| Mar 2, 2025
The Essential Guide to Complex Bowel Care
Providing complex bowel care is a crucial aspect of supporting individuals with disabilities who require complex healthcare. As a disability support professional, mastering these skills is essential to ensuring the health, comfort, and dignity of those you support.
This guide outlines the foundational knowledge and advanced skills required for delivering high-quality complex bowel care. It serves as an informational resource and does not replace formal training or certification. Details on training and clinical endorsement for complex healthcare tasks, including complex bowel care, in compliance with relevant state and territory regulations are provided at the end of this blog.
Understanding Complex Bowel Care in Disability Support
Bowel care is highly personal and can be invasive. Support should be provided in the least intrusive and restrictive manner possible, aligning with the person’s daily routine, preferences and health needs.
Complex bowel care is required for individuals experiencing chronic constipation, bowel incontinence, neurogenic bowel dysfunction, or other medical conditions affecting bowel control. Support professionals play a vital role in preventing complications such as impaction, infection, and autonomic dysreflexia—a potentially life-threatening condition.
Complex bowel care may be required for a person living with:
• Spinal injury or other conditions causing muscle or nerve damage
• Autism
• Stroke
• Neurological conditions
• Cerebral palsy (with a Gross Motor Function Classification System (GMFCS) level of 3, 4, or 5)
• Acquired brain injury
Registration and compliance. It is crucial that Service providers and Support professionals follow laws and regulations governing the provision of complex healthcare and organisation policies and procedures. NDIS providers in Australia, delivering high intensity supports must be registered and demonstrate adherence to key indicators, including:
• Comprehensive Participant Assessment & Care Planning: Developing a documented individual complex healthcare plan in collaboration with a health practitioner.
• Policies and Procedures: Implementing organisation-specific policies to ensure safe and effective complex bowel care.
• Regular Health Status Reviews: Monitoring participants’ health to identify potential risks.
• Incident and Emergency Management: Establishing clear procedures for managing incidents, documented in the care plan.
• Medication administration endorsement or accreditation if relevant.
• Workforce Training and Competency Verification: Ensuring all support professionals providing complex bowel care are trained and assessed according to the NDIS Skill Descriptors.
Training Requirements
For person-specific requirements, disability support professionals must undergo specific training delivered by an appropriately qualified health practitioner or an individual meeting the high-intensity support skills descriptor for complex bowel care. This ensures alignment with the individual’s healthcare needs and complex care plan.
Core Training Components
A structured training program combines theoretical knowledge with practical skills to equip support professionals for safe, person-centred and effective support and care delivery.
Skills Required for Complex Bowel Care
Support professionals providing complex bowel care should be able to:
• Follow the participant’s care plan and align care with their preferences and capacity.
• Communicate effectively and respectfully, adapting to the participant’s preferred communication style.
• Implement hygiene and infection control measures, including hand hygiene and environmental disinfection.
• Ensure required equipment and consumables are available and prepared.
• Support the participant in a manner that maintains their dignity and comfort.
• Observe and record bowel motions using reference tools like the Bristol Stool Form Scale.
• Identify and escalate concerns regarding bowel function to a supervisor or health practitioner according to organisation guidelines.
• Work collaboratively within the support and care team(s) and advocate for necessary care plan adjustments.
• Assist the participant in providing feedback or requesting changes to their care plan.
Theoretical Knowledge: Understanding the Basics
• Anatomy of the Digestive System: Understanding the structure and function of the intestines, rectum, and anus.
• Bowel Health Essentials: The importance of regular bowel care in preventing impaction and infections.
• Identifying Healthy Bowel Movements: Using the Bristol Stool Chart to assess stool characteristics.
• Recognising Red Flags: Symptoms that require medical intervention, such as blood in stool or persistent constipation.
• Autonomic Dysreflexia Awareness: Recognising triggers, symptoms, and emergency responses for individuals with spinal cord injuries.
• Nutrition and Hydration: Understanding the role of diet and fluid intake in maintaining bowel health.
Practical Skills Training:
To ensure competency in safe, effective person-centred practice, support professionals will need to demonstrate proficiency in advanced skill tasks such as:
• Applying ethical considerations, including consent, privacy, and cultural sensitivity.
• Administering suppositories with correct positioning and technique.
• Performing digital stimulation safely to promote bowel movements.
• Administering low-volume enemas and bowel irrigation with proper infection control measures.
• Performing abdominal massage to support bowel motility.
• Implementing hygiene and infection control practices.
• Recognising deterioration in health status and responding according to escalation protocols.
Surgical Options for Chronic Bowel Issues
Some individuals require surgical interventions to address chronic bowel conditions. Support professionals may need to assist with the management of these devices and the stoma (opening) on the abdomen. These skills require additional training.
People may have either of the following two devices:
Colostomy
A surgical procedure where the colon is shortened, removing a damaged section and diverting the cut end to an opening in the abdominal wall, connected to a colostomy bag.
Ileostomy
A surgical procedure where a damaged section of the ileum (junction between the small and large bowel) is removed, and the cut end is diverted to an artificial opening in the abdominal wall, connected to an ileostomy bag.
Support professionals supporting a person with a stoma should be able to:
• Assist the participant in keeping the stoma site healthy and clean.
• Replace and dispose of stoma bags safely.
• Monitor and record information as indicated in the participant’s support plan, including outputs, hydration, and stoma appearance.
• Identify potential issues such as blockages and escalate care to a health practitioner immediately.
Training & Certification
While this guide provides essential information only, formal training and competency assessment are required for complex bowel care tasks. Disability support professionals must receive training and clinical endorsement in accordance with organisational policies and national and state regulations.
📢 Need formal training? Medecs Learning offers certified courses to equip disability support professionals with essential high-intensity support skills. Enrol today to enhance your
By integrating theoretical knowledge with practical skills training, support professionals gain the confidence needed to deliver high-quality bowel care. This ensures better health outcomes and greater comfort for the individuals they support, aligning with best practices and regulatory requirements.
