Adults who prefer wearing diapers

[Emergent, RN]

What do you think of a young adult male patient who appears to be wearing diapers by preference? You have no idea about it until he uses his call light to let you know he had an "accident " in his diaper and needs help changing it. He has an erection during this process. Two hours later he does the same, only he has both urinated and and defecated. Another erection...

He has a passive, infantile personality, if you can believe that!

[Accolay]

Come on, give us some more. You mean he wears diapers because he enjoys soiling himself, or the care he receives from the diaper change or does he have a medical reason? Mobility issue?

[K+MgSO4, BSN]

If he is alert, oriented and mobile with no clinical issue for this.....point him in the direction of the shower.

[Davey Do]

I think, Emergent, that you're dealing with a patient who has a sexual fetish about wearing diapers and all the accompanying accoutrement that goes with it.

[NICU Guy, BSN, RN]

Have them start assigning male nurses and/or PCAs to him. His little sexual fetish will not get satisfied if you tell him to do it himself. It is one of those fetishes that they want to be treated like a baby. Some have even built an adult size crib to sleep in.

Paraphilic infantilism - Wikipedia

[Davey Do]

I an the King of the Typos, and in noticing yours, Emergent...

...I believe two p's would have been more appropriate.

[KatieMI, BSN, MSN, RN]

In my time, I was pretty shocked to discover how many mentally developmentally delayed young adults are out there in community. The trend about making word "retarded" medical equivalent of "n-one" does nothing with the fact that such people continue to be born, and that care options for them continue to shrink in numbers while getting more expensive. And, understandibly, families do not want to recognize their "special needs" children as just being mental invalids needing complex care.

As a result, patients and families do what they can to survive, including diapering. Decreased mental abilities often have nothing to do with sexual development.

This is just one of possibilities, but it is out there.

[Buckeye.nurse]

Was this a late April Fool's joke, or is this real? Just curious :)

[Emergent, RN]

This post is not an April Fool's joke. Working in the ER is a virtual freak show, but this was a new one for me.

[Buckeye.nurse]

Ok, just checking b/c I worked yesterday, and was "got" a few times. I agree with K+MgSO4. If the patient is able to ambulate, and is alert and oriented...give them supplies, and have them shower. Guyinbabyland had a great idea with the male staff too.

Good luck!

[Emergent, RN]

In the ER we don't have time to come up with a plan of care for a weirdo. I did give the floor nurse a thorough heads up about the situation during report so they'd know what to expect.

[psu_213, BSN, RN]

Emergent said:

In the ER we don't have time to come up with a plan of care for a weirdo. I did give the floor nurse a thorough heads up about the situation during report so they'd know what to expect.

It sounds like this individual does not have a medical reason to be wearing briefs and to be incontinent. If this is a one time visit, pass it on to the floor....it stinks (literally), but there is not a whole lot to be done in the ER setting.

If he is a frequent flier--do you have a care plan system? Our ED social worker/care manager develops a care plan for those who frequent the ED. Many come in with vague, often chronic, pain CCs. If that is the case, the care plan specifies to attempt to avoid opioids, especially IV opioids. Obviously if there is new, acute problem (perforated bowel, for example), the pt would be given IV opioids--but, the pt has a care plan that recommends against the use of IV opioids for treating the pt's chronic pain. Same goes for this--even if the pt demands a diaper, he does not have to be put into one. The plan should be only male caregivers, but I know that staffing and/or the craziness of the ED sometime prohibits this. Much like you will not cure an opioid addict of their addiction in the ED, you are not going to make this pt no longer have this fetish; however, when he is in your ED, there is no reason to feed into it.