Easing the struggle of adult incontinence for caregivers AND patients
illustration of a caregiver holding diapers next to an adult woman in a diaper lying in bed

When I moved my mother into a fully skilled nursing home, I asked the Certified Nursing Assistant (CNA) if I could watch her change my mother’s diapers (briefs, as they are known in the industry). I knew I might have to do it myself one day. I gasped at the indignant tussle, the inefficiency of it, and the necessity of having to do it at all with a 75-year-old woman.

My mother was grimacing, and the CNA was struggling and obviously straining her back.  It was a messy process. I left with tears in my eyes. Walking down the long hallway, I saw an elderly gentleman seated in his wheelchair. He was catatonic, but beautifully dressed in a white button-down collared shirt, pleated trousers with a belt, socks, and lace-up shoes.  His fly was wide open and his shirttail pulled through.  I know what was happening – he was fidgeting, getting anxious (typical of dementia patients). His caregiver was hurrying to change his briefs and others lined up and ready for their change). There has got to be a better way to handle adult incontinence, I thought.

The very moment got me thinking about the efficiency of physically caring for our elders, and I determined it was lacking. It’ll take a cultural change in our society to think through how to handle incontinence, dressing, feeding, and grooming from a standpoint of dignity, safety, and ease for both the patient and caregiver.

Why are we dressing our elders in the street clothes they wore 10 or 15 years ago?  Are we making ourselves feel better, or are they better because this is the way they have always dressed? Why are we placing regular forks and spoons in their arthritic hands, only leading to frustration? To speed up clean-ups after dining, why not use a laminated apron (not a bib, but a large apron).  Research indicates that in all of the above scenarios products do exist in the market today to help our caregivers and elders if we just take the time to find. It’ll take a generation of caregiving in today’s world to change the way we’ve been doing things.

I hope to see a different mindset in our communities with more people creating new and innovative products and methods that bring ease and dignity to caregiving.

What products and ideas have you found to help maintain the hygiene of your loved one?

 

Written by CareZips®

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11 Comments

  1. My mother asks several times a day for me to see if she is wet as I sometimes don’t think she is aware about when she urinates,Is there a brief that has a wicking sensor that would indicate a wet or dry brief. So caregiver could just look at instead of going through all the protocol involved in checking a brief. Would there be anything like this in diapers for children.

    Reply
  2. Mike…thanks for the review. I did recognize this as an ad type article and checked out the products. I wondered how useful they actually were. My mother is bed ridden and she just wears hospital gowns. She has become very tender and sensitive so I am concerned that the zippers may create bed sores. But the inventor is very genius in my book. I was just trying to think of something along these lines the other day, to help Mom feel less like a sickly person.

    Reply
  3. The author of this article did something about that. She created a very comfortable pair of pants with 3 zippers called Care Zips.

    They have a zipper on each side running from the top of the waistband which is kept in place on top with a snap. These zippers run all the way down to the knee.

    Then she placed a third zipper running from the inside of the knee to the other knee which gives full access for the caregiver to be able to change the patient’s brief or catheter without having to go through the struggle of removing the pants each and every time.

    I am fully incontinent due to a rare spinal cord disease/disorder called Syringomyelia (Google it! LOL!) and have progressive weakness in all four limbs which there is no cure or recovery. On top of that I have a torn rotator cuff which makes my left arm pretty much useless! LOL

    These pants are from a very soft material with a wider crotch to accommodate a thicker diaper if needed. The pants make it easier for me or a caregiver to get me dressed and/or undressed with the least amount of pain as possible.

    Reply
  4. What was the point of this article again? I came here thinking you were going to give us some great new ideas or pointers on changing adult briefs for bedridden patients. What you described is pretty much the norm everywhere and much better than a 3rd world country I must add as I have seen and experienced that also.
    But I am all for new inventions and innovations .I will be the first in line to buy if I feel it eases our roles as caregivers.

    Reply
  5. My husband is using the disposable men’s briefs and when he first started wearing them he was having a huge problem with diarrhea and he didn’t have the energy to make it to the bathroom. And then when he did make it to the bathroom he had already had an accident in the pull-up and it was a mess to clean up. He felt badly that I had to clean up everything and was embarrassed that he had made the mess. He was laying on the bed and was trying to get up when I told him to just lay back and relax and let it happen, that it was much easier to clean him up on the bed than in the bathroom. When he was finished I ripped the pull-up down each side and changed him like I had out children’s diapers. I was done and he was clean in 3 minutes tops. He was pretty amazed at how much easier it was. I just treated it like it was no big deal and handled cleaning him up like I was helping him wash his hands or face. I think that helped him be less embarrassed about needing my help. Changing the pad under him or changing the sheets while he is in the bed is just a matter of rolling him away from me, putting down the clean pad or sheet and pushing it up against him and then rolling him over onto the other side on the clean sheet or pad and then finishing the other side.

    Reply
  6. With my Dad, we used the version of Depends that has Velcro on each side – not the pull ups (though they could certainly work that way too) – and it was much easier to handle for us both. When he became bed-bound, he/we would roll him side to side to remove and replace – then afix the Velcro sides. Was a huge help, having that design.

    Reply
  7. Get personal!!
    When changing someone, I raise the bed to waist level, or if they’re in a fall bed, I get down on my knees. It’s a back saver! Talking to the person while you’re caring for them is important for many reasons. It can be a great distraction & and demonstrates compassion. Keep them covered with a sheet while changing shows that you respect their dignity. I’ve found that men are headstrong at insisting they wear an undershirt, & button down shirt, tucked in with a belt . If they fidget with their zipper, I’ll try to talk them into nice looking Pajama pants. If not, I tuck a nice lap blanket around them & they usually like the feel of the blanket enough to keep their hands in that area, sometimes picking at it.
    I’ve found that using the cloth napkin tucked in the front of their shirt is more receptive. If a clothing protector is warranted, then it should look less like a bib, & more like the covering Barbers use. As far as utensils, using ones with large rounded handles helps a lot & also ones that have a bent fork or spoon that goes to the right or left . Unfortunately there’s a short amount of time for us C.N.A.’s to perform these tasks (believe me when I say we would absolutely LOVE to be able to have more one on one time with our residents), but since most homes only hire the minimal amount required by state, we head home after our shift HOPING we made our residents feel loved.

    Reply
  8. Actually lots of older people are more comfortable in the clothes they have always worn. And they fidget because they need to go to the bathroom. There are many kinds of adaptive eating devices and plates etc. no one likes plastic bibs. They are germs and hot. Better to just use a regular one and wash it. Most people use pull-ups during the day and diapers and bed pads at night. Sorry but whatyou are describing is not a failure of adaptation but instead it is a SNF without adequate staffing.

    Reply
    • I agree. My Dad is more comfortable in trousers and pocketed shirts. He’s never worn sweat pants or t-shirts even lounging around the house. (I was surprised that he didn’t give me more resistance to changing “underwear” to the new pull-ups). Sure, it’s faster & more convenient for me, a caregiver or nursing staff but it isn’t about us, is it? I’d like for someone to maintain my dignity, too, someday.

      Reply
  9. My mother has been wearing Depends for quite some time. I convinced long before I moved in with her to wear them to help her when she wasn’t able to move fast enough to get to the bathroom before having an accident.

    She also has elastic shoelaces, a regular walker, a rollator, folding wheelchair, walker bag, sock aids, bed wedges, reachers, potty chair (used over her toilet), Lifeline, hearing aids.

    The one caution I will give, is that depending on your loved one’s pride, stubbornness, etc., you may find yourself spending money on things that they either will not use or give up on quickly. This will build resentment as you see money seemingly going to waste. So, be sure before you buy something whether or not it will really be of help to them or whether it will be just one more thing sitting unused. One thing I had to learn (the hard way) about my mother, is that she’s good for wanting everything she sees or that someone else like a therapist or doctor suggests, but then it goes unused.

    Reply
  10. Quick tip… I use Goodnites BedPads on my mom’s bed. They can be found in the children’s diaper section. These bedpads have the sticky back so when sliding mom up, they stay in place. Also, much more absorbent than the blue chucks that hospice supplies.

    Reply

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