Pelvic Dysfunction & Aging

Thank you to Guest Blogger and CSU Graduate, Hailey Jungerman.

Although many believe that it is a natural part of ageing, “age doesn’t cause urinary incontinence, age-related changes may predispose an individual” (Garvey 14). Not only is it not a normal part of ageing, but “more than 50 percent of older Americans struggle with incontinence” (Reinberg). It is important to understand that bladder and bowel incontinence is an issue that can go beyond just toileting. As owner Krista Covell-Pierson OTR/L, BCB-PMD points out in her article Are You Addressing Incontinence at Home? An OT’s Guide, “Unaddressed incontinence can lead to the following additional problems: depression, social withdrawal, anxiety, fatigue, increased fall risk, restricted sexual activity, increased expenses for supplies, higher risk of infection, and skin irritation.” All of these things can lead to reduced participation in activities of daily living.

So, how can OT help address incontinence? “Occupational therapists provide a comprehensive approach that looks beyond musculoskeletal skills deficits and recognizes the need for changes in performance patterns, such as habits and routines, while also considering the context and activity demands related to the problem. Additionally, occupational therapy practitioners have the background and training to understand the related distress and provide support for the psychosocial aspects of these disorders” (Neuman et al.).

Krista Covell-Pierson OTR/L explained to me what a normal plan to manage
incontinence would look like. The evaluation will touch on bowel and bladder health. Krista says it is important to look at both as the bladder can affect the bowel and vice versa. The therapist will discuss with the patient about their diet, toileting and leave the patient with incontinence reading material and a voiding diary. From there the rest of the sessions are working on finding the issue and working on the pelvic floor muscles. The therapist will work as an investigator to solve the problem. They will recommend small changes to see if that is helping, and work in stages as to not be overwhelming for the patient. If needed, the therapist can also use a
biofeedback machine to better understand what the pelvic floor muscles are doing and to get patients working them. Though the internal biofeedback is not required, Krista said there is about an 87% rate of improvement over those that do not do the biofeedback.

Incontinence is a serious issue that can lead to a decline in quality of life. It is the number one reason why people put a loved one in an assisted living community as it is draining on the patient as well as any caregivers. Getting the issue resolved can improve the quality of life and keep our loved ones home for longer. If you have any questions regarding incontinence our owner Krista Covell-Pierson is a great resource as she is Board Certified in Biofeedback.

Please call Covell Care and Rehabilitation at (970) 204-4331 to get more information or an appointment scheduled with us to address incontinence.


Citations:
Covell-Pierson, Krista. “Are You Addressing Incontinence at Home? An OT’s Guide.” 2018 National Patient Safety Goals: Communication | MedBridge Blog, Medbridge, 20 Apr. 2018, www.medbridgeeducation.com/blog/2018/04/addressing-incontinence-home-ots-guide/. Garvey, Kathleen A. “Toileting: Making the Most of Our Time in the Bathroom.” MiOTA Conference. 12 Oct. 2015, www.miota.org.
Neumann, B & Tries, J & Plummer, M. (2009). The role of OT in the treatment of incontinence and pelvic floor disorders. OT Practice. 14. 10-1318.
Reinberg, Steven. “Over Half of Seniors Plagued by Incontinence: CDC.” Consumer HealthDay, HealthDay, 25 June 2014.