The OT’s Perspective: Continence – One of the most vital activities of daily living
Stuart Barrow explains what healthcare professionals should consider when it comes to continence and toilet use and how this could shape what incontinence products to stock on your shelves and advice you provide to customers.
Toilet use is something that we ALL have in common, no matter whether we have a disability or not and because we understand it, we know how crucial it is to make sure that the people we help are able to do what they need to do as easily and as hassle-free as possible.
Because it is so fundamental, the question of continence and toilet use will be considered by all healthcare professional when assessing someone with a disability, and here are some of the questions that OTs, in particular, consider (these are the questions I’ll ask my clients):
- Do you manage your toilet transfers and continence?
- Do you need assistance to manage transfers?
- Do you need assistance to manage continence, bowel or bladder?
- Do you use equipment to assist with your continence or toilet access? This could be a medical aid, a grab rail, a raised toilet seat to aid transfers or many other products?
(N.B. When assessing a person fully clothed, you cannot now usually spot a stoma bag or know that there are issues, thus without asking and then observing vital information about how a person manages themselves can be missed.)
- If the client identifies continence issues, always ask if they are involved with an incontinence nurse.
Sometimes – despite many issues – a client won’t be. This could be because of embarrassment, a poor GP relationship which means the issue is never discussed or they’re simply not aware services and support exist. A sign there is an issue is a client self-funding their continence pads
Although toileting is something universal, it is also an area often overlooked by retailers in the industry.
Which equipment aids continence and toilet use?
- Some equipment that’s helpful for those struggling to clean after toileting is a Geberit or Closomat. The washer jets cleanse the bottom with the dryer function drying you and keeping you clean
- Absorbent pads
- Handheld urinals, with gel crystals to crystallise the urine
- Waterproof bedding
- Bed wetting alarms
What types of incontinence should we be aware of?
- Stress incontinence. Urine leaks at times when your bladder is under pressure. Laughing can cause this
- Urge incontinence. A sudden, intense urge to pass urine
- Overflow incontinence. This is often referred to as urinary retention, when you’re unable to fully empty your bladder, causing frequent leaking
- Total incontinence. The bladder can’t store any urine at all, which causes you to pass urine constantly or have frequent leaking
What are the possible solutions to incontinence?
- Lifestyle changes, i.e. a reduction in alcohol intake
- Reduction in weight
- Reduction in caffeine
- Pelvic floor exercises taught by a professional (like a physiotherapist)
- Bladder training (input from continence nurse/specialist required)
It is worth encouraging those with incontinence needs to purchase a RADAR key. This key will provide access to thousands of toilets for the disabled across the UK.
Look up the Bladder and Bowel Foundations, a UK charity providing information and support. They maintain an independent directory of products that will provide a great deal of information on products that could be helpful.
Stuart Barrow of Promoting Independence is a member of the British Association of Occupational Therapists panel and a recognised contributor in the field of home adaptations. His experience is sought by manufacturers and service providers looking for an expert opinion. He also runs the Occupational Therapy Adaptations Conference
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