www.incontinentsupport.org

This past weekend I was admitted to a hospital in Raleigh, NC for observation due to a back problem. Being admitted to a hospital was totally unexpected as I had gone to see my doctor for lower back pain and expected to receive medications and be sent back home.

I told the nurse that I am incontinent and would need diapers. Imagine my shock when she told me that the hospital had a "no diapers" policy and did not provide diapers. All that they provided was an absorbent underpad for the bed. The incontinent patient is forced to pee and poop on the pad while in bed.

Fortunately, I had two diapers with me in my backpack to tide me for a while. I then frantically called my wife to bring in more diapers from my supply at home.

As it turned out, I was discharged just as my last diaper was about full.

I had read that hospitals with "no diaper" policies exist but had never encountered one. I think it to be demeaning, humiliating, and outright abusive to anyone with medical incontinence. Had I remained in the hospital I would have demanded to see the patient advocate.

Using underpads completely ignores the problem of what the incontinent patient is expected to do when we get out of bed for medical tests and treatments - pee poop on the floor? Of course, if enough of us did that the policy might change.

I am really angry about this. Has anyone else encountered "no diaper" policies?

--John
(double incontinent - diapers 24/7)

About twelve years ago I was in a hospital for very long day of tests and my diaper was in need of changing ( i did not expect to be in the hospital that long) and they did not have diapers so they made me lay in my wet bed all day and it was infuriating, uncomfortable and much more embarrassing as I had visitors and my sheets got soaked over time, it was not a great experience for me.

I know there are several reasons why they might have the policy, but you have to wonder what the real main reason is.

1. Patient dignity, as most people have a negative reaction to them at first

2. costs of diapers (even though the typical diaper used in a hospital is trash)

3. labor for changes difficulty for med techs to change a soiled brief, lifting patients, etc.

4. the people that make this decision have no real experience or understanding with incontinence issues.

my thoughts in this,
Bed pads and wet sheets are not more dignified (personal experience much worse) and much more uncomfortable, new medical research is showing that catheterization has more complications and infection rates and is starting to be recommended less.

while many patients may not want to use the products removing the option and availability of diapers is not the better option.

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That was the policy at the hospital where I had my thyroidectomy last year. And yes, it was exasperating, embarrassing, and everything you described. It made extra and unnecessary work for the staff, who were professional and cheerful; I would not have been if I had been forced to work that way. Recently our hospital was sold to a for-profit group, so I am curious how that will influence incontinent care there.

Yes, I suspect that profit is behind the "no diaper" policy. Diapers are relatively inexpensive (at least the cheap ones hospitals issue) but nursing time is very expensive.

I would not be one to lie on a wet underpad without complaining loudly.

The admission was for a possible emergency surgery. Otherwise I would have inquired about how they handle incontinence and diapers.

Is "no diapers" becoming a common hospital policy?

--John

Incredulous, nonsensical and outrageous. I would think that a significant number of patients receiving care in a hospital at any given time for whatever medical issue have incontinence as a factor in their general medical history. I can't imagine that it's more cost effective and efficient to clean up a mess on an exam table, in a bed or on the floor than one that's contained in a diaper, which is more sanitary.

^^^...What she said

_________________
"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

I would complain LOUDLY if i was treated this way. I would write a letter of forma complaint to the hospital CEO and hell, even the hospital board. I can see possibly getting away with no diapers if a patient is urinary incontinent only, but w fecal icontinence no way. Without a diaper on, the feces would get EVERYWHERE! And what is the patient supposed to do, lay in it???

_________________
"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

If I am forced into this situation again, then afterward I think I would write a letter to the editor in the local newspaper protesting the policy. I think the general public is totally unaware of these policies.

Of course, most of the public will not care unless they themselves are incontinent, but enough people have incontinent relatives that it might evoke a response. Perhaps an approach such as "Would you want your mother or grandmother to be treated this way?" Or perhaps "Hospital forces patients to humiliate themselves!" article.

I still am mad as hell over this.

--John

As the owner of a diaper retailer, I speak with all the factories that make incontinence products for sale to hospitals. I don't sell to hospitals directly so this information is second hand, but a story I've heard many times from a variety of different vendors. It's likely only part of the story, but perhaps the part that is more difficult to learn about...

Hospitals get penalized now by insurance companies, medicaid, medicare, etc... if patients develop bed sores, pressure ulcers, etc... while staying in a hospital. Often times these can lead to painful and expensive surgeries to correct the problems for which the hospital will not get reimbursed if it "developed" on their watch.

Hospitals determined that "diapers" were one cause of this problem, since they allow urine to sit against the body which causes skin breakdown and makes the skin more susceptible to wounds. So they determined that to avoid skin breakdown, they would require the urine to flow away from the body to be absorbed by the bed pad. I know many companies getting rich selling these bed pads to the hospitals as way to prevent skin breakdown and they have many studies to show this reduced surgeries for bed sores...and as a result, the bottom line for the hospital.

Now this is really a "chicken and the egg" story. Don't blame the underpad manufacturers completely for pushing this narrative. They tried for decades to get hospitals and nursing homes to buy better quality diapers that wicked urine away from the skin...but these institutions refused to pay more for better quality diapers, even though there were many studies showing this also greatly reduced skin breakdown.

So when the insurance rules changed to limit payment for treatment of bed sores developed in the facility, the manufacturers tried to get the facilities to buy better quality diapers but failed again. So they pivoted and said...don't buy diapers at all, save the money and the labor of changing then...and many hospitals fell in love with this idea and have run with it. It is showing positive results to their bottom line.

So the big question is...knowing the hospitals and nursing homes refuse to spend more on better quality diapers even if you can prove they would save long-term...

Would you prefer (1) cheap diapers that need changing every 2-3 hours, even at night, and keep urine against the skin...or (2) No diapers and let the urine flow to the pad.

Yes, the health care system is messed up in the USA. There is little concern for patient experience by those that control the purse strings and it has gotten much worse now that almost all healthcare is owned by a relatively small number of giant corporations.

Just my two cents...Sorry for the reality check.

I am fortunate enough not to have experienced this, but I am mad on your behalf!

It does seem like a profit motivation. If your nurses are required to change patients, then you will have to hire more nurses to perform a task most teenagers are qualified to do, while paying them full freight. This is on top of sourcing and stocking diapers in different sizes, etc. A soaking pad is one size. I don't know if a nurse is required to change a soaking pad, though. Maybe they'll try to delegate that to janitorial staff whom they can pay much less.

On top of all this, I wonder how sanitary a pad is in comparison to a diaper. The ideal would be that we weren't incontinent, but.... I suppose that a pad minimizes the overall contact of excretions to the skin, but you still have potential for rashes on the rear of the patient as well as odor control going out the window. On top of all of this, you'll have stained sheets, undignified patient stays, potential transmission of parasite illnesses (fecal), and so on.

This might the second worst option (aside from actively cruel options). The worst being no absorbent pad at all.