Diaper research

[Kawaharu]

Check out this Diaper research that Northshore did with their diapers. 
https://www.mcknightsseniorliving.com/home/columns/marketplace-columns/solving-clinical-economic-problems-related-to-heavy-adult-incontinence-in-senior-living-communities/

[square_duck]

In a basic nutshell, bulky extended use adult "diapers" work!!! And work VERY  well!!! ??

( But, we already knew that ..? ? ????)

[Little Sherri]

This is really interesting, and supports something that I've believed, and something I've heard other people here muse about on many occasions. @oznl and I have spoken about this at some length, lamenting the generalized awfulness of low-end medical incontinence products that are seemingly designed strictly for the pleasure of purchasers and accountants, and not for their usefulness to either the people wearing them, or, the people caring for those people. I thought it was related primarily to misaligned KPI's (key performance indicators), whereby the purchaser gets compensated based on driving down the cost of consumables, so if they can show a 20% decline in diaper expenditures, they get a pat on the head for saving MinimalCare Inc. $42000 per year. Meanwhile, laundry costs (labour, water, energy, chemicals) go up $100000 a year, and the PSW's are run off their feet swapping out products the consistency of tissue paper-lined garbage bags, that leak with almost 100% reliability. Plus, every change is handling and disturbing a patient, which, for frail residents, comes with the risk of injury and possibly the use of lifting equipment and/or more than one caregiver. 

Oz posited that it might also be related to PR misunderstandings that could arise from the optics of introducing 8-hour or 12-hour diapers, ostensibly for the purposes of leaving granny to marinade for extended periods. Anyone who hasn't worn a diaper in recent memory might think it must be awful to have to wait a few hours for a nappy swap, whereas people who DO wear them are almost never polled on the topic, but if they were, would tell you that 8 hours in a decent diaper is highly preferable to 4 X 2-hour stints in undergarments designed for the terminally ill. 

And, per this article (thanks for sharing, @Kawaharu), what value should we put on someone frail getting 5 uninterrupted nights of sleep per week, versus zero!?!

Fecal incontinence introduces a confound, in so far as pooping in a 12-hour diaper, 1 hour into its shift, could make for 11 hours of discomfort and possible skin irritation, but anyone who has been a parent knows that once kids are on solids, the frequency with which they poop is quite predictable, and whereas they dribble regularly throughout the day, they typically torch their drawers a couple of times. A lot of immobile patients suffer from "situational incontinence" - they can't toilet themselves because they can't toilet themselves, and bed pans were removed from most institutions a long time ago because they're labour-intensive and also vectors for infection. So many of these folks could adapt the timing of their discharges to coincide with changing schedules. Cognitively impaired people can't adapt that way, but, they don't become geese just because they're out of their minds - they more or less defecate on somewhat of a schedule, so changing routines can be adapted to accommodate their rhythms. Some checks might still need to be peppered into the schedule, and on occasion, an 8-hour diaper might have to be consigned to an early grave, but the cost of that pales in comparison with systematically changing everyone in the building 4 times per 8-hour shift, with the linen swaps required when crappy diapers inevitably fail.  

[~Brian~]

8 hours ago, square_duck said:

In a basic nutshell, bulky extended use adult "diapers" work!!! And work VERY  well!!! ??

( But, we already knew that ..? ? ????)

@Kawaharu@square_duck@Little Sherri

THIS IS EXACTLY what I tried to tell the makers of those "tabbed underwear" that they make you "try" before they give you the correct diaper for someone who is totally incontinent BOTH ways:  Those "tabbed underwear" DO ZERO good for someone who needs absorbency and odor control, as well as that the diaper needs to HOLD its contents - Tabbed Underwear are NOT "diapers" and "diapers"  are NOT "tabbed underwear".  BOTH have their uses, but we all know that insurance will cover most things, but they cover the BEAR MINIMUM.

If you need the Megamax, or a suitable plastic backed diaper, they should NOT give you prevail air, or Megamax Air diapers:  Even NORTHSHORE's Reps told me that the Megamax Air is NOT for those that are severely incontinent, because they don't have the same abilities as the Megamax - I toyed with the idea of maybe trying the cloth backed megamax, but was told that the plastic backed ones are what i need for my situation.

NOW:  I don't know who writes the rules that say that someone should be changed every 1.5 to 2.0 hours in state run facilities or nursing facilities, BUT, why would comfort be deepsixed in favor of cost:  You want to make sure the person is comfortable, that they don't have to deal with rash or skin breakdown, and using a cloth backed diaper is like putting a Bounty Paper Towel on your butt, when a Megamax is appropriate.  Of Course, the people who "help us decide what product we need,  don't LIVE WITH the conditions we do, or EXPERIENCE the problems we do, so when they suggest diapers, and all of them are "sub par" there is NO choice than to have a person who can get you what you need - I swear that insurance companies would be selling shoddy merchandise if they could get away with it, and if a Megamax would be appropriate for someone's incontinence, that is what they should have, and there should be a selection of PLASTIC BACKED diapers available, because.......

THEY WORK:  and if you are a heavy wetter or totally incontinent, they would be a better choice than a paper towel

Maybe insurance companies should have to be in positions like me, @Kawaharu @~ashley~ and others that are incontinent:  They would BEG and PLEAD and GRAVEL, and Kiss our feet, if they had to wear or use the JUNK they peddle to us, and then when in a PROPER Plastic Backed product, we would be the heroes, because we KNOW that comfort and usability and other factors go into the decisions we have to make, and the Medicaid Program wants to throw low quality stuff FIRST, or use that when better diapers like the Megamax work so well:  Looks like we have proof of that

Nice Find   *HUG*

Brian

 

Edited August 5, 2022 by ~Brian~
Added Additional Information aansd handles

[~Brian~]

@Little Sherri

5 hours ago, Little Sherri said:

And, per this article (thanks for sharing, @Kawaharu), what value should we put on someone frail getting 5 uninterrupted nights of sleep per week, versus zero!?!

Fecal incontinence introduces a confound, in so far as pooping in a 12-hour diaper, 1 hour into its shift, could make for 11 hours of discomfort and possible skin irritation, but anyone who has been a parent knows that once kids are on solids, the frequency with which they poop is quite predictable, and whereas they dribble regularly throughout the day, they typically torch their drawers a couple of times. A lot of immobile patients suffer from "situational incontinence" - they can't toilet themselves because they can't toilet themselves, and bed pans were removed from most institutions a long time ago because they're labour-intensive and also vectors for infection. So many of these folks could adapt the timing of their discharges to coincide with changing schedules. Cognitively impaired people can't adapt that way, but, they don't become geese just because they're out of their minds - they more or less defecate on somewhat of a schedule, so changing routines can be adapted to accommodate their rhythms. Some checks might still need to be peppered into the schedule, and on occasion, an 8-hour diaper might have to be consigned to an early grave, but the cost of that pales in comparison with systematically changing everyone in the building 4 times per 8-hour shift, with the linen swaps required when crappy diapers inevitably fail.  

@Little Sherri

I think part of the problem may be that the people who make the decisions on what to cover and how much to allow a person per month don't look at the NEED, alone.  They ALWAYS decide the COST is more important to them, and of COURSE they would give us 300 cheap products that we have to triple to get the same mileage out of the cheap stuff, as you could get if you are using a Megamax for the same purpose.  Part of the REASON that NEED should OUTWEIGH the cost is because what COST do you place on a loved one's life?  There is NO COST that should stop someone from having what they NEED, and COMFORT and DIGNITY should be something that should be considered.

You want to make sure that your loved one lives an appropriate life, and lives as long as possible and feasible:  You want to make sure that they don't experience PAIN or DISCOMFORT, and you make their lives as rewarding and stimulating as you can.  If this means you spend $227/month on Megamaxes. and they WORK well, then that is THAT:  you also have to make sure that they are not filthy, dirty, or dealing with fecal contact, cause that will BURN the skin BAAAAD, so you need barrier creame, lotions, body cleansers, and anything else needed to make sure that they can live their lives to the fullest. 

I DON'T CARE HOW MUCH SOMETHING COSTS, IF IT ALLOWS ANYONE IN MY FAMILY, THAT IS UNDER DOCTOR'S CARE TO LIVE A FULL LIFE, AND EXTENDS THEIR LIFE IN A WAY THAT ALLOWS THEM TO ENJOY WHATEVER TIME THEY HAVE LEFT!  If they need something that costs a fortune, and it helps them, SPEND IT - because you CANNOT take it with you when you go!

When i started having accidents in 2018, and 2019, I was having problems with Mobility, and I was unable to get to the bathroom and was having wetting and messing accidents throughout this period, and I was struggling with the aftermath of it.  I was also spending 2 to 2.5 HOURS on the potty every night, and I was LOSING the other part of this, which you point out:  SLEEP!

I spent more time in the BATHROOM then sleeping, and as you have pointed out, you lose sleep, and that kills your energy levels.  I may not be "elderly" yet, but having the right diaper is like having a COOL refreshing DRINK:  Because I used a Megamax, it is DESIGNED for someone who is TOTALLY incontinent, SEVERELY incontinent!  After I got my Megamaxes, I had to get used to them, and I found that I could then just LET GO, and the megamax would handle what it needed to:  I could NOW spend time sleeping like a baby in his moms arms, rather than to fight the POTTY MONSTER, and I NEEDED the sleep, and when you have IBS and Diverticulitis, that can cause MAJOR disruptions.

I then came to the realization that Diapers were my FRIENDS:  I didn't have to worry about it, and I had a REASON, and I fought my "inner self":  I realized that what is the lesser of two evils, having ACCIDENTS and not getting any SLEEP, and then falling, hurting myself, or Wearing a Diaper, using it as needed, and getting the sleep I need?  I then could say my disability is a VALID reason for what I decided, and because I now was diagnosed incontinent, I NOW could wear diapers legitimately, and it helps with the feelings and emotions and liking diapers:  I don't have to HIDE what and WHO I am anymore!

As Sherri Says: Fecal Incontinence MEANS that you need the ability to RELEASE, and a diaper is only as good as it is MADE.  If you are dealing with someone who uses their diapers as their TOILET:  You need QUALITY diapers, and megamaxes are the best diapers available.  You want your residents to be able to live to the fullest extent POSSIBLE, and that means that you PUT residents in QUALITY briefs, and you make sure that they are COMFORTABLE, and that also means you need to have the GOOD stuff; TO HELL with the cheap stuff, and Insurance companies get away with the cheapest stuff available, and that IS NOT RIGHT!

My Question is:  WHEN will insurance companies GET that the CHEAP comes OUT EXPENSIVE??

When they get that, and we can BYPASS Crappy Products, or DEMAND better stuff be provided us, THEN they won't go cheap, cause we won't stand for it.

I wonder what would happen if Myself, @Kawaharu and @~ashley~ were to TEACH the idiotic companies a LESSON by making them use crappy products, then when they complain, WE HOLD THEM Accountable, and the ONLY way they get GOOD products is to place them in a position where we hold the Good Stuff back, and they have diapers that need changing - THEN we can play "mind games" with the insurance companies ehehehe   That way, @Kawaharu could switch her work uniform for a Nurse Uniform and SHE could enjoy the show  

Brian

 

Edited August 5, 2022 by ~Brian~
Added Additional Information and Edited some information

[ppdude]

ALL  of your  observations are correct. In my case, the cost of diapers is 100% absorbed by me. Insurance or the medical establishment only look at the cost and none of the factors that make up the cost. They only see and care about the bottom line. It is angering and frustrating!   We have no voice with these mega insurance companies. I have NO idea how @brian got medicaid  to pay foor his Megamax's. I can't duplicate it. I only have medicare and it pays less than shit.

 

 

 

[~Brian~]

32 minutes ago, ppdude said:

ALL  of your  observations are correct. In my case, the cost of diapers is 100% absorbed by me. Insurance or the medical establishment only look at the cost and none of the factors that make up the cost. They only see and care about the bottom line. It is angering and frustrating!   We have no voice with these mega insurance companies. I have NO idea how @brian got medicaid  to pay foor his Megamax's. I can't duplicate it. I only have medicare and it pays less than shit.

 

 

 

@ppdude

Answer to your question is:  State medicaid is available to me because I am on Disability, and they pay for me to have medicaid as secondary insurance.  Medicare pays for what they pay for, usually 80%, and Medicaid pays the remainder: 20%.  IF MEDICARE does NOT cover it, medicaid takes 100%, and I have proven medical NEED, have the diagnosis of Incontinence BOTH ways, and CP, and I used the garbage that Medicaid gave me for 2 months, and when the State saw that there was an issue, and that i was right, the doctor wrote the PA, it was approved by VT Medicaid, and they DID approve the megamaxes, and that is because that is what works for me

Brian

[drynot]

19 hours ago, square_duck said:

In a basic nutshell, bulky extended use adult "diapers" work!!! And work VERY  well!!! ??

( But, we already knew that ..? ? ????)

Gonna go out on a limb here and say the vast majority of us here are experts in extended diaper usage ?

[oznl]

My current viewpoint from the employment scrapheap (the IT industry shuns aged workers) is working part time in the equipment maintenance space for the disability sector.

Nappies are a daily reality for a very large proportion of the clients I deal with (this is of absolutely NO particular interest to me, just something I see every day now).

Those nappies simply do NOT work (we of all, know this already of course) but after you’ve worked on a few power chairs and electric beds you’ll encounter abundant evidence of their shortcomings.

Some carers will try to mitigate the inevitable product failure through profligate use of supplementary chair and bed pads (presumably they come from a different budget) but usually, everything just ends up drenched in pee.  I’ve seen actuators in medical recliners literally destroyed by pee and they are NOT cheap.

Pretty much all of the clients I deal with have conditions making being moved (and changed) exhausting and painful.  Hoists are required.   They’d be MUCH happier left in a BetterDry and a decent pair of PUL waterproof pants for 8 hours (assuming wet only) and so would their carers and their furniture.

Many of the “best practices” I see in care are prescriptive, formulaic and frankly, moronic.  My experience with management in this sector has been that of a medical culture that is authoritarian, top-down and fixated on blame and risk mitigation rather than learning anything new.  It’s a bit bleak.

The way OUT of this morass might be peer-reviewed science that can be fed down the chain of command, not ground-intelligence based opinion.  It looks like there is some glimmer of hope for that here so long as PR, marketing and “gotcha” journalism doesn’t get in the way.

[zzyzx]

And we should add a reference to @NorthShoreAdam with thanks for supporting this study.

[Crinklz Kat]

On 8/5/2022 at 9:04 PM, drynot said:

Gonna go out on a limb here and say the vast majority of us here are experts in extended diaper usage ?

Uh... make that OVER-extended usage!  

[MegaChar]

I can summarize this whole article with a few words:

Diapers with better "Absorbency to Mass" ratio perform better

 

The reason those wimpy in the store diapers that have to be changed every 2 hours is because their Absorbency to Mass is bad. Ill explain it better.

A 3 year old has a adverage weight of 32-35 lbs. The diapers that they use on adverage are 4-6 hours between changes and the reason for that is their diapers have high enough capasity around 1000-1250 ml iso. Minus that iso by 2/3rds to account for urine not being water and you have a absorbency capasity of 350-400 mls

That 350-400 ml diaper has to handle the mass output of 35 lbs, which it can do for 4-6 hours with around 20% left in the diaper. Now we know to absorbency to mass ratio for the child.

350-400 ml for 35 lbs

Lets do a adult.

Adverage mass is 200 lbs for a adult. Lets use those wimpy diapers for example

2000 mls iso - 66% is 680mls

That 680 mls has to handle the mass output of a 200 lbs or more which is 3-4 times the mass of that 2-3 year old. Therefore 3-4 times possible output

680 ml for 200 lbs= Absorbency to mass is too low. Can only handle one or two releases before leaking

Lets use a ABDL diaper. My favorite Tykables Camalots

8000ml - 66% = 2720 mls

That 2720 ml diaper has to handle the mass of a 200 lbs

2720 ml for 200lbs= that difference is muuuuch better and can handle 4-6 hours of continuous use. Muuch better absorbency to mass ratio.

 

Now you know why diapers at the store suck. Math is used to prove that the companys behind those "2 hour" diapers only want all your money.

 

Ive heard some people saying 10,000 ml iso is ridiculous. No its not at all. If you want the same equvalant absorbency that a child uses then the iso level should be around 12,000-15,000 ml iso

[Kawaharu]

I think this is something we should have here. Diaper research forum for all the research into diapers for Incontinent folks but also for ABDL folks to know about the latest research into incontinence and diapers.

[square_duck]

On 8/5/2022 at 1:07 PM, ppdude said:

......   We have no voice with these mega insurance companies. "I have NO idea how @brian got medicaid  to pay foor his Megamax's. I can't duplicate it". I only have medicare and it pays less than shit.

 

 

 

He made his insurance rep spend a week in Depends.....??

[ValentinesStuff]

15 hours ago, square_duck said:

He made his insurance rep spend a week in Depends.....??

And wet pants.

[oznl]

On 8/6/2022 at 12:03 AM, Little Sherri said:

This is really interesting, and supports something that I've believed, and something I've heard other people here muse about on many occasions. @oznl and I have spoken about this at some length, lamenting the generalized awfulness of low-end medical incontinence products that are seemingly designed strictly for the pleasure of purchasers and accountants, and not for their usefulness to either the people wearing them, or, the people caring for those people.

It seems we are not alone in this conclusion.  The paper below from an Institution of Mechanical Engineers (not an accountant nor a marketing analyst to be seen) is based on a study surveying the sentiment of compulsory-adult-diaper-users towards their products.  Their sentiments are not good and would be strikingly familiar to many of us.

https://journals.sagepub.com/doi/10.1177/0954411917750193

 

[Little Sherri]

This is really interesting, @oznl. I like that it's written by and for engineers, rather than being a marketing study composed by people trained in the black arts of euphemism, doublespeak, obfuscation, forced optimism, and disingenuousness. It's interesting that their findings, in many cases, align with those of many of the contributors to this forum. They don't mention manufacturers serving the ABDL market specifically, but arguably, they're on the forefront in terms of the quality and variety of products offered, at least in Western countries. The plethora of products and their aesthetics offered on the Asian markets suggests to me that, over there, "ABDL" oriented people can just shop where everyone else shops for diapers. The diaper model here, if it were applied to underwear, would look like this: everyone can buy low-end white underwear in stores. You have to go to specialty shops to buy white, high-quality underwear, and in some cases, you might need a referral from your doctor. If you want high-quality, colourful underwear, then there are only a few specialty shops available, and people tend to be secretive about going to them.