Support for dealing with incontinence
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PostPosted: Fri Dec 20, 2019 10:30 am 

Joined: Sat Mar 18, 2017 10:36 am
Posts: 11
Finding the best kind of protection is a big concern for those of us who are incontinent. Sometimes the variety available looks bewildering; many kinds of incontinence wear are usually referred to by brand names, which convey little to those of us who are not familiar with many of the brands available. So what can be done to give us guidance on how to identify what is best or at least good for each of us?

Before going any further, I should explain a little about my own situation, as this will affect how I see the choices available. In 2013 an accident left me with spinal injury at C4/5, paralysis, severe spasticity and double incontinence. I have a suprapubic catheter and bowel evacuations by district nurses on alternate days. I wear an Abri San Premium 6 pad all the time, held in place by Abena Abri Fix fixation pants or Allanda iD Expert Ultra.

Something that gives us the protection we need is essential but is not the only consideration: there are also issues of appearance and cost.

Appearance: many concerns are expressed about whether incontinence wear will be detectable beneath outer clothing; some feel restricted to clothing which will hide the fact that we are incontinent; so a less bulky alternative might be preferable so long as it does the job. There is also the issue of how we feel about the appearance of our incontinence wear when it is seen by nurses, carers, partners or whoever. Certainly manufacturers pay attention to making their products look attractive, in many cases, as close in appearance to normal underwear as they can.

For some, life style will influence the significance they attach to appearance. I spend all day in a wheelchair and all night flat on my back in bed. More active people are likely to be more concerned about whether their incontinence wear is hidden by their outer clothing.

Cost: why pay more than we need to for something that does the job and is of acceptable appearance?

Diapers, pull-ups, fixation pants, nets or knickers with many brand names are really all variations of ways to hold a pad of absorbent material in place and to be able to get access to it as needed. The differences between the variety of incontinence wear amount to a few features:

amount of absorbency;

whether they open with tapes or studs (diapers), usually at the sides or whether they are sufficiently stretchy so that no opening is needed (pull-ups or fixation pants);

material used: waterproof (usually plastic or rubber) or textile.

washable or disposable. This is likely to affect cost. My washable fixation pants cost very little. I use only about six per year. The last pack I bought cost £6 for 25. I use one disposable pad per day costing around 30-35p.

Whether the pad is fixed to the pants, such as in a pocket, or just covered by them might be significant for those who have an active lifestyle. Some fixation pants, including mine, allow the pad to be moved in them.

Gender: neither the pads or pants that I use indicate on the packets which gender they are intended for; presumably they are for both. This seems to be quite common. The difference in position of the urethra perhaps makes that surprising. My pads are long enough to reach the entry point of my suprapubic catheter if not placed too high at the back. Some brands of pad are clearly female.

So how can we find what incontinence wear suits us best or at least well enough? A good starting point would be an estimate of urine leakage, and if applicable, faecal leakage, per day. This will set limits on what would work, frequency of changing and whether disposable or washable would affect the cost. Having a suprapubic catheter reduces a great deal the capacity needed for my pad. Bowel evacuations result in faecal leakage being unusual for me.

Some of the advertisements for branded incontinence wear give quite good guidance on questions such as level of absorbency, method of opening, material used whether washable or not and other issues raised here.

PostPosted: Fri Dec 20, 2019 5:56 pm 

Joined: Sat Mar 29, 2014 11:45 am
Posts: 1386

I feel inadequate to respond to your thoughtful post. Perhaps you should aim your concerns and questions in the direction of a continence nurse. Living as you do from bed to wheelchair makes anything I might type, however well intended, irrelevant. Your situation and the ways you deal with it make your contribution here invaluable. Thank you, and report back when you can.

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