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Treading with Care: How Bladder and Bowel Health Shape Senior Fall Risks

By Arslan Wyne

Minimising falls is a crucial component of aging gracefully and the role urinary and faecal incontinence play in this is under-explored.

Whilst the link between incontinence and falls is statistically significant, how one contributes to the other isn’t clear. A possible mechanism could be the urgency triggered by bladder or bowel issues could lead to rushed movements, reduced balance, and uneven steps, elevating the risk of falls.

Current research places the impacts of urinary urgency and nocturia – which is needing to wake in the night to urinate – with a 1.2-fold rise in the risk of falls and a 1.3-fold rise in the risk of fractures.

Incontinence in older people is often underreported and untreated. It can be a sign of complex health problems and is linked to depression and social isolation.

Identifying incontinence is a crucial first step, with routine screening using the 3 Incontinence Questions tool and the Revised Faecal Incontinence Scale as advised by The World Falls Guidelines Task Force.

The next step is to refer on as appropriate to urologists, continence nurses, and pelvic floor physiotherapists. Pelvic floor training conducted by a physiotherapist is first-line treatment for urinary incontinence, but older people are often treated with medications or surgery (Dumoulin et al. 2017).

For anyone providing care to the elderly, we should also consider implementing simple interventions such as creating a bowel routine with structured and timed bathroom visits, particularly before bed at night. We can also consider the integration of bedside commodes as another practical solution to help reduce the risk of falls.

The connection between bladder and bowel incontinence and the heightened risk of falls in the elderly is an underexplored area that deserves greater attention. The intricate interplay of mobility, urgency, and balance further highlights the multifactorial nature of fall management and the importance of proactive management. With proper screening, specialised care, and immediate interventions, we can strive to ensure that the elderly age gracefully and remain fall-free.

About the author

Arslan Wyne is a Physiotherapist and KEO’s Regional Manager for Aged Care. Growing up, Arslan has always had a keen interest in the health sciences. A snowboarding injury led Arslan down a path of rehab, this became the inspiration to pursue Physiotherapy as a profession.

After completing his Bachelor of Science degree in Canada, an interest in travelling and learning was the force behind his decision to complete a postgraduate Physiotherapy degree in Australia. Going on 8 years in the profession Arslan has worked across a variety of sectors but has always most enjoyed working with the elderly.