(public domain image from isic @ Pixabay)
Yes, because the world is full of irony and oxymoron, someone has indeed created incontinence lingerie! [click the link to see for yourself, although it’s not quite what we think we need here.]
As a person’s hygiene needs change, what can a caregiving old guy do? All the changes seemed to happen gradually, so a caregiver gets to exercise continuous adaptation. A few accidents do not become a “new normal” automatically, for a tolerant optimist. One learns to do laundry efficiently and often, before finally deciding to try disposable adult underwear. Then the choices become baffling.
[This post is NOT a “pity ploy,” and certainly non-commercial. I hope it has stuff that is useful or at least amusing to some, and the link to the poem at the end is really worth the click.]
One current night time regimen: 1) four underpads (“chux”) spread out between a waterproof “mattress protector” and under a fitted sheet. 2) two underpads directly beneath the person, vertical under the torso, but horizontal under the hips. 3) overnight “high capacity” disposable underwear, with a “stackable” absorbing booster liner on top of a commercial “night time max” liner. 4) Generic zinc oxide ointment on any skin areas that look reddish; store brand skin protecting lotion for other areas, with dimethicone and petrolatum, etc.
The overnight underwear might have great reviews, maybe it’s the best available, but here it’s about 50-50 even with liners, so we are still hoping to find something that works better. Daytime regimen: rotate three different brands of disposables, trying various liners, several times a day.
Of course, being a parent and a pediatrician, I’ve changed lots of children’s diapers in my day. That’s why I prefer the more cumbersome term “adult disposable underwear” instead of “diapers” in caregiving, but that’s probably just me. “Underwear” is the term you find printed on most adult packages, usually denoting the “pull-up” types, while “briefs” is the term used for the ones designed with closing side tabs (confusing for an old guy with his own boxers or tighty whiteys that are all called briefs).
After months and months of doing trial and error, I found an educational resource, basically a buying guide (click here) at a national incontinence vendor (which I haven’t used directly). While it is helpful at this stage in trying to find better performing products, to meet a greater need, using products available locally was eye-opening. Reportedly now a $1.8B market, and growing.
A caregiving old guy gets a little sheepish when asking young store folks to help. Each was nice and apologized for not seeming to have the right products, or even knowing the difference between products, and why some products for “overnight protection” were grouped on different shelves (“the aisle of despair?” ha ha).
Most embarrassing was trying to understand if liners were mainly for menses, or for urinary or other incontinence, or whether or not it even mattered. Luckily I found an even nicer older store person who seemed to know some things; unfortunately none of her recommendations worked all that well, not her fault.
Along the way, we found that certain brands of disposable underwear seemed to cause more chafing and irritation of the skin, others seemed easier to remove (by tearing down each side), others seemed to have better waist bands, others leaked more. And we’ve tried a myriad of creams, wet wipes, dry wipes and underpads, with no real significant differences.
Taking care of skin that can get wet and soiled, and subject to weight-bearing (in a bed or wheelchair) is really important. We use a lot of chair padding and moving. Hospitals even have “wound care teams” that treat or prevent pressure sores (aka decubitus ulcers or bedsores), because they can be vexing problems ( a caregiving old guy sure knows vexation, but wants to prevent it). Basic info, from the US Nat’l Library of Medicine, with links, here.
I mentioned optimism and continuous adaptation earlier, which might seem a bit contradictory. Ever been subjected to fads like “continuous quality improvement” or “total quality management” or other nauseating terms like “lean processes?” Remember the ole Plan-Do-Check-Act cycle?
There are lots of videos about incontinence care (here’s one with a manikin). My approach, about products and the nitty gritty, has been simple trial and error, but here’s the problem: it takes some forebearance by the one needing care. It brings to mind the idea of “Learning by Doing,” the name of a poem by Howard Nemerov, a compelling perspective with a flash of ironic wit.
Still a work in progress here…..
