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Incontinence Essentials for Family Caregivers

Incontinence essentialsOver the years, we have had so many customers contact us and state one of the following:

  • "I wish I found Parentgiving sooner", or
  • "I am new to caregiving – what are the basics I need to manage my loved one’s incontinence?", or
  • "we are trying to care for our loved one in our home (or in their home) – what essentials do I need?", or
  • "these store brands simply do not work for my mother’s incontinence – what can I do?"

We decided to create and publish the following "Incontinence Essentials for Family Caregivers" – which focuses on those products and their applications, that best serve family caregivers caring for an incontinent loved one in a home setting. With this guide, we seek to answer the following common questions:

  • Which products require less changes per day?
  • Which products or combination of products reduces the number of overnight leaks – resulting in less laundering?
  • Incontinence waste for adults is a lot more than what we used to deal with for our babies – what can I do? How can I reduce the odors from this?
  • Toilet paper and/or washcloths really aren’t effective in cleaning up my loved one, and their skin is becoming irritated - what else is available?
  • Can I double up an adult diaper, or put a pad inside of a diaper to prevent leaks? NO
  • My car seat / sofa / mattresses is being ruined by incontinence leaks – is there something I can put down as protection?

We distilled our best product recommendations, how to use them, and what professional caregivers and home care aids use to make life a little easier when caring for a loved one. Here are our recommendations:

Premium Absorbent or Overnight Underwear / Brief / Diaper

Definition: Premium or superabsorbent incontinence underwear / briefs are built to hold a lot of voided urine and pull this urine away from the surface (skin) to feel drier and to prevent leaks, and to require less changes in a 24 hour cycle. Originally marketed as an overnight product, family caregivers use them for nighttime and daytime use – with less changes per day overall.

Benefits:

  • Less changes per day equals less physical labor for a family caregiver.
  • Preventing leaks (especially overnight leaks) equals less excessive laundering of bed clothes.
  • The ability to pull voided urine away from the skin and into the SAP core of the garment provides better comfort (feels drier for the user) and maintains the Ph level of perineal skin. Keeping the skin dry and without changes to Ph can prevent chafing, irritation, and dermatitis.

Underwear or Briefs?

  • The type of garment should be based on the fit and comfort of the user AND the caregiver (who may be assisting in the changing process).
  • Briefs (with tabs) can be secured to ensure a tighter fit in areas that tend to leak, and can sometimes be easier to change for the caregiver.
  • Underwear is far and away the more popular type of product. It is easier to convince an incontinent loved one to get into an underwear type garment and there seems to be a sense of dignity associated with that. The best underwear are featured laden with tear away sides and leg cuffs to better prevent leaks.
  • FIT is very very important. Bodies come in all types – and elderly bodies are no exception. We see and hear of all body types: Big bellies with skinny legs, obese persons, super skinny, etc. Sample different products to arrive at the best solution. Adult diapers / underwear should fit close to the body – in the waist and hips and especially at the leg openings. Gaps or openings provide an opportunity for leakage and should be avoided in the application.

Pro Caregiver Tip:

  • These products can be changed far less than what you can purchase at a pharmacy or Club Store or Mass Mart. Try a schedule of 4 changes a day (morning, noon, dinnertime, bedtime) and expand or contract from there.

Our Recommendations


Disposable Wipes or Washcloths

Definition: A disposable wipe or washcloth used to clean the perineal area on incontinent persons. Can be scented or unscented. Can include skin conditioners (Aloe e.g.) or not.

Benefits:

  • Specially formulated to preserve Ph levels and skin health for fragile elderly skin.
  • Disposable – use and dispose.
  • Some are flushable and can be put thru the septic system to reduce odors in the house.

Wipes or Washcloths?

  • Wipes tends to be smaller in dimension and slightly thinner. Washcloths tend to be larger, and can be used to clean and freshen anywhere on the body as needed. Because of their smaller dimension, wipes tend to be cheaper on a per piece basis.

Pro Caregiver Tips:

  • During an incontinence change, put soiled wipes INSIDE of the diaper/underwear garment and toss all of it at the same time.
  • Flushable wipes are very popular for easier cleanup and less smell in the home. Look for DISPERSABLE wipes that disintegrate in the plumbing cycle (and please note any local or regional restrictions).

Our recommendations


Underpads (aka Disposable Underpads aka Chux)

Definition: A large pad that prevents a void from permeating the surface below – typically used as a protective layer for a mattress, or recliner, or sofa, or even automotive seating. Underpads can be reusable or disposable (the latter were termed as chux back in the day – typically used in institutional settings).

Benefits:

  • A barrier of last resort that can preserve an expensive item like a mattress or a sofa when leaks occur (and leaks will occur).
  • When used in combination with a superabsorbent diaper or brief, an underpad can reduce or eliminate nighttime leaks and excessive laundering of bed clothes.
  • Although somewhat unsightly, an underpad used on a piece of furniture or mattress (or car seat) can prevent and expensive replacement or costly professional cleaning.

Pro Caregiver Tips:

  • Some disposable underpads have enough tensile strength to reposition a bedridden person – almost always deemed a two-person job, using an underpad to reposition a bedridden loved one can actually be more efficient than repositioning without the underpad.
  • If a bedridden loved one has compromised skin (dermatitis in the perineal area) – we advocate using a breathable underpad to accommodate better airflow. Almost all disposable underpads have a plastic or polyester backing to prevent a void from penetrating, however, this impermeable layer can build up heat / sweating / moisture – a breathable underpad alleviates moisture build up.

Our recommendations:


Incontinence Cleanup and Maintenance

Definition: As compared to changing a baby’s diaper in a nursery, an adult incontinence change (urine or fecal) can generate significantly more volume in human waste, material waste, and odor. The volume in waste output from an adult and frequency of changes per day can overwhelm a bedroom or shared quarters – as such, there are specific product applications that have evolved to address the problem.

Benefits:

  • Older persons tend to live in smaller spaces, and with limited mobility, tend to move in limited areas of a shared home. For those living with incontinence (especially fecal or bowel incontinence) the odor associated can be overwhelming – limiting interaction with guests and trying the patience of home care aides. Using the right tools and applications can reverse this course.

Pro Caregiver Tips:

  • Diaper Disposal systems are designed to keep incontinence waste in its own place, and away from waste receptacles shared within the home.
  • While never a replacement for good housekeeping, odor control sprays can be a quick and effective fix for soiled material in a small room, or for leaks or for small accidents – and for keeping embarrassing odors to a minimum.
  • Specialized cleansers formulated for both perineal and body areas can work so much more effectively on elderly skin than soap and water – most are designed to preserve ph levels and for easy application and removal – while still cleansing the area in question.
  • Exam gloves made of vinyl (latex-free) or Nitrile (synthetic rubber) are essential for incontinence changes performed either by family caregivers or professional caregivers. Nitrile gloves are slightly thicker and less prone to tearing vs. vinyl or latex gloves. Caregivers can utilize exam gloves for incontinence changes to provide a more thorough cleaning.

Our recommendations:


Booster Pads

Definition: A booster pad is a flow- through pad that is used inside of an adult diaper or brief and provides additional absorption capacity to the existing diaper or brief. Booster pads are engineered with an acquisition layer on the surface to wick away urine and an ample amount of SAP (super absorbent polymer) for additional absorption.

Benefits:

  • Booster Pads, when used in conjunction with an adult diaper of brief can boost absorbency by 6 to 12 ozs (depending on size)
  • When paired with an adult brief or diaper, a booster pad can make an average diaper very good, and can make a good diaper great in terms of absorbency.

Pro Caregiver Tips:

  • For a loved one in assisted living, specify that a booster pad is to be paired with the loved one’s daytime diaper of choice – this will provide greater absorption and less leaks for nighttime use….and will stretch dollars as the booster pads are only paired at night.
  • For a male user who is prone to leaks, wrap the booster pad directly around the opening in his penis to deflect urine back into the booster pad / diaper combo. Leaks from male users can sometimes occur when there are gaps in the leg holes of an adult diaper or brief – in these instances a booster pad can deflect the urine stream back into the “sandwich” of booster pad and adult diaper.

Our recommendations: