Slow the Flow

Submitted by Allison Bakke, OTR/L Above & Beyond Senior Services

Incontinence is not an inevitable consequence of aging, but it is a major problem for a lot of people, and has a major impact on quality of life. The National Association for Continence reports some alarming statistics about incontinence:

  • Ÿ Urinary incontinence affects 200 million people world wide.
  • Ÿ 53% of homebound elderly are incontinent
  • Ÿ More than ½ of nursing home residents are incontinent.

2/3 of men and women age 30 to 70 have never discussed bladder health with their physician. The consequences of urinary incontinence include:

  • Ÿ Embarrassment
  • Ÿ Socialization limitations
  • Ÿ Daily activity limitation
  • Ÿ Increased burden of care
  • Ÿ Depression
  • Ÿ Disrupted sleep
  • Ÿ Fatigue
  • Ÿ Increased risk of falls
  • Ÿ Skin integrity compromise/pressure ulcers

The Agency for Healthcare Research and Quality Guidelines cites studies that report improvement rates of 78% to 92% in people that participated in a continence training program. A continence training program is set-up by a physical or occupational therapist and consists of 3 parts:

1.      Diet: This includes education about avoiding foods that are known to be bladder stimulants, such as caffeinated beverages, alcohol, and many others.

2.      Behavior Modification: Going to the bathroom frequently (for example, just in case there isn’t a bathroom nearby in the future) can decrease bladder capacity and set up a false sense of urgency when the bladder is near empty.

3.      Pelvic Floor Exercises: This includes the “Kegel” exercises, which are exercises that help strengthen the muscles you use to stop the flow of urine, but may also include strengthening of other surrounding muscles.  Your therapist will determine which muscles are weak.

Keep in mind that bladder training can take 3 to 12 weeks. During your training program, your therapist may have you keep track of the number of urine leaks you have daily. This will help you and your therapist see if bladder training is helping. So please talk to your doctor and a physical or occupational therapist to begin a program that will “slow the flow” and get you back into living your life free of embarrassment and isolation.