Incontinence care and cloth diaper service?

fluffwad · Dec 12, 2004

From his point of view, he'd like something that doesn't "rustle" under his pants when he walks (He walks short distances on crutches, but sits most of the time).

The problem with cloth is it doesn't control odor, doesn't pull the moisture away from the skin ( so a barrier cream is a good thing to use all the time), and a lot of cloth diapers leak or bunch. Rustling is better than wrinkles and looking like you stuffed an extra pair of pants in there. You could try something like womens Serenity liners in nonboxer type mens underwear; but then the equipment would have to be arranged just right.

CapeCodMermaid, RN · Dec 13, 2004

I'm pretty sure that cloth diapers wouldn't be a good idea on an adult....the ammonia in urine can be very damaging to skin even with a good barrier cream. Have you tried a texas cath? or straight cathing every 3 or 4 hours?

SallyD · Dec 13, 2004

I'm pretty sure that cloth diapers wouldn't be a good idea on an adult....the ammonia in urine can be very damaging to skin even with a good barrier cream. Have you tried a texas cath? or straight cathing every 3 or 4 hours?

Yes, tried those options. Trouble is, he's allergic to the external caths (or they just plain leak like a sieve f you move wrong), and he'll just about get an infection just thinking about a straight or foley cath. But we do that occasionally, when changing just isn't going to work.

The diaper company provides an all-in-one diaper cover/velcro wrap that is supposed to help keep the fit trim and to help keep everything from bunching up. I just didn't know if any of you had tried this and had any success. I wouldn't have him use the cloth for traveling, just for at-home. I used both cloth and disposables diapers for our kids without any trouble, but I can see your point about the adult-quantities of urine being a problem. And I can see where the cloth might be a bit bulkier.

That brings up another question: Is there an elegant way to get him changed in public? He is embarrased to have me help him in a public restroom - but fortunately we have a minivan he can change in normally. But we have to fly across country for Xmas this year... and I'm trying to think of how the logistics of this are best going to work. Normally he will require my assistance with a brief change or a cath, and we've made use of handicapped restrooms - if they're available.

Thanks so much for your ideas!

-Sally D.

Antikigirl, ASN, RN · Dec 14, 2004

I haven't used the cloth diaper service for adults, but was so fortunate enough to get the service for 2 years for my child! Awesome present I assure you!

The thing I noticed is that the first year went well as long as I was very attentive to changing, then after about the 1 1/2 mark my child started getting rashes the moment after urinating...so if I didn't change it right then and there, I had a red, itchy, uncomfortable probelm. So I then changed back to the disposible. That is basically my experience with it (I lived in Beaverton at the time..Hi neighbor!).

Many of the folks in my facility use a 'go between' when they are not out and about, and this has cut down on probelms quite a bit, and the use of calmoseptine (although I perfer good old fashioned A & D ointment). I don't know if that would help you out or not...but letting air get to the area, and changing the go between often really seems to be doing so wonderfully for our patients, and cut down skin issues basically in half if not more! We use those great throw blankets (the fleece kind) to cover the residents while they recline or lay in bed to cover them up on these cold days...go between between the legs, and for gents...another on top so the blanket doesn't get wet as well (it is good to have more than one or two of the throws just in case).

Very careful attention to skin issues is very important...learning to get to the probelm before it becomes larger. Clean pinkened areas very well before they get red, and use of a ointment is great. I have some nurses that put opsites on open areas, but I find those to actually keep moisture in, or cause allergic rashes more so than just ointment and some air. For the coccyx I am a bit more agressive and put on duoderms cut only to fit the area when it is still pink...can't tell you how many times I stopped a larger probelm by hitting those very early (change Q 3-5 days depending on situation, I would check someone that has high potential for allergy daily to see if this is the solution).

Good luck to you, and if you use the service...please let me know! I have many folks that could benifit from this service seriously...and wow, it is one of those things where you go...'oh yeah...guess you can do that for adults too huh?!?!?" LOL!

Antikigirl, ASN, RN · Dec 14, 2004

ohhhhh the plane...hmmmmmmmm, have to thought of talking to his physician and explaining this, perhaps get a cath but have antibiotics in him prior to stop any new infections (and cranberry juice)? Wow, that is all I can think of...I wouldn't want to have to deal with those tiny bathrooms on planes! Oh boy!

Or call up the airlines and ask if they have anything that may be of assistance for you? Like a privacy screen deal (proably not but worth and ask), or a more private part of the plane to do this (dependant on size of plane I would suppose). Hopefully between your Doc and the airlines something can be arranged.

CarVsTree · Dec 14, 2004

I've never CD'd an adult, but used to sell a variety of cloth diapers for babies. Odor control shouldn't be a problem as long as you change as soon as he's wet, which I'm sure you do.

You can use microfleece as a liner, which will draw moisture away so that it is not on his skin. Here are some links so you can see what I'm talking about.

http://www.cloth-diaper.com/detail.asp?PRODUCT_ID=FUZZ9901

You can make them yourself and you can make them wider in the front and back to keep them in place better. Many people sew the edges of the liners, but its not necessary because fleece doesn't ravel.

I wish you the best and hope you find a solutin that works.

SallyD · Dec 14, 2004

These are all some great ideas and thanks so much for taking the time to write!! It really helps!! What a great idea about the liners!

OK, The diaper service will be delivering the first supply tomorrow, and we're going to test to see how this all works. I've signed up for a month's service to start out. They deliver/pick up once a week and include a pail and a fresh deoderant cake with every delivery. They want the diapers rinsed if there's bowel incontinence, but we don't have to worry about that.

I'm going to try the cloth diapers on him for while he's at home, and use the disposables for going out, and keep the caths handy for when there isn't any other choice. He has an appointment on Friday to get his antibiotic prescription renewed - next Weds. we're going to fly to Florida to spend Xmas with my sister (she's an HH RN, too, and she understands).

I'll post the results here.

I did call United Airlines and they said that caring for a disabled adult while on a flight is fairly commonplace and that I can notify the airline of the situation when we check in. They said that there are several options available and it would be best to seat us near the rear of the aircraft. They seemed understanding and accomodating over the phone - we'll see what happens when we actually go on the flight. They do request that the pt use a disposable pad on the seat, which is certainly understandable.

I did some sluething on the web, and found a few companies on the web selling cloth diapers, but these seem to be catering more to the adult diaper fetish crowd. "Lifestyles Emporium" and "LLMedico" seem to be in this category.

But I did order a few cloth diapers from "RP Diaper Designs" and "Babykins" - both of these companies are in Canada, and the price was very reasonable from both companies. The "RPDiaper" is a snap-on type and looks like it has good coverage all the way around. I wanted to see if there's any difference in the construction and comfort for him vs. the "delivery service" diapers.

Yesterday, I also received a package of "Molicare" super-absorbant disposable briefs as well. These are about the thickest adult incontinence briefs I've ever seen - they can hold up to something like 100oz and the padding is generous on the sides. These might be an option for a long airline flight also. I'm going to put him in these for a couple of "overnight" tests to see how they work.

Again, thank you all SO much for all the GREAT ideas, advice and understanding, and I'll be sure to let eveyone here know what I find out as we go!

-Sally D.

nurse annie1 · Oct 24, 2011

i am going thru the same things with my husband,and him being overweight, its very hard to find proper cloth diapers and plastic pants for him.

SuesquatchRN, BSN, RN · Oct 25, 2011

Good luck.

:)

1uvakindmom · Oct 28, 2011

As a previous response stated, mircofleece is a great way to keep moisture off the skin. I used CD for a while with my youngest, and just bought a sheet of fleece from the craft store and cut it into liners to put in his diaper to keep the moisture off of him. Good luck!