She still wets the bed!

What OT recommendations would you give for a 10 year old female who still wets her bed?

There are so many different reasons why a child might still wet the bed at 10, so there are lots of things to try and rule out first. Some possible causes could be medical or physical - small bladder, hormones, sleeping too deeply, conditions such as diabetes that cause frequent urination. I’d recommend a doctor’s visit first to make sure there isn’t anything going on that has to be medically addressed. There could also be sensory issues where she doesn’t “feel” when it’s time to go (or not until it’s very urgent). Then you may have the psychological part such as fear of the dark so she might not want to get up from the bed to go to the bathroom.

From the OT perspective, you can look at managing behaviours and the environment. For behaviours, explain that this happens to some people for many different reasons, support her as much as possible without punishment or ridicule, and involve her in the management process as much as you can. You’d have to spend a few days (depending on how often she wets the bed) monitoring her current diet, schedule, sleep, and frequency of urination - check to see how much she drinks or eats, how often she uses that bathroom etc. The OT can help come up with charts and schedules that would be appropriate. From there you can develop a schedule that would cease liquids after a certain time, cut out soft drinks or other drinks that might contain caffeine or diuretics, and help her manage her schedule to ensure she goes to the bathroom before bedtime. In terms of environmental management, you’d ensure that the path to the bathroom is accessible, even if this means having light sources if there’s fear, or even an alternative to going directly to the toilet. OT can also address the sensory part if there is an issue there, in terms of recognising wet vs dry.

There are other methods of addressing bedwetting such as using alarms and medication but it very individualised according to the person’s needs. This particular girl I don’t know her level of understanding, but picture stories and books can help her understand the process better.

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