Key Points

  • NDIS funds continence products (pads, catheters, leg bags, bowel care items) through the Consumables budget at actual product cost; there is no fixed quantity limit but products must be reasonable and necessary
  • The Continence Aids Payment Scheme (CAPS) is a separate Australian Government program that eligible people can access in addition to NDIS; contact the National Continence Helpline on 1800 33 00 66 to assess eligibility
  • A continence nurse assessment is the recommended starting point: it determines the type and cause of incontinence, recommends appropriate products, and produces a delegated care plan for support workers
  • Support workers can change products, assist with toileting, and monitor skin integrity, but catheter changes and clinical assessments require a registered nurse under a delegated care arrangement
  • Clinical escalation triggers include signs of urinary tract infection, catheter blockage, skin breakdown, and signs of bowel obstruction; any of these require nurse or GP assessment, not a wait-and-see approach
  • Pelvic floor physiotherapy is an evidence-based treatment for urinary incontinence that can be funded through NDIS or Medicare’s Chronic Disease Management plan

Understanding Incontinence in a Home Care Context

Incontinence affects an estimated five million Australians, yet it is consistently underreported and undertreated. Many people living at home with disability or chronic illness experience urinary incontinence, bowel incontinence, or both, and receive either no formal continence management or an approach that does not match the underlying cause.

Effective incontinence care at home is not just about having adequate supplies. It requires understanding what type of incontinence is present and why, selecting the right products and management approach for that cause, having support workers who know what they can do and when to escalate, and having a continence nurse or GP managing the clinical picture.

This guide covers the provider landscape, NDIS and CAPS funding, support worker scope and limits, and the clinical escalation triggers that should not be missed.

Types of Incontinence: Why the Cause Matters

The type of incontinence determines which providers are relevant and what management approaches are appropriate.

Urinary incontinence is loss of bladder control and falls into several subtypes:

  • Stress incontinence: Leakage triggered by coughing, sneezing, laughing, or physical activity. Caused by weakened pelvic floor muscles or sphincter dysfunction. First-line treatment is pelvic floor physiotherapy.
  • Urge incontinence: Strong, sudden urge to urinate followed by involuntary leakage before reaching the toilet. Caused by overactive bladder. Managed through bladder training, pelvic floor training, medication, and timed toileting schedules.
  • Overflow incontinence: Bladder does not fully empty, leading to constant dribbling. Often caused by neurological impairment or obstruction. May require catheterisation.
  • Functional incontinence: Person cannot reach the toilet in time due to mobility limitations, cognitive impairment, or environmental barriers rather than bladder dysfunction. Managed through environmental modifications and toileting assistance schedules.

Bowel (faecal) incontinence is loss of control over bowel movements. Causes include neurological damage, weak sphincter muscles, chronic constipation leading to overflow, or diarrhoea. Management includes dietary intervention, bowel training programs, specialist products, and in complex cases, specialist referral.

Mixed incontinence involves both urinary and bowel components and requires a coordinated assessment addressing both.

A continence nurse assessment is the starting point for any new or changed continence presentation. Without knowing the type and cause, product selection and management planning are guesswork.

The Provider Team for Incontinence at Home

Continence Nurse

The continence nurse is the central clinical provider for incontinence management at home. This is a registered nurse who holds post-graduate qualifications in continence care, ideally with membership in the Continence Nurses Society of Australia.

What a continence nurse does:

  • Comprehensive bladder and bowel assessment: history, symptom pattern, fluid intake, medications affecting continence, prior treatment
  • Physical assessment where clinically indicated
  • Diagnosis of incontinence type and contributing factors
  • Development of an individualised continence management plan
  • Product prescription: selecting the right type, size, and absorbency level for the person’s specific needs; prescribing catheter type and size where relevant
  • Product fitting and education: showing the person and their support workers how to use products correctly
  • Delegated care plan for support workers: specifying exactly what tasks support workers are authorised to do, what to monitor, and when to escalate
  • Review and adjustment: monitoring response to management plan and adapting it as needed

NDIS funds continence nursing assessments under Improved Daily Living (Category 15, code 15_051_0114_1_3) and ongoing nursing support under Core Supports (Category 1) at clinical nurse rates ($204.12 to $306.18 per hour for weekdays and weekends, 2025-26 rates).

General Practitioner

The GP’s role in continence management includes:

  • Initial medical assessment to exclude treatable causes (infection, medication side effects, pelvic organ prolapse, enlarged prostate)
  • Referral to specialist (urologist, colorectal surgeon, gynaecologist) when conservative management is insufficient
  • Medication prescription where appropriate (anticholinergics for overactive bladder, laxatives for chronic constipation)
  • Coordination with continence nurse and physiotherapist
  • Medicare-funded access to allied health visits under the Chronic Disease Management plan

Pelvic Floor Physiotherapist

A pelvic floor physiotherapist is the evidence-based provider for stress and urge urinary incontinence and some types of bowel incontinence. Their intervention includes:

  • Detailed pelvic floor muscle assessment, often using biofeedback equipment
  • Individualised pelvic floor exercise program targeting both muscle strengthening (for stress incontinence) and relaxation and coordination (for urge incontinence)
  • Bladder training programs for urge incontinence
  • Bowel training for faecal urgency and constipation

For NDIS participants, pelvic floor physiotherapy can be funded under Improved Health and Wellbeing (Category 18) where the continence problem is directly related to the participant’s disability. Five visits per year are also available under Medicare’s Chronic Disease Management plan.

Occupational Therapist

The OT addresses the environmental and equipment factors that contribute to functional incontinence and unsafe toileting:

  • Assessment of the bathroom and toilet setup
  • Recommendation of raised toilet seats, commode chairs, grab rails, and non-slip surfaces
  • Assessment of the path between the bedroom and bathroom for trip hazards and lighting
  • Bedside commode recommendation for overnight use when mobility limits timely access to the bathroom
  • Home modification report for NDIS Capital funding if structural changes are needed

See our guide on NDIS home modifications for detail on the modification funding process.

Support Workers

Support workers are the most consistently present person in a participant’s daily continence management. Their scope is clearly bounded.

What support workers can do:

  • Change incontinence pads, pull-ups, and briefs
  • Assist with toileting: transfers to and from the toilet, positioning, clothing assistance
  • Empty and clean leg bags for catheter users (not catheter changes)
  • Apply barrier cream and perform perineal skin care as directed in the care plan
  • Monitor and record bowel and bladder patterns
  • Observe skin integrity and report changes to the clinical team
  • Follow a timed toileting schedule as set by the continence nurse

What support workers cannot do:

  • Insert, change, or remove catheters
  • Perform digital rectal examination or manual bowel evacuation (unless specifically trained and authorised in a written delegated care plan from a registered nurse)
  • Diagnose or assess complications (UTI, skin breakdown severity, catheter blockage cause)
  • Modify the continence management plan or product selection independently

If a support worker is asked to perform a task beyond this scope without a written delegated care plan from a registered nurse, they should decline and request that clinical oversight be arranged.

NDIS Consumables Funding: What Is Funded and How

Continence products are funded through the NDIS Consumables budget (Category 3, Support Purpose: Consumables). Products are claimed at their actual cost, not a set price per unit.

Product TypeNDIS CodeNotes
Disposable pads, pull-ups, briefs03_093021079_0103_1_1Full range of absorbencies and sizes
Catheters and sheaths03_092400080_0103_1_1Intermittent and indwelling catheters
Leg bags and drain bags03_092700081_0103_1_1For catheter users
Urinary collection accessories03_092700083_0103_1_1Connectors, straps, accessories
Bowel care products03_091800084_0103_1_1Enema kits, suppositories, irrigation systems
Incontinence alarms03_050903053_0103_1_1Moisture-sensing bed alarms
Skin care productsConsumablesBarrier creams and perineal cleansers

Products must be recommended as reasonable and necessary. A continence nurse assessment that identifies the specific products needed is the most straightforward way to establish this. Without a clinical recommendation, the NDIA may query product claims.

There is no hard quantity cap, but claims should reflect actual use. Plan managers or self-managing participants claim the actual product invoice amount under the relevant code.

The Continence Aids Payment Scheme (CAPS)

CAPS is an Australian Government scheme separate from the NDIS. It provides an annual payment toward the cost of continence products for eligible Australians with permanent and severe incontinence. NDIS participants can access CAPS in addition to NDIS consumables funding for the same person, provided the same product cost is not claimed from both programs in the same period.

To check CAPS eligibility, contact the National Continence Helpline: 1800 33 00 66 (free call). CAPS eligibility is assessed by a healthcare professional and the application is submitted to the Department of Health.

Clinical Escalation: When Support Workers Must Act

Support workers and family carers managing incontinence at home need to know the signs that require immediate clinical attention. These are not situations to monitor further or manage with product changes; they require nurse or GP assessment.

Urinary Tract Infection (UTI)

UTIs are the most common complication for people with indwelling catheters and are also common in people with urinary incontinence generally.

Escalate immediately if you observe:

  • Urine that is cloudy, dark, or has an unusual odour beyond the person’s baseline
  • Visible blood in urine (haematuria)
  • The person reporting pain, burning, or discomfort in the bladder or urethral area
  • Fever or feeling hot and cold
  • Sudden increase in confusion or agitation in an older person or person with cognitive impairment (these can be the primary signs of UTI in this population without the typical urinary symptoms)

Catheter Complications

For participants with indwelling catheters, escalate if:

  • The catheter is not draining or draining significantly less than usual (possible blockage)
  • There is bypassing: urine leaking around the catheter rather than through it
  • The person reports pain at the catheter site or in the abdomen
  • The catheter has come out or appears displaced
  • There is blood in the urine that was not present before

Do not attempt to flush or reinsert a catheter. Call the community nurse or GP.

Skin Breakdown

Incontinence-associated dermatitis (IAD) and pressure injuries in the perineal area are serious complications of incontinence.

Escalate if you observe:

  • Persistent redness that does not resolve with repositioning and barrier cream application
  • Open areas, blistering, or broken skin in the perineal, sacral, or buttock area
  • Signs of skin infection: warmth, swelling, increasing redness, or discharge

Stage 3 or Stage 4 pressure injuries require specialist wound management, not standard community support worker care.

Bowel Obstruction

Constipation that escalates to bowel obstruction is a medical emergency in participants with neurogenic bowel (spinal cord injury, multiple sclerosis) or those on opioid medications.

Escalate if the person has not had a bowel movement for three or more days and has:

  • Abdominal distension (stomach visibly bloated and hard)
  • Nausea or vomiting
  • Abdominal pain
  • No passing of wind

Call the GP or community nurse immediately. Do not administer laxatives or perform any bowel intervention without a clinical instruction.

Home Modifications for Continence Safety

An OT assessment of the bathroom and bedroom identifies modifications that reduce the risk of accidents, falls during urgency, and unsafe transfers.

Priority modifications for continence:

  • Raised toilet seat: Reduces the effort and time needed to sit and stand, critical for people with limited lower limb strength or hip flexibility
  • Grab rails beside toilet: Supports safe transfers and reduces fall risk when urgency is present
  • Commode chair beside the bed: For overnight use when walking to the bathroom is too slow or risky; also useful during recovery from illness
  • Non-slip flooring in bathroom: Wet environments plus rushed movement during urgency create high fall risk
  • Adequate lighting on the bathroom path: Night navigation to the toilet is a common fall trigger; motion-sensor lighting reduces this risk
  • Clear pathway from bedroom to bathroom: Removing trip hazards, low furniture, or loose rugs on the path taken during urgent toilet trips

For structural modifications (widening a doorway for a commode, installing a wet room shower), the OT produces a home modification report that is required before NDIS Capital funding is approved.

Frequently Asked Questions

Does NDIS fund continence products?

Yes. Disposable pads, catheters, leg bags, and bowel care products are funded under the Consumables budget at actual product cost. A continence nurse assessment is recommended to establish reasonable and necessary justification.

What is the CAPS program and how does it relate to NDIS?

CAPS is a separate Australian Government annual payment for eligible Australians with permanent and severe incontinence. NDIS participants can access both CAPS and NDIS consumables, provided the same product is not double-claimed. Call 1800 33 00 66 to check eligibility.

What does a continence nurse do?

Conducts comprehensive assessment of incontinence type and cause, prescribes products, creates delegated care plans for support workers, and monitors for complications. Their assessment is the clinical foundation for NDIS consumables claims and support worker instructions.

Can support workers change continence products?

Yes: pads, pull-ups, briefs, and leg bag emptying are within scope. Catheter changes and clinical assessments are not. Any clinical task requires a written delegated care plan from a registered nurse.

When should a support worker escalate to a nurse or doctor?

Escalate for: cloudy or foul-smelling urine, catheter not draining, fever, perineal skin breakdown, or absence of bowel movement for three or more days with abdominal discomfort. These are clinical signs requiring nurse or GP assessment.

Does pelvic floor physiotherapy help with incontinence?

Yes, for stress and urge urinary incontinence. NDIS funds pelvic floor physiotherapy under Improved Health and Wellbeing where it is related to the disability. Five Medicare visits per year are also available under the Chronic Disease Management plan.

What home modifications help manage incontinence safely?

Raised toilet seats, grab rails beside the toilet, a bedside commode, non-slip bathroom flooring, improved lighting on the bedroom-to-bathroom path, and removal of trip hazards. An OT assessment produces the home modification report for NDIS Capital funding.

What is an indwelling catheter and when is one used?

An indwelling catheter drains urine continuously into a collection bag, used when the bladder cannot empty independently. Insertion, management, and changes are registered nurse tasks. Support workers assist with emptying leg bags and observing for complications.

Key Resources

Carevo connects people with continence needs to continence nurses, pelvic floor physiotherapists, OTs, and NDIS-registered support providers across Australia. Find providers through Carevo to build your continence care team.