Question

I work at a nursing home that forbids adult diapers from being used whenever the resident is in bed (nap or bedtime), to save money. However, those residents that are able to express an opinion are very distressed about this; their beds and bedgowns get urine and bowel movements on them during this time. The residents are changed every 2 hours or as needed when they wear the diapers, and they are also turned and positioned every 2 hours or as needed throughout the day and night. Is it really a cost saving to not use the diapers?

Answer

Incontinence of urine and feces is extremely distressing, not only to the patients but also to their carers and to the staff who have to look after them. The main thing is that treatable causes of this incontinence need to be sought out and remedied. The condition should not be thought of as inevitable in somebody who is old. Otherwise, there is no effort to make a diagnosis or to treat the condition adequately, and one just tries to mop it up.

There are many studies which show that wearing body pads not only aids the comfort of the patient, but also results in considerable cost saving. The saving in cost is in nurse time required to change and wash a patient, and so forth. So although body pads may seem more expensive initially, they are extremely cost-effective in most cases.

Some people have a reaction to these pads and it is most essential to check that they are not sensitive to anything within the lining or the pulp itself. With adequate attention and with regular changing, problems such as skin infections and so forth can be avoided. Indeed one might comment that the residents in your home are very well looked after if they are changed and turned in position every 2 hours.

Finally we provide you with a reference below for a chapter in which there is a large section on pads.

Fonda et al. Management of Incontinence in Older People. Incontinence: First international consultation on Incontinence - Monaco 1998;(18):731-774