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Roll for Control® Incontinence Program
Patient Case Study


Florence is a 95 year old patient who was admitted to Great Lakes Caring Home Health after a
routine doctor’s visit. The patient voiced to her doctor her concern of not getting to the bathroom
in enough time and having incontinence as a result. A referral for Home Health Care was given.

Florence was identified as having urge incontinence. Florence reports she has had multiple falls in
the past trying to get to bathroom facilities too quickly. She had an occupational therapy assessment
and met criteria for Great Lakes Caring Roll for Control® program, an Evidence-Based Practice
(EBP) that was applied to her plan of care.

The occupational therapist worked with Florence through the four step process which aims
to strengthen the pelvic floor muscles that influence bowel and bladder function, improve the
incontinence, decrease risk of falls, and reduce potential hospitalization from an injury if a fall
occurred. Pelvic floor muscle exercises were implemented with the use of Thera-bands and exercise
balls. Physiologic quieting (a form of biofeedback) was performed to engage the parasympathetic
nervous system. Additional education on dietary restrictions was given. Instructions to decrease
caffeine, chocolate, artificial sweeteners and acidic juices that have effects on urinary incontinence
were discussed and eliminated from her diet.

Florence continues her exercises daily with her equipment given for the program and states that
since the onset of the Roll for Control® program her episodes of incontinence have decreased to one
every couple of days. At the time of discharge from Great Lakes Caring, Florence’s incontinence
decreased to only once per week. She still gets up at night to use the bathroom but feels confident
that she now can manage the urge and prevent an injury or fall from occurring by rushing.

Use of the Roll to Control® program, in conjunction with her doctor’s guidance and the assistance of
the therapists, dramatically decreased Florence’s urge incontinence and made for an improved quality
of life, decreased risk of falls, and reduced the potential for hospitalization from a fall.


Presented by Sarah Thurston, LMSW
Great Lakes Caring Director of Education
October 2017