Incontinence affects many people and research has shown that it has a huge negative impact on their lives, often resulting in the person becoming isolated and depressed.
One in four people suffer from some form of incontinence, with 10-35% of all adults, and 50% of the elderly in nursing homes, suffering from incontinence.
There are many products on the market which help people manage this condition, but it can be quite confusing finding the best product for your needs.
Important factors to consider:
Features to look for :
It’s the number of drops that counts!
The first factor to consider is the amount of urine leakage. The best way to work this out is to keep a diary over a few days and measure how much fluid goes in, and how much (and when) it comes out.
Remember, fluid output is directly proportional to fluid intake. Also, certain medications and fluids, (tea, coffee and alcohol etc.) are diuretics and will increase the output, so on ‘teaparty’ days, you may need to use a more absorbent product!
General guide for grading severity:
(within a four hour period)
Slight = 50ml – 100ml
Moderate = 100ml – 200ml
Severe = 200ml – 300ml
Products are graded according to absorbency. Do match the absorbency grade to the user’s needs. It is a waste of money to have an expensive, highly absorbent product on a person who is only mildly incontinent. Products should show the ISO absorbency rating, indicating the amount of liquid the product can absorb when entirely wet, for comparison purposes. Brands also use their own scales. Tena use eight drops to indicate the absorbency level, while Hartmann and Clemens use only four. Products are designed to move the moisture quickly away from the body so those for bladder incontinence differ to those for double incontinence.
Don’t fall into the ‘savings’ trap. Disposable absorbency products are expensive, so people look for cheaper solutions. Be careful as you may end up using more, and then it’s not really cost effective. Using the cheaper makes can also result in rashes, discomfort and leakages.
It is important to check that the leakage guards are standing up.
Sometimes they remain flat after being packed. Fold the pad in half lengthways before fitting it. This will get it to take the anatomical shape and lift the leakage guards.
Once fitted always ensure that you create a channel to provide a place for the urine to be quickly absorbed, thus preventing contact with, and burning of, the skin. It takes about one – three minutes for the product to absorb all of the liquid and for the surface to feel dry again.
Napkins – Diapers – Briefs – Slips
These terms describe the conventional types of product with fasteners on the sides.
For people who are sitting or bedridden, the traditional napkin designs are preferred as they are easier to change when a caregiver is available.
This absorbency product is the most commonly available and, as a general rule, the most absorbent, making it suitable for night time use. It is not always the most comfortable design and, unless it has a breathable backing sheet, may make the user sweat.
They are available in a variety of sizes, according to waist measurement, and absorbency ratings.
Pull - up pants are worn like regular underwear. The design has improved vastly, so that they have the look, and feel, of normal under-wear. They are a great solution for people who are still active or able to walk, or can change their own under-garments, but less so for people who are bed-bound.
As a general rule, pull-ups are less absorbent than the traditional napkins, but can be used for both bladder and bowel incontinence. All makes featured have a tear away side seam making the pants easy to remove and dispose of.
Pant Liners / Inserts
Liners can be the most cost effective solution. They are designed to be worn under close fitting underwear (with an adhesive backing to keep them in place) or in combination with pouch pants.
Pant Liners are designed for very light stress incontinence eg: sneezing, coughing and laughing, also known as “giggling incontinence.”
The Euron Flex range (left), as well as the Tena Flex, handles severe incontinence, including bowel incontinence.
Liners come in either a rectangular shape or, the more popular, body contoured shape and are available.
Euron, Hartmann and Lille all make specialised pocket pants to be used with their liners.
The Lille – Fix Pants (left), Euron – Net Fixation Pants and Hartmann’s Molipants (right) are all elasticised net stretch underwear designed to keep liners securely and comfortably in place.
Euron have recently launched their new Comfort Super, (right) which are soft, comfortable and durable net pants.
For a low cost, or emergency solution, cut the legs off a pair of pantyhose!
An exciting new and revolutionary product has recently been launched by TENA and Euron. The TENA Flex Maxi and the Euron Wings consist of a fixation belt that goes over the hips and fastens with Velcro, enabling the patient to change the belt themselves, without need of assistance from a caregiver. They are a great solution for people with severe incontinence (Tena’s Flex Maxi X-Large absorbs up to 4,890mls!) and also suits patients who are trying to improve their bladder control after an illness. The belt and backing-cover are both made from breathable materials and, as less of the body is covered, they promote better skin health.
Day time vs Night time
Night time absorbency products are specially designed to be used when lying down and are also able to absorb far more than day time products, providing an undisturbed night’s sleep and no having to worry about getting up in the middle of the night to change. Most people find the traditional napkin design to be the most reliable choice for night.
What is out there for men?
We now have a limited number of products that have been specifically designed for men, some being extra rounded while others make use of a “pocket”.
Lille Supreme Light for men provides maximum protection for men focussed in the front area of the pad, whilst their Lille Classic Line pads offer a wider protection area suitable for men, specifically those who need limited protection.
TENA for men is a very popular solution shaped rather like a cricket box. Their level 2 is now available in South Africa and is ideally suited to men with moderate to heavy incontinence.
MoliMed for Men (left) is available in a pad or penis pouch (Activ) for mild incontinence, while the MoliForm for Men (right) is suitable for moderate, as well as severe, double incontinence.
Don’t forget the kiddies
There are plenty of nappies for babies but, once a child has outgrown the baby products, there is a huge gap in the market, with the next size up quite difficult to find.
Tena’s Pants Plus accommodates the smaller waist size 50 – 70cms and also 65 – 85cms.
The Molicare and Molicare Air Active briefs X-small and small can be used for children, as can Lille’s Supreme Fit X-small and small.
It seems that in this industry there is a high turn-over of product range availability, possibly due to difficulties sourcing and stocking the products.
Companies listed on the table below may change product ranges, or have name variations, especially if they have older stock.
Tips for self-care
Deodorising tablets, moisturisers and powders are available that can help you feel hygienic and eliminate urine odour.
You also might consider using a barrier cream, such as petroleum jelly or cocoa butter, Fissan paste or Bennets Bum cream, to protect your skin. Use them sparingly as they may interfere with absorbency.
TENA’s info booklet: Continence, The Guide to Managing Incontinence (published in association with Rolling Inspiration) is available to subscribers for download from our home page.