an effort to not re-invent the wheel. I am going to refer you to ...
Delivery Incontinent Supplies Co., Inc. (HDIS)
just a catalogue but a resource tool on adult incontinence products.
This company will
give you a catalogue complete with pictures, descriptions, a list of the brand names,
and how to order them. Their
deliveries are in plain packaging, they are extremely helpful through their
hot line, and they are a nation wide company. I believe they also accept
discount coupons for product brand names. They carry all the
will send you a sample pack of a variety of products upon request for you to
try out and a full
catalogue which will allow you to look at and examine the products at your
Their 800 number is: 1800 269-4663
Web Page: is: www.hdis.com
The products fall into these categories:
and Pant Systems
will be referring to these various products throughout this section of the
web page and I will be breaking the tasks and techniques into the Three
Stages of Care
because there are different needs and different techniques for the different
stages of this illness.
and Supervision Stage of Incontinence Care
the 'accidents' become more than very infrequent happenings, you will be
relying on reminding them, hovering to help with fastenings of their
clothing, helping them find the restroom in public places and generally
taking a somewhat benign approach to the increasing hygiene problems.
the end of this stage this will begin to change. The 'accident's will
happen more often, the race to the bathroom will get more frantic, you won't
be able to trust them completely on their own in public rest rooms because of
the increasing problems with managing their clothing, and the constant
reminders won't work.
They aren't wiping themselves properly after a
They will be wetting themselves
They may have an
occasional bowel movement in their undergarments.
In the section on
'Dressing for Incontinence Care,' I advised of the need to get men
out of boxer shorts and women out of the flimsy panties and into a more substantial cotton
brief-like pant as soon as possible. Now it is essential if it hasn't already been accomplished.
is also time to buy that first bag of incontinence products.
questions are: Which product? Where do I start? How do I
Your person will still be
able to understand a great deal of what is going on, they will probably deny
the need to use these products so don't ask for permission to use them, and you
can anticipate a major blow up at the
mere suggestion that they need them.
this in mind and minimize the taboo aspect of what incontinence products
symbolize. They are simply a device, a tool, a product, that eliminates
the need to go through hell every time your person needs to use the
bathroom. It takes the stress off the family member and it gives the
caregiver control over what is only going to be a worsening situation until
they are fully accustomed to wearing these. You need to understand
that they are not going to be able to relearn how to be independent in terms
of their personal hygiene any more than a small child can. Your
attitude towards the use of these products is more than 90% of the battle.
So get a grip. Your fears associated with this step in care is far
worse than what reality will be.
Tips about using incontinence products:
the pad as part of the dressing drill.
a beltless pad that can be affixed to the underpant as the first product.
it in the underpants before your dress them. They may not even notice
feel you have to go into lengthily explanations of what you are doing
and stay away from words like Diaper or product names such as Depends or
Attends to qualify what your are doing. Keep it simple.
them the truth if they ask. Tell them it's too crazy racing to the
bathroom 40 times a day and this pad will take the stress off
Them. Pads are just a back up in case they can't get to the
bathroom on time. Add
that you love them and it will be easier on you and less embarrassing on
them. You support, love, and encourage them and don't dwell on it
ad nauseum. If your
female person protests mention it in relationship to a menstrual
pad. If your male person protests, minimize emphasis on the pad
and talk about jock straps or trusses as something marginally familiar
to them. They may focus on the marginally familiar more, and less
on the incontinence product.
You might be surprised
at how little they respond to this change in care. It all depends
on your attitude and manner. Everyone who takes care of someone
with this disease makes this transition so you aren't the only one going
practice you can accomplish inserting a pad and removing and replacing a
pad in a few minutes. A routine is a routine.
from behind them. It helps with privacy issues and as their
confusion increases they will have less and less awareness of what you
they do have a bowel movement the beltless pad will at least hold the
majority of it in one place, another reason to get them into substantial
are several different types of beltless pads on the market, some of them
designed specifically for males and females and some that are genderless.
Products range from those that look very much like womenís menstrual pads to
rather substantial pads that measure 14 inches or more in length.
of the brand names to look for are: Reassure, Serenity Poise, Surety,
Attends, and Depends. Don't ignore the generic brand names sold in
chain drug stores and department stores. They work just as well and
are less costly.
are called guards, pads, shields, and beltless pads. Most of them
have gathers on the sides to help contain liquid flow and the absorbent material
is the same as used in baby diapers, a form of absorbent gel or
fiber. Shields donít have gathers but they do have channels designed into the
pad to help move liquid flow along the pad quickly to aid in absorption. All of
these products come with adhesive strips.
used all of them in varying ways.
Note To Consider:
are used to wearing menstrual pads and may
actually have less reaction to a little more bulk in their underpants than men.
with a pad that is similar to a menstrual pad such as those offered by Poise,
Serenity, or Reassure to name a few.
have used cups, jock straps and other various devices during their
lifetime and wearing such items along with underwear is not totally out of
their realm of experience. Men need something a little more substantial because
their equipment is less contained in one place than is that of women. I used
both guards and shields for my husband as well as other forms of beltless pads.
The guard has a natural contour to the body, it has a gel inside that absorbs
liquid very quickly, and I placed it in his underpant in the spot where it would
catch the most flow. (Similarly to how we folded cloth diapers differently for
boys and girls back in the days before disposables. The principal is the same.)
facilitate ease in moving the pad in and out of the underpant just tear off
part of the adhesive tape. I tore an inch or two of the
tape off in the front and back of the
pad and it stayed in place well enough to meet the needs. If the underpants are snug enough you
may not need to stick it in place at all. The
less adhesive to deal with the faster and easier it is to remove the used pad
and slip in the new one.
common sense, and do what works for you.
are two ways to insert that first beltless pad while helping to dress the
the pad of choice, secure it to the inside of their underpants with its
adhesive strip. Treat the entire package as one item of clothing and then
assist them getting it on.
the pad in the underpants as you help pull the underpants up. Do this while
working behind them.
a used beltless pad for a fresh one is the same for men and women.
behind them and undo clothing from behind.
clothing, undo trousers or clip up skirt.
the clean pad within reach.
the back of the underpants away from the body, slip
used pad out of underwear and discard out of their reach and visual field.
(You donít want them to be able to reach for it.)
in clean pad and adjust for position.
up underwear, rearrange clothing
with the used pad after your person is re-arranged.
pads usually have gathers on the sides to help contain liquid flow and elastic
belts which fit around the waist. They come in medium and large sizes,
the difference being in the length of the elastic strips that come with the
elastic belts come with buttons and some with Velcro, (similar to baby products now on the
medium size may be too large for a small boned woman or man. I moved
one set of buttons
on several pairs of elastic bands, and using double strand button hole thread
and a large needle the whole process only took a few minutes of television
viewing time. The elastic bands will take months of wear if they are hand
laundered and air dried. Do not put them in the drier, the elastic will
disintegrate over time.
of the brand names to look for are: Reassure, Surety,
Attends, and Depends.
The generic products offered by chain drug
stores and department stores. These work just as well as the
more costly brand names.
belts to the front of the pad and place inside the underpants
on the underpants, reach around from behind your person and fix the
buttons/Velcro of the elastic strips one by one in the back of the
the used belted pad while the family member is dressed..
from behind your person.
the elastic strips in a clean pad, buttoning in back only and set within easy
reach. If also using an inset pad secure it in place at this time.
undo clothing and drop underwear from behind.
front buttons of the belted pad, remove used pad from behind and discard out of sight and
reach of family member.
elastic strips in back of pad, slip
in clean pad, pull the front up into position, reach around and button elastic strips in front.
(It is easier to move the strips around the side of the person and button in
front that to try and to sling them between the legs if they're attached to
the front to begin with.
clothing and then deal with used pad.
to heavy urine flow - or if you are not going to be near a toilet for an
extended amount of time:
Use both the belted and the
beltless pads together as one unit.
Place a guard or shield inside the belted
pad. In this case I often used one of the smaller feminine products so
that the overflow would be caught by the larger belted pad. There are
also benefits for doing this on a regular bases.
I only had to change the inset thus saving on the use of and costs of the
more expensive belted products. The belted product held the
smaller pad in place without having to use the adhesive strip at all and
with the strip covered it was easier to slip it in and out of the other
The belted product took care of any
over flow the beltless pad might have and the elastic waist strips helped hold
the whole package in close to the body, which made wearing them more
comfortable. Surprisingly the added bulk never seemed to bother my husband.
the inset pad in a belted product involves the same process as that listed for
the beltless pads.
them and undo clothing from behind.
the back of the underpant and belted pad away from the body, reach in and pull the
used pad out and discard out of reach and visual field of your person.
in clean pad.
belted pad and underwear up and rearrange rest of clothing
with the used pad after your person is re-arranged.
all these products with underwear. This is why I recommend substantial
cotton brief-life items. They hold the whole package together and keep
air from the wet pad. Body heat will keep it warm and less
uncomfortable to the wearer until you can get them to a bathroom to change
it. If the underpants droop, air hits the wet pad and it becomes cold
and clammy to the wearer.
Underpants with liners:
products mimic normal underwear. These
are underpants designed to hold a disposable liner and in some cases,
for those who wish to minimize use of disposable items, washable/reusable
liners. The disposable liners are in line with the cost
of other disposables but there is the problem of finding the specific liners for
your specific product in a pinch. Not all stores carry all products. They
are available in Medical Supply Stores, Drug Stores and through HDIS.
I never got into these.
An incontinence product in the guise of a regular
underpant seemed unnecessary to me. Tom made the adjustment to regular
products without any problems, his regular underwear held them in place, so this product was never a real consideration
for me. I also think the purchase of these products
hold more value to women and men who are dealing with other kinds of
incontinence problems, who have their cognitive function, and lives that are
active in ways different from those with Alzheimer's.
the caregivers I've met who used these products with their AD family
members, most discarded them early into the process, and opting for them had
more to do with their own reluctance to accept the incontinence needs than their
family member's. In the end convenience of purchase and use of other
out. It was simply easier to use the standard
If the use of these products makes the transition easier for the caregiver
and offers them the comfort zone they need to work through this period, then go for it.
Whatever works! One caregiver used them exclusively for day time
mother was more aware of her appearance," and switched to a more substantial pad for over night.
This like anything else is a personal preference.
description of this product is listed in the next section in the Taking
Stage of Incontinence Care.
are not recommended in this phase of care. The
drawback in using this product as a primary one at this time is that it is bulky
under clothes and unwieldy to get on and off a still active person. Between the tabs, the wrapping, the
clothing, the time element, it is just too much stuff to deal with. For the most
part your person will only be dealing with urine incontinence during this stage
of care and they are still able to use the facilities normally to a large extent.
The brief, slows the whole process down. and there is nothing familiar about it
to the family member that will enable them to use the bathroom unassisted when
on long trips or over night if your person has had even one Ďaccidentí in
bed, this product is a life saver and I do recommend that you have at least one
bag of these on hand. Eventually you will need it.
of the Changes you can Expect towards the end of this stage of incontinence
may have to help wipe them after a bowel movement, unless you are
comfortable letting them mess their underpants.
will have trouble using toilet paper. You may find the entire role
unrolled and on the floor on in the toilet or shards of it stuck to
gross that this sounds, what I did was wet a thin terry wash cloth with warm
water and poured lotion on it. As Tom stood up from the toilet I
made a quick swipe of his behind with the cloth and discarded it in a pail
with soapy water I
kept by the sink. Because the cloth was warm to his body he was barely
aware of what I was doing and because there was so much activity with
helping him to arrange his clothing he was also distracted from what I was
doing. I rinsed and washed the cloth out after he left the
room. Mothers have dealt with the fall out of their children's
bodily waste and hygiene for thousands of years. This too can be
speaking I got tired of watching Tom miss the toilet. One day I stood
by the door watching the fumblings knowing what was going to happen and
decided there had to be a better way. I quietly moved behind him,
reached around and guided his hand and penis towards the center of the toilet bowl
while I uttered... 'Ready - Aim - Fire.' He laughed so hard we
almost missed the toilet anyway. Believe me, he was just as concerned
about missing the toilet as I was.
I know a daughter isn't going to feel able to make this leap across the
'private space' line as easily as a wife can, but it is an option to think
about. One does just guide the hand.
problem will overlap at the end of the early stage and throughout the mid
stages of this disease.
do you do in public when their needs are so obvious?
accompany them and you do for them as you would for a child and you do it
with authority, kindness and confidence.
check out the articles entitled: "I
There Tried it, didn't Work"
These articles deal with some of the obstacles we throw in the way of doing what has
to be done during the early stage of this disease.
talking with other caregivers:
found it more comfortable to take their wives/mothers into the men's room
found it more comfortable to take their husband/fathers into the women's
this stage it is mostly about managing clothing although towards the end
you may be dealing with pads as well.
to carry an emergency kit with you, one that includes 'Handy Wipes,' and
extra pads, lotions and extra underwear.
the handicapped stalls.
traveling, look for stops off the main highways such as gas stations
that have single occupancy toilets. This way you have more privacy
than you do on major rest stops with multi-stall units and a sink within
I don't know of a owner who wouldn't rather have someone help a family
member with dementia in the rest room than leave them to mess themselves,
the floor, or the toilet seat.
I will state over and over in this site, caregiving is mostly attitude!