealth include lower costs, such as travel and accommodation, less inconvenience in time spent getting to appointments as well as earlier assessment and treatment.
Whilst video-conferencing consultations are now being conducted by health professionals via SKYPE, Facetime and other phone and Internet apps, private health insurers and the Medicare Benefits Schedule do not currently provide a rebate for these services.
The free National Continence Helpline on 1800 33 00 66 is available anywhere in Australia, for confidential advice, resources and referrals to local services in your area.