What is it?  “Incontinence” is the involuntary loss of bladder control.  It is not a disease, but typically a symptom of other underlying health conditions.  These include recent surgery, pelvic muscle weakness, urinary tract infection, medications, constipation, and even diet.  Bladder control problems can also result from neurological conditions including stroke, Parkinson’s disease, cerebral palsy, multiple sclerosis, and spinal injury.  Many people accept incontinence as a natural part of aging, when in fact it occurs among people of all ages and genders. 

What can THERAPY do? Therapy can assist with urinary incontinence through therapeutic exercise, electrical stimulation, toileting schedules with voiding diaries, caregiver and patient education, and transfer and mobility training.  An effective 10 week program is completed to strengthening pelvic floor muscles for increase bladder control.

What is it?  Refers to a large range of high level brain functions, including the ability to learn and remember information:  organize, plan, and problem solve; focus, maintain, and shift attention as necessary; understand and use language; accurately perceive the environment, and perform calculations.  Due to medical complexities, many people develop difficulties in cognitive areas.

What can THERAPY do? Therapy can assist with cognition in a variety of ways including teaching strategies to foster improved communication skills and language abilities, assisting with low vision techniques to improve understanding of tasks and environment, assess and treat pain in relation to cognition, and assess the environment and safety concerns for resident.  Therapy can also instruct with medication management to allow for increased cognition to allow for increased independence with this task, as well as creating memory books to assist with increasing sense of self and security.  Therapy can help make the resident feel at home while at the same time increasing and maintaining independence.

What is it?  Pain is what a resident describes to us by verbal and non-verbal expressions and behaviors.  Pain is whatever the person experiencing the pain says it is, existing whenever the person says it does.  Pain is the message sent by the body to the brain, signaling that disease, injury, or strenuous activity has caused trouble in some area.  There are two types of pain CHRONIC and ACUTE. 

What can THERAPY do?  Therapy can manage pain symptoms through many approaches.  These include modalities, manual therapy techniques, aromatherapy, and psychosocial interventions such as relaxation and visualization, and patient/caregiver education.  Joint range of motion and strengthening exercises can also relieve pain.

FACTS about falls:  Greater than 60% of institutionalized elderly fall yearly.  The single most effective predictor of future falls is the history of a fall in the past six months.  Alarms do not prevent falls; they simply alert staff when a fall may have occurred.

What can THERAPY do? Occupational, physical, and speech therapy all play an integral role in reducing a resident’s risk of falling.  Therapy intervention can include a thorough assessment of the cause of the fall and prevention measures.  Therapy can also include assessments of the environment, cognitive status, visual concerns, ROM/strength issues, and balance deficits.  Occupational therapists can focus treatment on safety factors, vision, strength, endurance, and use of adaptive equipment.  Physical therapists can focus on vestibular testing, ROM/strengthening, transitional movements, and modality programs specific to weak musculature.  Speech therapists can focus treatment on safety concerns, cognitive issues, and sequencing of movements and patterns.  All therapies can address patient and caregiver education to assist with reducing the amount and frequency of falls.

What is it?  Low vision is the visual acuity of 20/50 or worse that cannot be corrected with prescription lenses and/or abnormal visual field loss that limit functional performance and safety.  Some eye pathologies that relate to low vision are cataracts, diabetic retinopathy, glaucoma, and macular degeneration.

What can THERAPY do? Therapists can evaluate and use visual assessment tools to determine what is limiting for a patient visually.  A treatment plan can be established to focus on developing compensatory strategies, visual treatment to assist with improving weakened eye musculature, and set up of an environment that is conducive to maintaining autonomy as fully as possible.  Therapists can work with patients and caregivers to develop strategies that promote independent functioning within the limits of eye function.

What is it?  The pulmonary system of the body involves many organs including, the lungs, the diaphragm, and the thoracic wall.  Many disease processes can affect the pulmonary system and in turn lead to difficulty breathing, swallowing, endurance, strength, and overall decline in quality of life.  These pulmonary issues can be seen in patients with COPD, emphysema, asthma, bronchitis, CHF, Pneumonia, Lung cancer, and many neuromuscular diseases, such as multiple sclerosis, Myastenia Gravis, and others. 

What can THERAPY do? Therapy can intervene in a variety of ways including, but not limited to the following:
* Breathing training and education, including pursed lip and segmental breathing
* Chest mobilizations and percussions
* Education with incentive spirometry
* Coughing and suctioning techniques
* Positioning in bed, seated, and standing to allow for optimum drainage
* Energy conservation
* Exercise conditioning with monitoring indexes

What is it?  Lymphedema is the swelling that generally occurs in one or both of your arms or legs (however, can occur in both) and is caused by a blockage in your lymphatic system, which is part of your immune and circulatory systems.  This blockage prevents lymph fluid from draining, it builds up, and swelling increases.  Ifleft untreated, both edema and lymphedema can cause: Increasingly painful swelling, difficulty walking, stiffness, stretched skin –becoming itchy and uncomfortable, and increased risk of infection. 

What can THERAPY do? Lymphedema can be controlled and treated by a certifed Lymphedema therapist. Therapists use Manual Lymphatic Therapy to re-route the edema and help control edema along with provide appropriate bandaging.  Along with management of the edema/lymphedema, therapy will also address range of motion, strength, ADL retraining, and mobility to return to highest level of independence.