COUNSELLING PEOPLE WITH

COUNSELLING PEOPLE WITH DISABILITIES STATE CONFERENCE ELLEN-MAY EATON MSWA CLIENT CHERRY CHAPMAN MSWA COUNSELLOR In November, we both attended the inaugural State Conference, organised by People with Disabilities WA (PWdWA). PWdWA plays a key advocacy role for both individuals and systemic issues. The conference was largely planned by a committee of people with disabilities and most sessions were presented by people with disabilities. It was certainly a fresh approach to attending a conference and one where we were made to feel welcome. Arrangements considered a full range of disabilities – from access for wheelchairs, to supports for those who were deaf, blind, as well as many other issues. The significant key speakers shared their life stories of achievement and overcoming adversity. Prue Hawkins, who created her own successful law firm here in Perth, was inspiring, as was Senator Jordan Steele-John (WA Greens Senator) who highlighted the disability rights movement, its achievements to date and areas for future focus. Samantha Jenkinson, the State Director, gave a detailed account of the new NDIS Quality and Safeguards Commission, and finally Dr Rita Kleinfeld-Fowell, professional advocate and disability discrimination lawyer working for Midlas (Midland Information Debt and Legal Advocacy Service), shared her life’s journey through adversity. A smaller organisation we became aware of was WA Individualised Services (WAis) which works in partnership with people, families, service providers and government to promote and advance individualised, selfdirected supports and services. It was difficult to choose between the many workshops on offer at the conference. We came away filled with information, energy, and excitement about what is out there to support people with disabilities. PWdWA website: pwdwa.org WAis website: waindividualisedservices.org.au 22

PHYSIOTHERAPY CONTINENCE PHYSIOTHERAPY Hello everyone, please allow me to introduce myself. My name is Marga and I am a physiotherapist who recently joined MSWA. I am currently finishing a post-graduate in Continence Physiotherapy at Curtin University. I am currently promoting bladder and bowel healthy habits. In this article, I would like to focus on bladder issues and some tips on how we can support these symptoms. Bladder function in neurological conditions MS, Parkinson’s and other neurological conditions can affect the nerves that connect your brain with your bladder, and this may produce a change in your ability to empty or store urine. What are the common symptoms? 1. Issues with storage - Urgency: the need to urinate in a rush. For example, before opening the door at home - Frequency: the need to urinate regularly more than 6-8 times per day - Nocturia: needing to go to the toilet more than one time per night 2. Issues with emptying Failure to empty your bladder completely. Some issues can include interrupted flow, poor flow, straining when emptying, dribble post emptying and needing to empty again immediately. 3. Issues after emptying Incomplete emptying is the feel that your bladder is still full after urination. What does a physiotherapist ask or do during a continence assessment? We ask what symptoms are bothering you the most, as we want to focus on your individual goals. During your initial assessment, we ask questions in relation to your bladder symptoms, your diet, your current medication and your previous treatment. During the assessment, we may provide you with a bladder diary that you will have to complete at home for three consecutive days. This is a simple way of having a measurement of input versus output of your fluids. With your bladder diary information, we can determine if you have issues with storage or emptying and make a joint decision of what can help your symptoms. During examination, we can also perform a pelvic floor muscle examination. What can I do to help my symptoms? 1. Bladder habits: including bladder retraining, avoiding bladder irritating foods and drinks, suppression strategies to calm your urgency. 2. Pelvic floor muscle strengthening: if your main bladder symptom is leaking with coughing, sneezing, lifting, or moving between different positions, pelvic floor muscle strengthening can help your symptoms. It is common not to be aware of your pelvic floor muscles. In some cases, people find it hard to strengthen them correctly. Margarita Ruiz Martinez, the newest member of the MSWA Physiotherapy team 3. A review with your MSWA Neurological Liaison Nurse would be indicated if you are having symptoms of urine retention. In this case, your nurse will go through an assessment and treatment options. 4. Further management: review with a specialist to discuss other options such as Botox. If you would like to book a continence physiotherapy review, please speak to your MSWA Nurse or Physiotherapist for a referral. MARGARITA RUIZ MARTINEZ MSWA PHYSIOTHERAPIST 23