www.incontinentsupport.org

New blog post, "How often should I change?" based on new products available that claim enormous fluid capacities how long can you go between product changes? here are some of my thoughts!


*I made a slight edit to the opening of the blog and included issues with skin breakdown from extended use with the older products.

https://www.realworldincon.com/blog/how ... d-i-change

_________________
Incontinence does not Define NOR limit you!
http://www.realworldincon.com

Join us on Discord! https://discord.gg/VCUBeUd

realworldincon@gmail.com
#realworldic on Facebook and Twitter

I've found with the latest super premium diapers (Better Dry, Dry 24/7, MegaMax, etc.) I can easily wear them for 10-12 hours (or more) without a leak. But, recently after wearing them for extended periods each day I developed a rash on my inner thighs. I tried to treat the rash with various rash creams and anti-fungals but with no results. After a bit of research I learned that it wasn't a regular rash. Those are typically caused by bacteria or fungus. In my case it turned out to be a chemical burn from ammonia that was building up in the diapers that I was wearing for extended periods. As soon as I started changing more frequently the rash slowly healed on it's own with normal showers and cleaning with wipes at diaper changes. I can get away with extended wearing times from time to time but not on a daily basis.

As far as I know most products are desiged for a wearing time from round about 4 hours. This time is used also for the calculation of the daily needs. Some products my be able to depress the ammonia development for a longer time - how ever, the better way is to change more often and don’t let the skin stay wet for a longer time. For this reason it may be an option to use a lower absorbent product but change more often. In the end this might be even cheaper and more over - at last for germany I can say - it’s easier to get the costs covered by the health insurance.

Skin problems are also the reason way diapers sometimes are not the first choice and draining systems may be in some cases the better option.

@Padded I used to get those ammonia burns when i was using cloth, but I personally never get them with disposables.

@Micheal

Generally speaking, using less absorbent products, and changing more frequent works out to being more expensive. It's as if there is a base code per unit, and then a cost for the absorbency, and adding more diapers to the day just drives up the unit price too much. I'm sure the balance depends on which two products you're comparing, but I don't think more frequent changes works out cheaper as a general trend. Also, in the US, it's almost impossible to get diapers covered by insurance, period. Tricare (which is the military plan), and Medicaid (which is the government plan for people that are generally permanently disabled) are there only plans that cover it. Medicare (the government plan for folks that are destitute, and the elderly) doesn't cover diapers, and all private insurance plans seem to base their coverage on Medicare.

I don't disagree with your point in making that the skin must stay dry as that is critical to an individuals health and that why we put it so high in importance- "Rule 2"

As for costs, this can get tricky and it boils down to cost per brief and how often they need to be changed a premium brief can usually easily be changed every 8hours and more and the lower product at 4hrs or less if you consider many institutional products. you can do the math on individual products to find the value. In my experience, the products that were of decent quality but only had the capacity of 4hrs were way more expensive to use per day than using a few higher qualty products with the benefit of less changes and more time and freedom. but there are other things to consider in this equation besides cost per brief.

1. does the wearer need assistance? if so you must include the labor for the product change (even family members helping have a labor cost (usually called love) but the more changes in a day the more labor required.

as for other drainage systems they absolutely work for many people and worth a try, however, they do not work for some people and are not without risks they can cause skin breakdown as well.

but no matter what, the product is only good as long as it can keep the skin dry for the wearer.

_________________
Incontinence does not Define NOR limit you!
http://www.realworldincon.com

Join us on Discord! https://discord.gg/VCUBeUd

realworldincon@gmail.com
#realworldic on Facebook and Twitter

I use BetterDry brand disposables, which are a high quality and large capacity product. I find that using three of these over 24 hours while keeping myself adequately, but non excessively, hydrated works well. When I make a change, I also liberally cleanse my diaper area with baby wipes. This regime keeps my skin healthy and free of rashes.

Hi MSUSpartan,

it is really interesting to see how various this is handled in different countries. In Germany it seem to be very different compared to the US. Medical aids (like wheelchairs orthopaedic braces and also diapers) are (at last partly) covered by the national health insurance system. If it comes to diapers this is again somehow "special" because the way how this is handled depends hardly on the insurance company itself. There is a law, that bound the companies to a supply mandate for medical aids but it's up to the insurance company how they handle this in detail.

Just to make things even more complicated it's not always easily to change a insurance company. If you are lucky and the company you are working for have it's own insurance your are normaly fine because these normally make less problems compared to the public or privat companies. You can chose also the insurance company if you are over a dedicated income threshold. Otherwise you have to live with the national health insurance.

The way the insurance often deal with incontinence supplys is, thats they shift there responsibility to subcontractor (if you are not in institutional care). The subcontractor do it's business model on a mixed calculation with the assumption that the most common absorbing products are pads. Diaper are expensive and a "exception". More over he do a very simple calculation of your needs: He take mean value of your leakage over 4 hours and chose a product that is capable to take that. With this calculation normally a simple pad will do the job. If you are not happy with this it's up to you to negotiate with the subcontractor and prove him wrong.

If you simply ask for diapers, the contractor will try offers your pads or a cheap solutions in any case and try to explain you should simply change more often or that the products your asking for are oversized for your grade of incontinence. This is indeed cheaper for him because of the mentioned business model. Despite of the fact that this may sometimes also a better solution at last I can say that I prefer a individual supply that fits to my own needs. But to get this, you normally end up that you have to prove the supplier wrong and it's up to you to show that the products they are offering do not live up with your demands and the law.

On good base for this argumentation is a database from the umbrella association of the health insurances in Germany where all medical aids that can be prescribed are listed with there technical parameters (if you can read a bit German you my try this link: https://hilfsmittel.gkv-spitzenverband.de/produktlisteZurArt_input.action?paramArtId=4514. The good thing is, that the technical parameters that have to be listed are given by law. The way the argumentation had worked for me was to take this database and check for products with the appropriate parameters. This was in my case the ABL value and the absorption speed. With this knowledge I went to my urologist and ask him to put the parameters on the prescription.

The supplier have the right to offer medical aids of his choice after a thorough consultation. How ever - he have not right to ignore the prescription from the treading doctor. So if the prescription say something like "absorbing aids for incontinence" the supplier can deliver nearly every think he want - but the more the doc specify the prescription the less freedom of choice have the supplier.

Unfortunately this is often ignored by the supplier in a first step, and this is the point were you have to start writing endlessly letters, and maybe have to involve also lawyer. I may case I had at last a little bit luck because one of the subcontractors of my insurance company was also a manufacturer - in my case Attends. It still need over 6 month before we find an gentle agreement that fits more or less for me. In the end I had to pay 15€ extra per month for the supply of 28 Attends Slip Regular 10 + 21 Attends Adjustable 10 + 56 Attends Air Comfort 7 pads per month.

For me personally I do not have heavy 2 complete loss of bladder control, unlike quite a few users here. That being said, the sheer volume of my voids when I do have episodes can easily overwhelm most if not all mid-range products with a single wetting. I still cannot predict when and where an incontinence episode will occur, thus I wear adult diapers 24/7. More often than not, my bladder behaves and the product I have on goes unused. For this very reason until recently I opted for cloth, because it seems very wasteful to invest in a case of Premium diapers only 2 dispose of half of them unused, that is to say they have been worn for the sake of keeping my dignity protected, but have not absorbed any urine nor contained any fecal matter. In my case thankfully fecal incontinence is quite rare, but it has happened. I only recently stopped using cloth products because I gained enough weight where the products I had no longer fit comfortably. In order for me to ensure that my work mornings go well in Comfort, I invested in a case of betterdry. I bought it with the intention of using it only in the mornings, but I admit to preferring betterdry 2 my Medicaid provided attends do to comfort. Needless to say, every products whether or not it has been what needs to be changed eventually because The padding breaks down and sweat accumulates. So, what does this mean for me when it comes to how often to change? Since I do not often suffer small and repeated incontinence episodes, although it sometimes happens, for the most part it makes sense to wear the Medicaid provided products until they are wet Evan change immediately. This is done despite the fact that theoretically the diaper could absorb more than it has. My skin tends to sensitive, so for me wearing a wet diaper gets uncomfortable rather quickly with standard mid-range absorbency products. Which is why I operate on change when wet basis when I I'm not using premium products. If I am ever in a situation where I can't change immediately after wetting, case in point working, I opt for premium products. I have discovered that the more absorbent potential a product has the more comfortable it is when it is wet. This isn't true for every product but it stands as a general rule. So with all this in consideration I tend to underuse capacity wise any and all products I wear. But when to change should not only be based our capacity but comfort of the user. I have long said you should not push extended wear if you don't have to. This is really best for comfort of skin. Now, if I were in a situation where I had the bladder capacity at control of an infant, where I was wetting small amounts every hour or half-hour, it would not make sense 2 op round change home when wet basis. I thank my lucky stars that that is not the case. Everyone needs to decide for themselves what Thing Conference level is and what is comfortable for them it's comfortable for them. Because at the end of the day all that really matters is it the products you War and disposed of or washed got you through your day or night dry and upholding your dignity. Any other consideration of cost or waste is secondary to that.

_________________
"We cannot do great things. We can only do small things with great love" Mother Teresa

"THERE ARE FOUR LIGHTS!" - Captain Picard from Chain of Command, Part II

"But when to change should not only be based our capacity but comfort of the user. I have long said you should not push extended wear if you don't have to. "

Well said!

_________________
Incontinence does not Define NOR limit you!
http://www.realworldincon.com

Join us on Discord! https://discord.gg/VCUBeUd

realworldincon@gmail.com
#realworldic on Facebook and Twitter