Adult diaper with additional pad for night use??

These patients are being taken care of at home by their families. Our last visit is around 1900-2000, then we are there again in the morning as early as possible. So yes, unfortunatly these patients are lying in a very wet diaper for the last few hours in any case. For the most part the family members are not able to do much themselves, thats why they are in our care. The patients can turn themselves a little bit, but not always. All of our patients, when called for, have a antidecubitus mattress. (forgive my lack of wording, I've been living in germany a long time, my english is fading...) So turning is not the problem. What I simply don't get is that if you don't use pads or a diaper what do you use then? I mean, I can't let them just make a huge mess in their beds, they will also smear everything with their hands, get the picture?
These patients cannot simply be institutionized, their families want them to stay home and it is of course a financial problem for many.
I've been working with this team for almost 10 years and I've never seen a patient develop severe problems due to diapers with a pad. I think sometimes we as nurses have a tendency to over react. We're so afraid of getting the blame when a problem occurs, know what I mean?