Managing Incontinence in Assisted Living

A growing number of family caregivers are managing incontinence care and supplies for loved ones in Assisted Living or Continuing Care Communities. As Parentgiving serves both residents and Assisted Living facilities (ALF), we understand how challenging it can be for adult children with parents in these communities to manage incontinence issues.

Here are some recommendations:

1. Get to know the caregivers and care manager for your loved one. It is important for you to understand how the facility helps residents manage incontinence, and for the staff to know your monthly budgetary limits on incontinence supplies. To keep your loved one comfortable, you and the facility need to know:
   • How many times the resident is being changed.
   • If and when leaks occur.
   • How the ALF caregivers are helping to manage incontinence overnight.
   • What medications could be contributing to incontinence.
   • If there are mobility issues that could affect their ability to get to the bathroom in a timely fashion.
2. More changes per day lessens the need for super absorbent incontinence products. Superabsorbent products (30+ ounces capacity), which enable less changes per day, are popular in aging-at-home environments, but they cost more on a per piece basis. In an Assisted Living environment, it’s common for caregivers to change residents six to eight times per day. With a higher frequency of changes, it is not necessary to purchase superabsorbent products when “value” selections will stretch your dollars much further.
3. Use Booster Pads for Overnight Use and for Male “Leakers.” A booster pad is simply an additional layer of absorption material that transforms valuable leakproof diapers for adults into a super-absorbent diapers. For men who sleep on their side, incontinence manufacturers recommend wrapping a booster pad around their penis to help with leaking that may occur overnight.
4. Don’t use mass market brands found at “big box” stores or national drug store chains. Simply put, the big consumer packaged goods (CPG) companies put their money into advertising and paying for shelf space and not into the absorbency or quality of their products. Many caregivers come to us highly frustrated with the performance of CPG and store brands. This is why we recommend investing in quality incontinence products that will make your loved one more comfortable and stretch your family’s hard-earned dollar.
5. Write your incontinence directives on a piece of posterboard and tape it to where the incontinence supplies are stored. This dovetails with getting to know your loved one’s caregivers (#1 above) and ensures that your directives are plainly communicated for any new staff or nighttime staff.
6. Speak up if you notice “shrinkage” of your loved one’s incontinence supplies. Sometimes staff will “borrow” supplies from an adjacent resident room rather than walking down the hall to a supplies closet. If this becomes the standard operating procedure, then you are subsidizing your loved one’s neighbors. Be direct with the staff (#1), keep an inventory of supplies, and be sure they have clear instructions about supplies (#5).
7. Keep track of how much incontinence supplies are being used on a daily / weekly / monthly basis. For a resident with full-time incontinence that requires six changes per day (each change entails a new diaper/underwear + wipes + gloves), the cost can easily exceed $300 per month. A resident who has light incontinence, or only nighttime issues, can budget their monthly spend to under $100 per month.
8. Set up automatic orders of incontinence supplies. After determining how caregivers are applying the incontinence products, and tracking product usage per month, set up auto reordering to ensure your loved one never runs out of supplies.