Depends (diapers) at night?

Specialties Geriatric

Published

Does your facility leave incontinent residents in Depends (or adult diapers) at night?

Specializes in LTC, home health, critical care, pulmonary nursing.

Now don't even get me started on the CNA who feels 2 diapers are better than one :uhoh3:

Are you freaking KIDDING me? Anyway, my facility (supposedly, my hall does) leaves briefs off any time the resident is in bed, even in the daytime. My unit has zero breakdown, and hasn't had any in two years. We've had people admitted with stage 4's, and we heal them. And I HATE chux. I'll use a brief before that. With those godforsaken things, the moisture just lays on top of the plastic, leaving the resident in a puddle. At least a brief pulls it away. But we go commando.

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As far as ease..it is much easier to use the pads than wrestle and wrangle some residents in the middle of the night puttting attends on. Now don't even get me started on the CNA who feels 2 diapers are better than one :uhoh3:

I couldn't believe that a CNA would put 2 diapers on a person, until I found out that one of them at my job did exactly that this past week! At our place, just like many others around here, the residents wear diapers at night. I guess it's to make it less likely that body excrements will mess up the sheets for the CNAs.

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Specializes in Gerontology, Med surg, Home Health.
I couldn't believe that a CNA would put 2 diapers on a person, until I found out that one of them at my job did exactly that this past week! At our place, just like many others around here, the residents wear diapers at night. I guess it's to make it less likely that body excrements will mess up the sheets for the CNAs.

It's actually because they are too damn lazy to really change the brief, wash the peri-area and put a clean brief on. They take off the inside brief leaving the dry one on the outside. I write 'em up if I catch them using two briefs on anyone.

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i don't like the idea of briefs on everyone in bed, but our don insisted that if the resident wants them, we they get them. also our diaper representative (not sure what brand we use tenna?) insists that they will not cause break down because they wick the urine away. i still insist on keeping diapers off of res with skin probs (decubs, excoriation, etc)

as far as ease..it is much easier to use the pads than wrestle and wrangle some residents in the middle of the night puttting attends on. now don't even get me started on the cna who feels 2 diapers are better than one :uhoh3:

i must admit this is a pretty hilarious concept of "double-diapering" a pt, yet from an amelia badelia perception its not too bad of an idea. the problem is not with the staff all the time, its mainly the quality of the 'briefs' the facility is using. if hospitals/facilities would step up to a brand like abena, or molicare there would be alot less problems. there is one brief called x-plus by abena, and they can absorb up to 1300-1500 ml, as well as a 3-6 hour changing period.

"all passion flowers, melt into dreams"

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I have worked at facilities that did not want the residents to wear briefs at night to help prevent skin breakdown. The only time it gets to be a problem is when you get the residents that like to play in their excrements. I have caught CNA's double diapering, inserting wash clothes and towels into diapers, and placing external catheters on patients to keep from changing them as scheduled. Of course, I wrote them up and after the external catheter episode they were finally fired.

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Specializes in ICU.

All of our incontinent residents wear briefs. I just recently started the practice of checking how many diapers residents are wearing on evening rounds. I once found a resident with three diapers. When I confronted the CNA she denied it. I told her I personally removed two and the resident is still wearing one. She just looked dumbfounded and continued to shake her head.

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If diapers are used then when the licensed nurses are supervising the CNA's they can take a black marker and mark the time on a diaper when they are doing their rounds on the res. every 2 hours. If a diaper found wet is not changed in 2 hours then the disciplinary steps need to be taken. Besides being written up a CNA could be reported to the CNA boards for res. neglect.

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Now don't even get me started on the CNA who feels 2 diapers are better than one :uhoh3:

Are you freaking KIDDING me? Anyway, my facility (supposedly, my hall does) leaves briefs off any time the resident is in bed, even in the daytime. My unit has zero breakdown, and hasn't had any in two years. We've had people admitted with stage 4's, and we heal them. And I HATE chux. I'll use a brief before that. With those godforsaken things, the moisture just lays on top of the plastic, leaving the resident in a puddle. At least a brief pulls it away. But we go commando.

I care for a father with alzheimers that we put in depends at night. He is suffering from very red, itchy skin as a result. Are you saying that you would let him sleep with no depend at night? There is no one to change him during the night. Is it really best to let him just soil the bed? It is soaked every morning as it is. Not sure what to do or how to treat his skin.

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Specializes in LTC.

We leave the "brief" open at night for those residents prone to fungal rashes.

They had an excellent barrier cream that the CNA's would use on the residents. It was expensive and the facility stopped using it. And what do you know.. a good portion of them got pressure ulcers.

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Specializes in Geriatrics.
Now don't even get me started on the CNA who feels 2 diapers are better than one :uhoh3:

I have actually removed both briefs from patients when they put 2 on the pts. They were not happy at having to do bed changes and I never had the problem of any aide using the 2 brief system after doing that. I tried explaining that 2 brief were not better than 1, and that ripping the inside brief off w/o removing the outter one damaged already fragile skin. If they did it anyways, they'd have full bed changes during the next round. One actually tried to complain to the DON, who sided with me!

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Since starting this discussion with what to do with my Alzheimers father, with limited care (unfortunately), I have asked my Dr. about creams. I have found a moisture barrier cream "Calmoseptine" that is thicker than glue, but it really seems to seal things up. I am on day two of using it. I do, in a fashion, double diaper him. I use Wal-Mart wrap around briefs (they seem to breath better on the edges and fit better) and I stick a Tena extra absorbant pad in the blue area of the brief. It really does absorb a lot that way. Double diapering doesn't work at all. I wish he could be changed more often, but we have no help and I am the only one that can take care of him. This cream seems to be helping a lot at this point. I will be able to tell more tomorrow on the morning of day 3. Thank you all for your input.

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Are you freaking KIDDING me? Anyway, my facility (supposedly, my hall does) leaves briefs off any time the resident is in bed, even in the daytime. My unit has zero breakdown, and hasn't had any in two years. We've had people admitted with stage 4's, and we heal them. And I HATE chux. I'll use a brief before that. With those godforsaken things, the moisture just lays on top of the plastic, leaving the resident in a puddle. At least a brief pulls it away. But we go commando.

I care for a father with alzheimers that we put in depends at night. He is suffering from very red, itchy skin as a result. Are you saying that you would let him sleep with no depend at night? There is no one to change him during the night. Is it really best to let him just soil the bed? It is soaked every morning as it is. Not sure what to do or how to treat his skin.

The gist behind treating or preventing presure sores is removing the skin irritation or preventing it and pressure relief.

Cleaning the skin after inct, applying a moisture barrier and preventing the inct from having contact with the skin . If you unable to change him alot at night, you might want to look into inct products that are made for night time or have better wicking properties. Reguardless of weather you choose to leave them open to air on a pad or in a diaper...the above is important also. Some pads work better than others in wicking away fluids...I think the paper type stink and the cloth ones work but the urine seems to spread thru the pad and it gets cold very quickly.

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