Thursday, June 24, 2010

The Great Diaper Dilemma for Incontinence: Your Own Risk Assessment

I’ve been living with incontinence and diapers for a long time now, but I’ve recently been thinking about how hard the initial adjustment can be. It seems to me that the dilemma of whether and when to wear adult diapers can be thought of as a risk assessment of sorts.

Without adequate protection, we have the ever-present risk of an embarrassing accident. For many incontinent people, this risk could be all but eliminated if we could guarantee easy and available bathroom access within a few minutes. But how realistic is this? It certainly doesn’t apply in many work environments, stores, malls, cars, airplanes, etc. Even at home, there are times in which the access isn’t guaranteed in such a short time frame. Imagine chatting with a neighbor outside, when all of the sudden…

The extent of this risk is different for each person, of course. The time horizon and strength of urges varies by person, as does our lifestyle, work environment, etc. Nevertheless, I think this general concept of accident risk applies to all of us.

On the other side of the ledger, with protection, what do we balance this against? Of course, there are risks here too. These range from the risk of a leak to the risk that people may discover our incontinence. On its face, though, these risks seem a lot smaller than the risk of a large, embarrassing accident. The risk of someone discovering our protection seems potent at first, but fades as we find that most people simply don’t see what they aren’t looking for.

But other concerns remain, since there are negative aspects of wearing protection. I think the first big issue is an understandable inhibition to the idea of wearing diapers. This is a powerful initial inhibition and embarrassment, which is probably why it can take multiple public accidents before people try protection. Thankfully, this embarrassment of wearing diapers fades as time goes on. You simply get used to the idea, and come to see it as a need that millions of people share. In the rare case that someone does find out, it is a lot less embarrassing than the non-protected potential of flooded pants in public.

The second issue is the actual experience of wearing diapers. An absorbent diaper doesn’t feel like underwear, no matter how long you wear them. At first, the change is shocking and not very comfortable. Over time, though, you get used to it. For some, like myself, after many years it now feels normal to be in a diaper. Since the other concerns fade away, wearing diapers is preferable to the risk of embarrassing accidents.

For others, the dislike of wearing diapers doesn’t fade substantially. If the diapers remain very uncomfortable over the long run, the person may choose to avoid protection and alter their lifestyle enough to minimize accidents. For these folks, the disadvantages of diapers continue to outweigh the risks of not wearing protection – so they avoid them at all costs.

What is my advice to “newbies”? There is no magic bullet, but give it time. If accidents can’t be easily avoided or eliminated with treatment, you should try protection. The embarrassment of purchasing supplies and worry that people may notice your protection will fade; I promise you that. Afterward, you can judge the balance between the long-term use of diapers with the risk of embarrassing accidents and disadvantages of an altered lifestyle.

There is no “right answer” to the dilemma, but I hope this helps you find your path!

Wednesday, June 23, 2010

Review of Attends With Waistband

The Attends diaper is a decent choice for light to moderate incontinence. A competitor of Depend, there are advantages and disadvantages of each option. Although it contains a little more fluff, the Attends diaper is less absorbent than Depend. However, it is one of the most comfortable options available. I should note that I have received a few batches that had more of a paper feel, which was substantially less comfortable. Leaks won’t occur with light wetting, but become more likely with heavier or multiple voids. The tapes occasionally have problems, but the version with waistband helpfully features six tapes. The cost is roughly $65 for a case of 88, which is similar to the cost for Depend.

The limited absorbency makes it hard to recommend Attends for moderate or heavy incontinence. However, the Attends is a good option for when combined with a very absorbent liner. At night, I typically wear Attends with an Abena or Tena Super liner (note: I’m referring to the thick, wide liners available online, not the narrow pads available in stores). Although somewhat bulky, the combination is secure, fairly comfortable, and reduces leaks when sleeping on my side.

Final Grade: B
Absorbency: C
Leak Protection: B-
Comfort: A
Tapes: B
Cost: ~$68 for a case of 88 (medium)
Appearance: White

How to Find the Right Incontinence Product

(Also posted to Health Central's Incontinence Network)

For those who need absorbent protection, but are just starting to evaluate their options, I thought I would share some suggestions on finding the right product. I can’t claim any special expertise, but I’ve tested options for a long time now.

First, stop being embarrassed. This is easier said than done initially, but you may ultimately spend a lot of time purchasing products in stores and online. The sooner the embarrassment ebbs, the better off you will be.

For light or occasional incontinence, try pads or absorbent underwear. The best Poise or Tena pads, widely available in stores, have pretty good absorbency. The main drawback is that they are pretty narrow. This may make them feel discreet, but it increases the risk of an embarrassing leak. The Depend or Tena underwear have a wider area of coverage, which make them a good option for light incontinence.

For moderate to heavy incontinence, you probably need the protection provided by adult diapers. Thankfully, there are diapers available that can handle any level of incontinence. Start with Depend, since they are available in stores and have decent absorbency for the cost. Then branch out and try some of the diapers available online.

For heavy incontinence, you will probably need the more absorbent diapers sold by online stores. Some of the options, such as the Abena X Plus, are thicker and very absorbent. The chief advantage is impressive capacity, but not everyone is comfortable with the extra bulk (though, I assure you, people won’t notice under most clothing). Others, such as Attends Extended Wear, have moderate thickness and absorbency. They may feel more discreet, but won’t last as many hours. Although it will take a while, I recommend that you allow some testing time and find the best option(s) for you.

Regardless of where you fall on the incontinence scale, there isn’t one single option that is ideal for you at all times. Different types of pads or diapers might be better given different places, time of day, activities, etc. I personally have a rotation with different options during the first half of the day, late afternoon/evening, and then overnight.

Tuesday, June 22, 2010

Review of Depend

The Depend brief/diaper is a reasonable choice for light to moderate incontinence. For most incontinent adults, Depend’s wide branding and in-store availability made it the first line of products many use for protection. The Depend is the thinnest diaper I will review, but it is more absorbent than the limited thickness implies. It isn’t a good choice for heavy incontinence, but it actually works pretty well for light to moderate incontinence. The inside fabric feels similar to baby diapers, which probably explains the decent capacity despite the limited thickness. Leaks will occur when the diaper is too wet, but are otherwise not common. On the negative side, I don’t think the Depend diaper is particularly comfortable. It fits fine, but the fabric feels rougher than the typical diaper.

The limited absorbency makes it hard to recommend Depend for heavy incontinence, or even moderate incontinence over longer periods of time. However, the capacity of Depend can be easily augmented by inserting a narrow, absorbent pad such as Poise or Tena. Due to the slightly cheaper cost of this combination, I sometimes wear Depend with a pad in the afternoon or evening. I should note that the larger pads from the pad and pant systems (Tena, Abriform, etc. ) don’t fit well inside Depend.

Of course, Depend also makes absorbent underwear and other products as well. Others should feel free to comment on those options!

Final Grade: B
Absorbency: B-
Leak Protection: B
Comfort: C+
Tapes: B
Cost: ~$14-15 for a package of 20 (small/medium)
Appearance: White

Monday, June 21, 2010

Review of Attends Extended Wear

The Attends Extended Wear diaper is a more absorbent version of the standard Attends diaper. The diaper is pretty comfortable over time, with a cloth-like cover and tapes that may be easily refastened. While not as absorbent as the Abena X Plus, the extended wear Attends is a good option for moderate to heavy incontinence. I often wear these in the afternoon or evening, with only rare leak problems. It is thinner than Molicare and X Plus, but quite a bit thicker than the standard Attends. The cost is roughly $55 for a case of 36, which is a little on the expensive side. It is nevertheless a good option.

Final Grade: B+
Absorbency: B+
Leak Protection: A-/B+
Comfort: A-
Tapes: A
Cost: ~$55 for a case of 36 (medium)
Appearance: White

Sunday, June 20, 2010

Review of the Wellness Diaper

The Wellness diaper is a good option for moderate and heavy incontinence. The chief advantage is the comfort, since it feels somewhat softer and remains comfortable until it is pretty wet. It is thinner than Molicare and Abena X Plus, but expands as it gets moist. The tapes work fine and it won’t leak unless it is too wet. The cost is roughly $80 for a case of 60, which is reasonable. This is one of my common diapers in the late afternoon or evening, since it is comfortable and offers at least a few hours of protection.

Final Grade: B+
Absorbency: B+
Leak Protection: A-/B+
Comfort: A
Tapes: A-
Cost: ~$80 for a case of 60 (small/medium)
Appearance: Light blue

Friday, June 18, 2010

Review of Abena X Plus

For heavy incontinence, the Abena X-Plus is an ideal option. It is probably the most absorbent diaper available, with remarkable capacity. While many people would prefer less bulk, the extra padding in the X Plus provides several hours of protection. Once you get used to the bulk, the X Plus diaper is also pretty comfortable. While not impossible, leaks are very uncommon. Lastly, the tapes are strong and work quite well. The cost is roughly $60 for a case of 42 (medium size). This is reasonable given that the protection lasts for several hours. These are my most frequent diaper at work, since I can wear one from the early morning until ~2:00 in the afternoon.

Final Grade: A
Absorbency: A
Leak Protection: A
Comfort: A-/B+
Tapes: A
Cost: ~$60 for a case of 42 (medium)
Appearance: White, with stripes