Services A to Z

There may be an underlying condition that causes this resistance, or they may not understand that care is required.

Think

• Does they understand the care required?
• Do they recognise the toilet and remember how to use it?
• How might they interpret the assistance being offered?
• Is there an underlying condition causing this (e.g. pain, embarrassment, etc.)?
• What can you do to avoid the distress this causes?
• Can you implement a plan that takes a positive approach to communicating with and supporting this individual?

Do

• Try to find ways to promote independence in using the toilet, e.g. environment, signage, toileting programmes, prompting etc.
• Don’t talk to other’s on route
• Use mobility aid if needed
• Good visual aids – no clutter
• Good lighting, clean, warm toilet/bathroom
• Mirror may need covered/removed or any reflective stimuli
• Try not to cause embarrassment and ensure privacy
• Try distraction techniques
• Never force things, go away and come back later trying a different method of explaining, or ask a colleague to take over.

This could indicate a prostate problem (in a man) or a neurological condition that results in incomplete bladder emptying.
This symptom should be considered in relation to other symptoms (i.e. a sensation of incomplete bladder emptying,
etc). It could also be related to inadequate oral fluid intake.

Start a timed toileting regime (see SPHERE information leaflet: Voiding Programmes).

Encourage them to practice double voiding (see SPHERE information leaflet Successful Bladder Emptying).

Keep a bowel chart and resolve constipation if present (see SPHERE information leaflet: Constipation and Laxatives).

Discuss with the medical staff for potential further investigation of prostate.

A post-void bladder scan should be carried out.

Record fluid intake and output over a 24-hour period using a bladder diary and do this for 3 days in a row if possible.

This symptom may indicate an underlying health problem that requires attention and should be considered in relation to other
symptoms, e.g. urgency, urge incontinence, symptoms of UTI etc. Medical intervention may be required.

Could they be drinking an excessive amount of fluids, i.e. more than 2,500mls (see SPHERE information leaflet: Impact of Fluids on Bladder).

They may be reacting to a high intake of caffeine (caffeine should be reduced gradually to avoid caffeine withdrawal headaches). Caffeine is found in coffee, tea, some fizzy drinks such as Cola and Irn Bru and high energy drinks. (See SPHERE information leaflet: Impact of Fluids on the Bladder).

Are they constipated? Encourage the individual to practice double voiding (see SPHERE information leaflet: Successful
Bladder Emptying).

Do they have any pain or discomfort passing urine. If so, routine checking of urine sample
should be done to rule out urinary tract infections.

This symptom may indicate an underlying health problem that requires medical attention.

See SPHERE information leaflet Types of Incontinence: Nocturia.

Find out when they take their last drink of fluids before sleeping and what type of fluids they are taking.

Do they have any problems with lower limb oedema during the day?

This symptom may indicate an underlying health problem that requires medical attention.

Could they be constipated? Constipated faeces can put pressure on the bladder and cause symptoms of frequency and urgency, but it can also cause low urine output during the day, followed by passing large volumes of urine at night, when the pressure on the bladder is released by lying down.

Do they have lower limb oedema? Large amounts of urine passed during the night might be in response to fluid being reabsorbed from the skin when lying down.

Are they drinking large volumes of fluid (especially caffeine-containing drinks) later in the day?

Individuals vary widely in the frequency with which they empty their bowels and any change to the normal routine and/or eating patterns will have an impact. However, most people have their move their bowels at least 3 times per week.

Healthy bowel elimination is characterised by regular bowel movements (every 1-2 days), a soft, formed stool that is easy to pass (no straining). If their bowels move less than 3 times per week and have difficulty passing a hard stool, this is likely to be due to constipation. An increase in fibre, fluid, activity or laxatives may be required to achieve healthy bowel elimination. (see SPHERE Information leaflets: Constipation and Laxatives; Gastro-Colic Reflex; Medication Impact on the Bowel)

Pain and discomfort is not normal and should be investigated. It may indicate an underlying pathology, such as haemorrhoids or constipation (or both) or other underlying bowel disease.

Establish a regular bowel pattern, which might improve symptoms. Aim for a daily bowel movement, type 4 or 5 on the Bristol Stool Scale. See SPHERE Information leaflets: Gastro-Colic Reflex; Constipation and Laxatives
See NICE Guideline on Colorectal Cancer

Indicates constipation and/or an underlying problem. Keep in mind that people with acute or chronic health conditions may have difficulty in achieving abdominal pressure that facilitates full bowel emptying.

Straining must always be discouraged. If an individual is unable to have a bowel movement without straining this should be investigated (even if it is normal for them). Establish a regular bowel pattern, which might improve symptoms. Aim for a daily bowel movement, type 4 or 5 on the Bristol Stool Scale. See SPHERE Information leaflets: Gastro-Colic Reflex; Constipation and Laxatives; Bowel Incontinence and NICE Guideline on Colorectal Cancer.

Bleeding during a bowel movement is not normal.

This may indicate haemorrhoids or another underlying medical condition and should be discussed with GP/medical staff. See information leaflets and guidelines above.

Bowel movements should be soft and formed -refer to the Bristol Stool Scale for assistance in differentiating between a healthy and unhealthy stool.

See SPHERE Information leaflets: Gastro-Colic Reflex; Constipation and Laxatives; Medication Impact on the Bowel, Types of Incontinence: Bowel Incontinence

Can impact on bladder emptying and can cause symptoms of frequency and urgency and can contribute to nocturnal urinary
frequency and/or incontinence and urinary retention. Keep in mind what the person’s normal bowel pattern is and try to encourage a regular daily bowel movement utilising what you know about the gastro-colic reflex. Aim for a daily type 4 on the Bristol Stool Scale. Remember that a change of routine, different food etc. can adversely impact on the regularity of bowel movements. Check that they are taking adequate fluid intake and passing urine regularly during the day and if not a post void bladder scan should be carried out.

To prevent further risk to the skin they will require a care plan that addresses this issue. Urine and faeces can be very damaging to the skin, so it is essential that a toileting regime is put into place to minimise contact with the skin by urine and/or faeces. See Voiding Programmes and Gastro-colic Reflex.

Can cause symptoms of urgency and frequency. Make sure the urine is dipstick tested and if the patient shows signs of UTI initiate treatment: antibiotics if prescribed; encourage fluids; avoid faecal incontinence and make sure if faecal incontinence occurs, that the perineal and anal area is washed from front to back to avoid contamination of the urethral orifice with faecal matter

Is caused by a lack of oestrogen and occurs in women after the menopause. It can lead to symptoms of frequency and urgency and stress incontinence. This condition can be treated with topical oestrogen in the form of a cream or small pessaries which are inserted into the vaginal area. This treatment it can settle the symptoms of urinary frequency and urgency when other treatment options have not helped.

Can lead to urinary frequency, urgency and urge incontinence because of the presence of glucose in the urine, which can irritate the bladder wall. Longstanding diabetes can also lead to damage of the nerves supplying the bladder and/or bowel
and affect ability to pass urine/open bowels. If a patient has symptoms of urinary frequency and urgency, dipstick urinalysis will highlight any abnormalities that can be reported to the GP/medical staff for a review of their condition by Diabetes Specialist Nurse. Keep in mind that there are medications used to treat diabetes that will excrete glucose in the urine, please check with GP/medical staff.

As men age their prostate can increase in size and in some cases lead to voiding problems. Symptoms include urinary frequency, hesitancy (difficulty in passing urine), nocturia and a sense of incomplete emptying. Some men also experience post-void dribbling incontinence. Constipation will add to the discomfort

Make sure you ask about all symptoms and report to medical staff if you suspect a male patient has symptoms of enlarged prostate, complete an IPSS score sheet (see Hints and Tips section of SPHERE website). There are medical treatments available, but some useful tips to pass on can be found in the following SPHERE Information leaflets: – Impact of Fluids on the Bladder, Medications for Bladder Dysfunction, Successful Bladder Emptying, Urge Control Techniques. Double voiding and penile milking – see SPHERE Self Management Booklet for Men.

The list below shows which services are available for our different hospital sites. The services are fully confidential and can assist with a wide range of issues including social security benefits, charitable support and grants, debts and various other elements of financial wellbeing.

Beatson West of Scotland Cancer Centre – Working 4U West Dunbartonshire

Email: Beatson.MoneyAdviceService@ggc.scot.nhs.uk

Glasgow Royal Infirmary – GEMAP Money Advice Service

Email: ggc.moneyadvice@ggc.scot.nhs.uk

Gartnavel General Hospital – Citizens Advice Hospital Partnership Service

Email: SafeAndWarmDCAB@DrumchapelCAB.casonline.org.uk

Glasgow Royal Infirmary – Homeless Hospital Outreach Service

Email: ci.homeless.outreach@nhs.scot

Inverclyde Royal Hospital – Inverclyde Advice First

Email: triage.advice@inverclyde.gov.uk

New Stobhill Hospital – Citizens Advice Hospital Partnership Service

Email: ggc.moneyadvice@ggc.scot.nhs.uk

New Stobhill Hospital – Homeless Hospital Outreach Service

Email: ci.homeless.outreach@nhs.scot

New Victoria Hospital – Citizens Advice Hospital Partnership Service

Email: ggc.moneyadvice@ggc.scot.nhs.uk

Queen Elizabeth University Hospital – GEMAP Money Advice Service

Email: ggc.moneyadvice@ggc.scot.nhs.uk

Queen Elizabeth University Hospital – Homeless Hospital Outreach Service

Email: ci.homeless.outreach@nhs.scot

Royal Alexandra Hospital – Renfrewshire Advice Works

Email: adviceworks@renfrewshire.gov.uk

Royal Hospital for Children

Email: RHC.MoneyAdviceService@ggc.scot.nhs.uk

Vale of Leven District General Hospital – Citizens Advice Partnership

Email: ggc.moneyadvice@nhs.scot

Working Age Patients (18-67) from GGC Hospitals who wish to contact the Department of Work and Pensions (DWP) now have the option of direct access to advice and support. This will enable immediate access to an Advisor, without waiting in the call queue for the national helpline. It will also enable much quicker resolutions for clients.

The helpline can be used to discuss benefits, appointments, appointees or any other DWP related enquiries.

Please note the Helpline Advisors are unable to take new benefit claims and cannot answer queries on Personal Independent Payment or any Scottish Government Benefits. Please contact staff from the DWP between the hours: 10.00am and 2.00pm Monday to Friday

On any of the following numbers:

Jacky Kean: 07920812160

Laura Ferguson: 07388852348

Gordon Wallace: 07788708753

People diagnosed with a new health condition, or parents with a child who needs to attend hospital as an inpatient or outpatient, may be newly entitled to certain benefits.

At present the benefits system in Scotland is administered by both the Department of Work and Pensions and Social Security Scotland.

NHSGGC have a partnership with Social Security Scotland to support patients in New Stobhill and the Queen Elizabeth University Hospitals. The service can assist with applications for Adult Disability Payment, or any benefits administered by Social Security Scotland. For more information, please contact the hospital Support and Information Services.

Information on Child Disability Payment, Scottish Child Payment and Best Start Grant and Foods and a range of carer’s benefits can be found on the Social Security Scotland website: SSS – Benefits.

Help with hospital travel costs

Help with travel and subsistence costs for visiting a young person in hospital: Young Patients Family Fund – mygov.scot

1. The Hospital Travel Costs scheme is for hospital only appointments and is for people with a low income or on certain benefits including Universal Credit. There are criteria for the type of transport reimbursed. The claimant must pay first then can get a refund from the cash office in the hospital. For more information on hospital transport, travel and parking, please visit: Transport, Travel and Parking – Information for Patients and Visitors – NHSGGC.
2. Young Patients Family Fund covers travel and subsistence costs for those who have family members who are in-patients in hospitals.
3. Patient Transport Service for patients who have a medical condition or mobility need that requires ambulance transport to get to their healthcare appointment. The service is available to take patients to and from pre-arranged hospital appointments, or for admission and discharge to hospital.
4. There is a National Entitlement Card for people with disabilities who are entitled to have a companion travel with them on the same journey. Companion travel is charged at a reduced rate. To apply call SPT on 0141 333 3211 or Concessions | SPT | Strathclyde Partnership for Transport.
5. The MyBus scheme provides a drop off and pick up service for those accessing health appointments – MyBus | SPT | Strathclyde Partnership for Transport. Please note that there is currently a reduced and restricted service.
6. There is the National Young Persons’ Free Bus Travel scheme, support may be required to access this, it’s for all children and young people aged 5-22 in Scotland.
   
   For children aged 5-10 years application can be made at parentsportal
   For applications aged 11-21 years applications can be made at getyournec.scot
   Libraries can help with the application and verification of evidence, they can also advise on those already with/eligible for a Young Scot card. There is support available through schools also.