- Types of incontinence
- How to change a garment
- Attitudes surrounding incontinence
- Skin issues with incontinence
- Controlling odor
- Tax deductibility
- Modern day incontinence products
- The future of incontinence products
- Challenges shopping for incontinence products
Types of Incontinence
- Stress incontinence
- Urge incontinence
- Overflow incontinence
- Functional incontinence
- Mixed incontinence
- Anatomic or developmental abnormalities
- Temporary incontinence
These activities apply sudden pressure to the bladder, causing urine to leak out. Stress incontinence is the most common type of incontinence among women, and may be due to weakened pelvic muscles, weakening in the wall between the bladder and vagina, or from a change in the position of the bladder. In many cases, the condition develops as a result of pregnancy and childbirth. Other causes of stress incontinence include:
- Weakening of muscles that hold the bladder in place, or of the bladder itself
- Weakening of the urethral sphincter muscles
- In men, benign prostatic hyperplasia (a noncancerous overgrowth of the prostate gland) prostate cancer or from prostate surgery
- In women, a hormone imbalance or a decrease in estrogen following menopause, which can weaken the sphincter muscle
- Damage to the nerves controlling the bladder resulting from diseases such as diabetes, stroke, Parkinson's disease and/or multiple sclerosis, or from treatment of gynecologic or pelvic cancers with surgery, radiation or chemotherapy
Urge Incontinence - Most common in the elderly. Urge incontinence is the frequent, sudden urge to urinate with little control of the bladder (especially when sleeping, drinking, or listening to running water). It’s a problem with an over sensitive bladder.
- Diseases of the nervous system, such as multiple sclerosis, Alzheimer's or Parkinson's
- Tumors or cancer in the uterus, bladder or prostate
- Interstitial cystitis (inflamed bladder wall)
- Prostatitis (inflamed prostate)
- Prostate removal, cesarean section, hysterectomy, or surgery involving the lower intestine or rectum
- Severe constipation
- Infections in the urinary tract or vagina
- Certain medications, such as diuretics (water pills); sleeping pills or muscle relaxants; narcotics, such as morphine; antihistamines; antidepressants; antipsychotic drugs; or calcium channel blocker.
How to Change Disposable Briefs (Adult Diapers)
Supplies to Have On Hand
- Disposable briefs, pull-on underwear, booster pads, bed pads (whatever meets your need)
- Latex gloves
- Disposal bags
- Skin cleansers, skin replenishers and moisturizers, skin protectants, powder
How to Change a Disposable Brief
- It is helpful if the person is wearing a gown with the opening in the front for easy access to the brief (like a hospital gown).
- Before every change, put on latex gloves. This keeps you from spreading any germs.
- Next, have some wipes ready. You can use a dry wipe with a skin cleanser or a wet wipe. You want to clean the skin of urine, powder, fecal matter, etc. Also have a moisturizer, skin protectant and powder nearby. Clean from front to back and ensuring you clean any folds or crevices.
- Undo the tabs with the person lying on their side facing away from you. To help them onto their side (if necessary), move them gently using their hips, not legs, shoulders or arms. You could injure them.
- Move their knees toward their chest making cleaning easier.
- Roll the soiled brief inward as you pull it away from the skin, keeping any mess tucked inside. Place the brief and wipes in a disposal bag.
- In order to make sure the new bed pad will be centered under the person, keep one third of the pad rolled up against their body so it is easy to pull into position once they are situated on their back again.
- Roll them over on their other side towards you, and flatten out the bed pad. Ensure that the brief is smooth over the person’s skin. Wrinkles in the bed pad or brief can lead to bed sores.
- Fasten the tabs on the brief, smoothing out any wrinkles pulling the gown gently down in place.
- Cover the person with blankets, making sure they are in the middle of the bed to prevent them from falling out onto the floor. Use a bedrai for peace of mind.
- Take your disposal bag out to an outside trash can, put soiled linens in the washing machine immediately and then remove and throw away your latex gloves. It is extremely important your gloves are removed after the job is completely finished. Once you throw away your gloves, wash your hands with warm, soapy water.
Attitudes About Incontinence
Pull-On Underwear and Adjustable Underwear
Treating Skin Issues
- Wearing the right sized product to avoid leaking and chaffing
- Changing frequently so the skin stays dry
- Cleaning, moisturizing and protecting the skin at each change - don’t short change this step
Treat diaper rash as soon as you notice it. The faster the treatment, the faster the cure. A "normal" diaper rash should clear up within three days with good hygienic care. If it lasts longer, see a physician to ensure that the condition is not something more serious than a simple rash. Possibilities such as a more complex bacteria or yeast infection, psoriasis, atopic dermatitis, seborrhea or an allergic reaction should be ruled out.
- Do not use baby powder while a rash is present. The powder can build up in the skin creases and hold moisture. This may help bacteria grow and cause an infection.
- Do not use corn starch as a powder. Despite its seeming homeopathic appeal, it actually feeds yeast, making it multiply rapidly.
- If the rash is bright red and continues after three days, it is quite possible you are dealing with a yeast infection. Over the counter yeast ointments such as Lotramin are safe to apply to the affected area. Of course, seek a doctor's advice about if you have a lingering rash.
- Keep the skin dry and make sure the skin is not in contact with urine or fecal matter.
- Apply a zinc oxide based ointment to the affected area which will act as a moisture barrier and speed healing. Use a good adult diaper rash ointment such as Aloe Vesta Antifungal Ointment, Ca-Rezz Moisture barrier cream, Elta Seal, Remedy antifungal cream or Tri-Derma protect and heal cream. We offer over 32 different varieties.
- Avoid use of ointments containing hydrocortisone or neomycin. A normal adult diapers rash will not be helped or healed by their use.
- Increase the persons fluid intake, particularly of water or cranberry juice. Acidic juices are not (i.e. orange). The persons urine will be less concentrated and less irritating to their skin.
- Leave the briefs off as much as possible. With more severely compromised skin where a brief may be painful to wear, try allowing the person to lay on the bed pad without wearing a brief. We have a line of super premium bed pads which are specifically designed for this purpose. Samples are available to try before you buy.
- Gently wash the diaper area with warm water and a soft cloth. Rinse well and dry completely.
- Do not use any soap unless the area is very soiled. Use only a mild soap if soap is needed.
- Do not use wipes that have alcohol or propylene glycol to clean the skin while a diaper rash is present. These may burn the skin and spread bacteria on the skin.
- You may use a blow-dryer set on warm setting to get the diaper area fully dry.
- When using disposable product, fold the plastic area away from the body, and do not put the brief on too tightly.
- Do not use bulky or many-layered incontinence briefs.
- Do not use plastic pants until the rash is gone.
- Soaking in a warm bath for 10 minutes, 3 times a day, if the skin is very raw.
- If you use a cloth product, switch to a disposable product. The cloth or the products used to clean the cloth diaper may be causing the rash.
- If you use cloth and do not want to switch to a disposable product, change detergents. Rinse cloth briefs twice when washing. Use vinegar in the final rinse at a strength of 1 fl oz (30 mL) vinegar to 1 gal (4 L) of water.
Follow these tips:
- Steer clear of coffee and foods like asparagus that can give off odors. Drink some cranberry juice. It naturally reduces odor.
- Keep yourself, your clothing and bed sheets clean.
- Use a disposable incontinence product with superabsorbent material. The super absorbents help trap the odor.
- Try taking vitamin C or deodorizing tablets. Check with your doctor before taking vitamin C tablets. And don’t substitute citrus fruits or juices for the tablets, as they can cause bladder irritation and odor in the urine.
- Use an air freshener that eliminates odor rather than masking it. Two examples of professional grade products are April Fresh Odor Eliminator, Hex On Sween Odor Antagonist
- The best way to control odors is a combination of good hygiene and the use of commercially-prepared cleansers and deodorants.
- After voiding or bowel movements, wipe from front to back with a wipe.
- Clean the area at each change with a gentle cleanser - rinsing and drying thoroughly.
- If the skin is dry or reddened, a moisturizing cream may be used.
- For further skin protection, a protective ointment (not urine soluble) may be applied to the skin as a final step.
- Keeping skin and products clean and frequently changed is the best guarantee against odor.
- Always dispose of products in an airtight container. We offer special disposal bags for incontinence products. These should also be used when traveling or visiting with others.
- If you have a persistent odor problem in a particular room, use a black light to illuminate all surfaces in the room. Urine will glow under black light, and once detected can be cleaned.
- A good quality stainless steel pedal or step trash bin placed in the bathroom would be a good start. These can be found at WalMart, Target, etc. It should have a lid that closes securely. Line it with a trash bag before use and seal the soiled underwear in a disposal bag before tossing it into the trash.
- Poly packaging (versus cardboard boxes)
- Male guard (primarily for use after prostate surgery)
- Pull-On underwear (and refastenable underwear) and finally gender specific
- Pads for women (such as Poise)
Tax Deductibility of Incontinence Products
Modern Day Incontinence Products
Movie Star Drives Awareness of Depend
Three Decades of Change
- The first product was briefs, also known as adult diapers. They were, and are, anything but “brief.” Then came undergarments with button straps.
- Different sizes of briefs were introduced.
- The outer shell was changed from plastic to a cloth-like, breathable material, reducing the rustling noise and allowing skin to breathe better.
- Product packaging changed from bulky cartons to slimmer poly bags. The packages were easier to tote also.
- The use of super-absorbent material, which replaced a lot of the “fluff,” made the products better fitting while improving absorbency.
- Guards for Men were introduced, targeted to men experiencing incontinence following prostate surgery.
- In the late 1980s, it was discovered that 20 percent of feminine care pads, such as Kotex, Always and Stayfree, were being used for incontinence. This led to the introduction of Poise by Kimberly-Clark, a successful line of pads ranging from 7.5 inches to nearly 16 inches long. Unlike pads for feminine care, incontinence pads like Poise were super-absorbent and protected three times better.
- The last major innovation was pull-on underwear, first introduced in the United States by Kimberly-Clark. One day, I was sitting in my office wearing a “brief” over my suit pants, thinking about we could do better than that and that I wouldn’t want to have to wear one of those. Within two years, Depend protective underwear were introduced and they became the #1 seller because they were more like regular underwear while offering a high level of protection.
- There are no naming standards for styles, and the descriptions are changed frequently. For example, undergarments are now called shields, even though there were shields that were a different product form.
- There are no standards for describing absorbency levels. One manufacturer’s most absorbent product is “extra absorbency,” while another’s is “super plus.” How does an individual decide?
- Nomenclature used to describe products is not easily understandable, especially when trying to compare brands. For example, there are ultra-thin pads, ultra-thin with wings, ultra-thin long, moderate and maximum - yet the maximum version is not as absorbent as ultimate. This is how just one manufacturer describes its pads; another uses its own descriptions, such as moderate, heavy and overnight. How does one decide?
Swim Pants for incontinence. This are reusable, washable products which are worn next to the skin, under a swim suit. They are designed to contain stool from a bowel movement while at the beach or pool. They allow a fecally incontinent individual to have the confidence and dignity to spend a day at the pool or beach.
Other Important Incontinence-Related Products
- Look like normal underwear. Colors and patterns will look more like regular men’s and women’s underwear. No matter her age, a woman might like to match her underwear to her outfit when going out. The days of “any color as long as it’s white” will soon be over.
- Fit like normal underwear. Wearers also want a close-to-the-body fit for better containment. Manufacturers may replace fluff with thinner fabric-like materials that contain a new class of super-absorbency. This will make the product much thinner, more flexible and less noisy.
- Be sized to protect better. Since the ability to absorb and protect is directly linked to the fit of the product, more sizes will be available. While there are products to fit waist sizes from 20 inches to 94 inches, most are unfortunately not available in stores.
The manufacturers will introduce products especially designed for individuals with special needs who lack of muscle tone doesn’t allow current products to fit correctly - either the children’s or adult pull-on products.
- Cost less and offer better value. Future incontinence product designs will use less materials to provide the same or better protection, and will be manufactured on equipment that is more efficient than today’s.
- Simplify product selection. Manufacturers or the governments will establish comparative nomenclature to help consumers decide which product is right for them.
In the 1980s, tampon manufacturers used different absorbency ranges with different descriptions. None were comparable between the different brands. One manufacturer even used the description “heavy duty” for its most absorbent tampon! Ultimately, the federal government mandated standard absorbencies and descriptions. Perhaps this is what it will take in the incontinence products category.
Difficulty Shopping for Incontinence Products
Here is a resource you may find helpful: The CareGiver Partnership offers more than 500 incontinence products, ranging from the limited selection found in most stores to the hundreds used by health care professionals. Whatever you need can be delivered to your home on a schedule that you determine and that can be changed at any time.
Experience tools that help you quickly and easily find the right product, such as the Incontinence Product Finder. Browse a library of more than 1,000 caregiver resources, the largest in the world. And enjoy access to a board-certified Physician Assistant and Mayo Clinic-trained Nutritionist.
But what many customers say they really appreciate is the personal help by an all-female team of knowledgeable Product Specialists who have each been a caregiver to a loved one. Since this is their only business, they know incontinence products inside and out. Call 1-800-985-1353. Ask about a sample service that allows you to try before you buy; for $3.49, you will receive a two-count sample of your choice from more than 100 products.