Managing the problem: aids and appliances
Over the last 20 years there has been an increase in the number of companies producing incontinence products as the true size of the problem has become apparent. There is a market for aids and appliances because most women prefer to deal with their incontinence themselves rather than seeking professional help.
Unfortunately this can prove expensive and not always effective, because the appliances bought may be either unsuitable or incorrectly sized. They are available on the NHS and through the District Continence Advisory Service.
The aim of these products is to contain the problem sufficiently to allow ‘social’ continence. With this in mind there is a spectrum of products available, from panty liners allowing simple discreet protection, through to fail-safe absorbent pads similar to nappies, from underpads for seats and beds to catheters to keep the bladder permanently empty.
Most chemists now stock a wide selection of products. The key to success in the choice of product is assessment of your requirements.
The choice of incontinence aid is therefore based on many factors. Help is available through the Continence Foundation and the District Continence Advisory Service; people in these organisations can advise you what can be done to limit the impact of your incontinence on your lifestyle and help you select the best appliance for your needs.
Panty liners and pads
The simplest protection offered is panty liners, which can be discreet and unobtrusive but are very poor at absorbing urine. They are generally available everywhere and are quite comfortable and easy to change. They offer only very limited protection and may require regular changing.
Sometimes they can lead to problems because the plastic backing causes an increase in perspiration, which can be mistaken for leakage. They are attractive because they are ‘normal’ for women to wear and hence not particularly associated with incontinence.
Pads with waterproof backing allow greater security. These are more absorbent than panty liners, but may still allow leakage around the edge of the pad. They also tend to be thicker, longer and wider. Some are shaped to allow a better fit. Heavier pads are available for severe leakage problems; for the best results these require stretch pants to hold them in position.
Marsupial pants
Marsupial pants are waterproof pants with a separate changeable pad within a pocket. This allows the pad to be changed without needing to change the pants. Urine drains through the porous layer of the pants into the pad. The major advantage of this system is that it allows the pad to stay in place without repositioning.
This is useful for someone with reduced dexterity who is likely to forget to reposition the pad after being in the toilet. The drawback is that the inner lining is not changed after incontinence and there is then one persistently dirty layer next to the skin.
There is now an increasing number of clothing companies marketing underwear with either waterproofed gussets or built-in pads. These products are helpful in improving body image and allow women to feel more normal in their choice of underwear.
Nappies
The most reliable of all systems, however, is an all-in-one pad, that is, disposable pants with built-in pads. Improvements in the design have resulted in better fit and therefore greater comfort; they are considerably lighter and better at containing leakage than older versions.
Mattress covers
There are a wide variety of covers available. The choice depends on the amount and frequency of leakage. A child who is occasionally wetting the bed, for example, will require a much lighter sheet than someone who empties his or her bladder every night and is likely to continue to do so. Newer designs of breathable fabrics tend to be more comfortable, but also more expensive.
Underpads
There are a variety of underpads available that can be used for protection of furniture. The underpad works by collecting any leakage in a storage layer away from the skin. This protects the skin from sores caused by the irritation of long-term contact with urine.
KEY POINTS
- There is a range of products to help you manage incontinence
- Advice on products is available through the Continence Foundation and the District Continence Advisory Service
- The key to choosing the best product is an assessment of your requirements
