4. Choosing and using continence products (for example, pads)
Key points
- Continence products can be useful tools to help continue with daily activities.
- Choosing the right products can be tricky.
- You might need to try more than one type, size or absorbency level.
- There are products to help protect the bed and furniture too.
Making the decision to start using continence products can be hard. Some people find them embarrassing and try to avoid them. But for many people they are useful and help them continue with day-to-day activities. A wide range of continence products is available, for example absorbent pads or pants and urinary sheaths. They all have different pros and cons. Different products might be needed for different activities. For example, what works well during the day, might not work for night.
This section gives a summary of absorbent products (ones that soak up pee or poo). For more information go to www.continenceproductadvisor.org. This website also gives information on other products such as urinary sheaths and urinals.
You should also speak to your GP or local Bladder and Bowel service who can assess needs, give advice and might offer some products if treatment is not possible.
Things to think about when choosing products
- The absorbency (how much the pad soaks up) is often shown by the number of ‘droplets’ on the packaging (one drop for very light and eight drops for very heavy).
- Getting a good fit is important. Sizing information is shown on packaging.
- You might need to try different designs. Pad manufacturers will sometimes send sample packs to help with this.
- If changing the product is easy, then you could consider using a smaller (lower absorbency) product that needs changing more often but might be more comfortable. If it’s difficult, then a larger (more absorbent) product could be better.
- Can any products help to keep the person you care for more independent? Many people living with dementia find pull-on products easier to manage than other designs.
“We use the pull-up. I got them to hold the poo so it didn’t go everywhere. And you can take them off easily because you can rip the sides. He is happy to put them on, they’re like pants.”
Wife
Summary of absorbent continence products
Get much more information at www.continenceproductadvisor.org
| Product | Who are they for? |
Pros | Cons | Where can you get these products? |
|---|---|---|---|---|
 Small pad |
Men and women Some are designed specifically for men or for women |
Good for light urinary leakage Can get products designed for men or women Not too bulky |
Not good for heavy urinary leakage or bowel leakage |
Some Bladder & Bowel services, Supermarkets, Pharmacy On-line |
 Large Pad |
Men and women (unisex) |
Good for moderate to quite heavy leakage (urinary & bowel) Fairly easy to change |
Quite bulky. Need close fitting underwear |
Some Bladder & Bowel services, Pharmacy On-line |
 Pull-on |
Men and women Some are designed specifically for men or for women |
Good for light to quite heavy urinary leakage Good for light bowel leakage (but might not contain odour) More like normal underwear |
Need to remove trousers/tights to change |
Some Bladder & Bowel services, Supermarkets, Pharmacy On-line |
 All-in-one |
Men and women (unisex) |
Good for moderate to heavy leakage (urinary & bowel) Can be easier to change for someone who is lying down |
Quite bulky |
Some Bladder & Bowel services, Pharmacy On-line |
 Belted pads |
Men and women (unisex) |
Good for moderate to heavy leakage (urinary & bowel) Can be easier to change for someone who is standing |
Quite bulky |
Some Bladder & Bowel services, Pharmacy On-line |
 Washable |
Men and women Some are designed specifically for men or for women |
Can be good for light to moderate leakage Can be good for men with heavy night-time leakage |
Bulky Need washing and drying |
Some Bladder & Bowel services On-line |
Using continence products
Using pads (or other products) can cause problems. Some people forget that they need a pad so don’t use one. Others forget to change the pad, put them on the wrong way round or throw them away in the wrong place.
Things to think about:
Pads
- Make it as simple as possible to use the pad. For example, if the person is using pull-up pants then put the pull-ups in their normal underwear drawer so they can be easily found.
- Putting used pads in the wrong place can be a difficult problem. It might help some people to have a note or picture on the bin to help remind them.
- If you are helping someone to change a pad, you might need to explain what you are doing each time. If the person with dementia doesn’t understand what you are trying to do, they are more likely to be scared or confused and try to stop you.
- Don’t let embarrassment stop you talking about using pads.
- Using pads can make some people’s skin sore. Get advice on skin care from a healthcare professional if you notice any problems.
“I always say show me the pad and then we make a decision as to whether we’re going to put another one on or not.”
Husband
Other continence products
- Pads are not the only continence products. Others include urinary sheaths for men (like condoms with a drainage bag attached), hand-held urinals for men or women and urinary catheters. More information on these products can be found at www.continenceproductadvisor.org. Speak to your healthcare professional if you think any of these products could be useful.
- Urinary catheters come with many problems, particularly for people living with dementia. They often cause infections, become blocked and can be accidently pulled out. Catheters should be avoided for most people.
“I’ll say have you remembered to put your lady knickers on? Then we go through the same process again, ‘I don’t wear special knickers do I?’ And because she doesn’t retain any information every time it’s a brand new experience for her.”
Daughter