Pelvic Health OT In Inpatient Rehab: Bowel and Bladder

Your inpatient patients had a life before they became patients — and their continence issues may be newer than the chart suggests. Here's how OTs can catch what everyone else is missing. Lindsey Vestal sits down with Rebecca Hearst, an OT with 17 years of inpatient rehab experience who became her facility's go-to specialist for bowel and bladder programming — not because she had extra training, but because she started asking better questions. Rebecca shares the laminated screening card she made for her coworkers, the detective mindset that catches acute incontinence being misread as chronic, and the specific diagnoses (spinal cord injury, spine surgery, stroke, cardiac surgery, frontal lobe involvement, catheter removal) that should always prompt a continence conversation during the OT eval. She walks through what treatment actually looks like in inpatient settings: weaving in education during ADL sessions, offering bathroom breaks as natural touchpoints, timing bowel programming with medication schedules, collaborating with nursing on reinforcement strategies, and even how her unit created a privacy sign protocol for intimacy after spinal cord injury. None of it requires a separate session — it all fits inside the work OTs are already doing. For OTs who've wondered whether bowel and bladder programming is within OT scope of practice, Rebecca's answer is clear: toileting is an ADL, and this is exactly where we belong. If you're an OT in acute care, inpatient rehab, or hospital settings looking to expand your pelvic health OT practice and add meaningful continence interventions to your toolkit, this session will give you a starting point you can use tomorrow. Download free resources and explore pelvic health OT courses at functionalpelvis.com, and find the community at facebook.com/groups/1427498174239216