Newly Incontinent Elderly Mother-In-Law

[packrat]

Hopefully someone can offer some advice. My mother-in-law is residing in an assisted living environment and has recently become increasingly incontinent. For a long time she has used POISE pads and more recently, Depends womens pull ups. The Depends leak frequently, and she is chaffed by the elastic. This may also be related to too few changes. My wife understands my personal fetish, but I try not to be too knowledgeable on the issue. I've been looking at the Abena line but don't know if she is able to use a tape on disposable. I've looked at the Abena pull up line and wondered if anyone could offer their opinion of quality. We are trying to get something she can put on and also a brand that will leak less. My only experience is with the XPlus version, which I find excellent.

We would be ordering from a mail order house, as the over the counter brands are all pretty much crap.

Thanks,

Rat

Peace.

[AutieAB]

Well the Abena pull ups are better than store brands and Depends but it all comes down to how much she wets (at once) and how often. Pull ups are meant for small amounts, with time between wettings to absorb it fully. If she wets large amounts or frequently no pull up is going to be able to cope without leaking - that's what tape-on diapers are for.

[LuvsGurl]

You might want to consider refastenable products like Secure. I know I always like having the refastenable tapes when I change myself, which is why I prefer Bambino.

[lil_baby_wet_n_squishy]

The Abena Abriflex pullups work well and hold a decent amount (2 wetting). I use them for daytime when working. I wouldn't recommend using them at bedtime.

[square_duck]

This here is a prime example of how this community can be of positive service to others

Thanks for asking!

I know no one (well, almost) wants to be incontinent, it isn't any fun. There are a couple of things going on here. Ok, she is in an assisted living environment, which means she has 'help' available. You are 62, so I can presume that your mom is somewhere in her 80's which isn't young. I am sure she's embarrassed about her condition, and the thought of having to resort to some brand of tape on disposable "DIAPERS" is not very appealing. Yes OTC brands SUCK, so given the sensitive nature of this, and to try and take care of your moms dignity, going with a pull on garment seems to be a win for everyone.

You mention that she has issues with the current products leaking, which, to me, indicates that she might have what is known as 'urge incontinence' and she can't tell when she has to go, until it's to late and her bladder lets go, resulting in a flood, which over whelms what ever she is using for protection. You don't mention weather she is ambulatory (able to walk on her own) or not, which is also a factor in her situation. But you mention she is also having problems with chaffing, so that indicates she is able to get around with out aid of a walker or wheel chair etc.

The chaffing means she isn't changing regularly, so she might be in need of the services of a care giver, since she isn't changing when needed. This doesn't sound fun, and it's not. All I know if from experience, and it sounds like she isn't able to fully take care of herself. I don't like writing that, and all I can go on is by what you wrote, and again, my own experiences.

As for products, I haven't tried the Abena Pull ups (yet) so I'm not sure about their performance, or capabilities. I have used "protection plus" pull ups, Which are made by Medline, the same company that makes Molicare briefs (diapers) so the quality is very good. The extended wear or 'over nights' are fine for day use, and hold a good amount, but I am not sure how they handle a flood, which most pull ups have issues with. I like them as a kind of "trainer", but thats just me and how I work, as I am fully 'functional' in that department.

The other options are, going with a heavier duty pull up such as the Abena or protection plus extended wear, or possibly using a booster pad, like Abena offers through XP medical, as a supplement to what ever product she is using. This will increase the capacity, and might be able to help in containment as well, but it depends on her level of incontinence and output.

Given her age, and as you said, there is uncertainty about her ability (or desire) to use a tape on brief. Coming from a dignity angle, it could be a psychological disaster for her to have to deal with, but so is walking around with leaky pull ups and wet clothing etc. If she is open to something like that and understands that it is a management tool for her (evidently deteriorating) condition, and she has the manual dexterity to manage a tape on brief, then that might be your only choice left. I doubt that they have any kind of laundry facility to handle cloth diapers...so that choice might be out.

Your best choice might be as you are doing now, collecting as much information, and available product choices and presenting them to her as an aid in helping her maintain a level of "quality of life" give her situation. It's not a fun thing to do, or to have to deal with or talk about. I don't know you or what kind of relationship you have with your parent, but the fact that you mention her previous attempts at managing her condition, you have a pretty good relationship which is to be commended.

Anyways, thats all I have for this. I'm a D/L, and have used a wide variety of products, and know what works for "ME" but that doesn't mean it will work for everyone.

To me, having had to deal with elderly parents and grandparents, it might just be best to sit down and discuss it with her and involve her in parts of the decision, and offer her choices. Again, I am sure she doesn't WANT to deal with this, but from a management angle, offering her choices and showing the benefits (non fetish) of each, will help in the long run

I sincerely hope this helps and you are able to find a solution that works for everyone involved

[Dougie]

I would recommend a good quality tape on brier like the Abena S3, M3, or L3 depending on size. If that isn't enough consider the 4 x-plus line.

A pull-up might sound like it will afford more dignity, but leaks and having to completely undress your lower half including taking off shoes every time are very humiliating if a person is still mobile. You CAN'T change a pull-up without taking your shoes and pants completely off. With a tape on diaper (call it a brief if it makes her feel better about it) you only need to drop your pants down to the knees. I have done this many times and been able to get changed in a public bathroom while standing without any help. Since I an still mobile, mostly anyway, I prefer to have as little help as possible and still manage a decent quality of life.

There is not a single pull-up that can compete with a quality diaper for absorbancy and prevention of leaks. I would rather tape on a regular diaper than have an obvious leak showing when out in public from a product that is not adequate to handle the need.

If a pull-up is a must, and it is just psychological need that I also fought in the early months of incontinence, the Abena pull-up is the best on the market. They still fall far short of the Abena (3 and 4) and Secure Personal Care lines.

Good luck and I really hope you find something that will help you to help her be less stressed over her current challenges.

[packrat]

Thanks to all who are kind enough to respond. Our issues include a concern that her dexterity may prevent her from making up the tapes for non-pull ups. The assisted living environment that she lives in does not offer the level of assistance that would be customary in a nursing home environment. As was suggested, the rash may well be from infrequent changes; although I have found also that the inexpensive "store bought" pull ups, like Depends can irritate my skin where friction is created from walking. We do not have clear understanding of her incontinence, but presume it to be urge related; and with her ambulation problems she may just not be able to make it to the toilet.

In our case, she is barely able to walk, and uses a walker when she does. Her preference is a wheelchair, which we object to, as she needs to walk....even if slowly. With the advice you have all offered, I'm thinking I might order one package of briefs to see how it works. Maybe we can get the staff to help her put on the nighttime diaper to help prevent the wet bed in the morning. When I suggested the addtion of plastic panties, my wife thought she would never go for them. Too much like a diaper, she thinks.

I have not looked at the Molicare brand as yet and will do so. My heavy duty ones are the Abena XPlus.

[dmavn]

The active ultras may work as well. They seem to hold quite a bit, don't bulk up all that much, and with Velcro they can be removed and re applied as needed.

[square_duck]

The active ultras may work as well. They seem to hold quite a bit, don't bulk up all that much, and with Velcro they can be removed and re applied as needed.

^Theres another idea^

[ThomasInWVa]

The absolute best disposable is wellness briefs. They are actually diapers but they hold the most and have the best fit. Go to http://www.wellnessbriefs.com/ for more info. They are very comfortable and I won't use any other disposable diaper anymore. These diapers are designed to last 8 hours or more. And they do! What is great is that my skin problems cleared up after using them. I have sensitive skin and these diapers don't cause any problems at all. I tend to wear these until they are completly soaked, say about 6-10 hours at times. They hold very well and when worn right, don't leak. These are great disposables for nightime and are the only disposables I can wear at night that I'm confident about not leaking.

[Aina]

Indeed please do consider having a quiet word with the caregiver. Chafing means being left wet for too long. Also I can recommend Tena products; their TenaLady pull-ups are designed to fit snugly to the female form and are effective.