You spot Ruth, who is in her 50s, browsing your display of bladder weakness pads. In your team, think about how you might approach Ruth. This is a sensitive issue and will require all of your communication skills.

Ruth tells you she has had a few 'accidents' recently and wants to buy some suitable bladder weakness protection pads.

• What questions might you ask Ruth? Is she making more frequent trips to the toilet than usual? If so, how often? Does she need to get up in the night?
• Why might this happen? Think about fluid intake and which drinks might increase Ruth's need to visit the toilet more frequently
• Does she have a sudden urge to urinate? Does this happen when her bladder is full and/or when it is empty or partially full?
• Is she taking any other medication?
• How does this situation affect Ruth at work or when she is going out?
• How can you help? Would you recommend some incontinence pads? Would you refer to the pharmacist?

Ruth buys some bladder weakness pads and the pharmacist refers her to a GP. Ruth returns to the pharmacy a couple of days later to buy some shampoo and tells you that the doctor has recommended bladder training along with pelvic floor exercises. Ruth has an appointment with the practice nurse next week.

• What is bladder training? Can you explain to Ruth what this involves? (Bladder training is the main treatment for OAB syndrome and can be used with or without medication. See here for details)
• What is the role of pelvic floor exercises in OAB syndrome? See: www.patient.co.uk/health/overactive-bladder-syndrome
• What general lifestyle tips would you recommend to Ruth?

Practice point

• Think again about Ruth. The pharmacist has referred Ruth to the GP. How could you best prepare Ruth for her visit to the GP? See: www.bladderandbowelfoundation.org/wpcontent/uploads/2015/02/Bladder-Advice-Sheet-Approaching-Your-GP8.pdf
• What is a bladder diary? How can a customer keep a bladder diary and why might it be useful?