7 Reasons Why Incontinence Belongs in OT Scope of Practice

Raise your hand if you learned about incontinence in occupational therapy school.

If your hand is raised, congratulations—you are a rarity.

If you did happen to learn anything about incontinence during your formal training, did you have more than one lecture about the subject? Most likely not!

Why do you need to know anything about incontinence? Is addressing incontinence even within an OT’s scope of practice? Wouldn’t nursing or physical therapy address this need instead?

The truth is that incontinence negatively impacts an array of your clients’ activities of daily living, and this means that it should be a focus in your evaluation and treatment plans.

Why Should an OT Address Incontinence?

As an occupational therapist, you are an expert in human occupation. You restore your clients’ quality of life by helping them improve their ability to engage, initiate, and execute meaningful tasks. This is at the root of all levels of occupational therapy.

In your work, you examine why your client cannot interact, engage, or perform tasks by investigating their impairments and then addressing those impairments with treatment plans. You lay the foundation for improving these impairments either restoratively or through compensatory strategies.

Your role in client care necessitates that assessing and addressing incontinence takes place on a regular basis. Both bladder and bowel incontinence impacts all areas of life. When you investigate the connection between your client’s incontinence and their life experience, you may find several areas to address.

7 Ways Incontinence Impacts Your Clients’ Quality of Life

1. Depression

Your client may voice frustration around toileting routines or the cost of incontinence supplies, become tearful during the discussion, or feel hopeless in controlling their bowel and bladder.

2. Anxiety

Your client may express feelings of overwhelm, stress, or helplessness regarding their toileting routine. It may feel to them like their bladder or bowel needs control their life.

3. Social withdrawal

Your client may no longer participate in social activities like church or they may withdraw from family functions. They may also avoid visitors because they are self-conscious or concerned about odors. Additionally, your client may be forced to change their daily routines and schedules to accommodate their bowel and bladder needs.

4. Extreme fatigue and possible cognitive decline

Nocturia, frequent bathroom trips, and leaking that causes wakefulness may lead your client to feel tired from being “up all night.” This can lead to difficulty managing daily routines, a frequent need for naps, or a sense that they are “living in the bathroom.”

5. Falls and injury

Incontinence is associated with an increased risk of falls. This could be due to the need to rush to the bathroom. It could also be attributed to functional incontinence, which occurs when your client has physical or cognitive issues that prevent timely toileting, including difficulty safely managing bathroom mobility as well as challenges with clothing management, pericare, or other toileting routines.

6. Laxative or other medication abuse

In an effort to control incontinence or constipation, your client may create a self-imposed medication regimen outside of over-the-counter or doctor recommendations.

7. Pelvic pain

Your client may feel pain while voiding, while they are at rest, or with certain movements.

You can build treatment plans around multiple levels of impairments and performance areas, but if incontinence is not on your assessment and intervention list, your client may not achieve the maximum level of possible improvement.

Simple and practical interventions are available for generalist occupational therapists. You may also choose to push beyond these interventions to specialize in this area. OTs who empower themselves to learn more about this topic will, in turn, empower their clients and greatly improve their quality of life.