Tuesday, February 27, 2007

A Stinky Situation

Dealing With Incontinence

It's a sad fact that many people suffer from incontinence as they age. If you have any doubts, just check out the wall of incontinence products at WalMart. There are more types of adult diapers than you can imagine!

Fortunately, these products do work very well and will soak up an amazing amount of liquid. Disposable mattress pads and wheelchair liners reduce the mess if there are accidents.

The biggest problem is disposing of the used diapers; just throwing then into an open trash can leads to a stinky mess. Flip-top kitchen cans help contain the odor, but dumping the can is still not a job for the faint of heart....or nose.

A tour through the baby aisle reveals a number of diaper-containment products. None of the instructions mention adult diapers, and most of these products depend on a number of steps to spirit a used diaper safely away. For example, one type of container requires folding the soiled nappy, inserting it into the lid and twisting the lid around 3 times. The result is like a string of frankfurters... but even with rat lips and dead flys, there is no comparing this sausage to the real thing!

Our search for a good solution led us to the Diaper Dekor Plus at Toys-R-Us. This picture shows the standard model...the Plus has rectagular trap doors and is slightly larger. The instructions from the website sum it up best.

Diaper Dékor® Disposal System

Baby Talk Editor's ChoiceThe only hands free system!

The innovative Diaper Dékor is a convenient, easy and
sanitary way to dispose of dirty diapers. With a contemporary and hands free design, diaper changing won't become a dreaded experience. There is no twisting or turning – just step on the pedal and drop the diaper in.

The unique triple seal system helps to prevent odors from escaping....

The Plus size easily swallows a full adult diaper and seals it behind snap-shut trap doors and a drop down lid. It's simple for someone with cognitive impairment to use with the familiar "step on the pedal and drop it in" operation. The diaper falls into a continuous bag. After a day or two , it's a simple matter to open the door, pull out some additional length, cut the full section off and tie a knot in it. No mess, no smell and it's ready to go into the trash. The picture below shows how this works.

The Diaper Dekor Plus is allegedly widely available, but the only place we have been able to consistently find it is Toys-'R'-Us. The refill bags are not inexpensive but being able to dispose of the smell along with the diapers is well worth the expense! Remember to stock up on refills...you don't want to run out. Trust me on this.


Anonymous said...

Thanks for this website. It's really helpful and practical. I'm recommending it to the LBD spouse group. Imelda

Carri said...

Pragmatism is good.

I just found your blog by way of reading the LBD forum, and how ironic that your latest entry regards incontinence! This morning was yet another day of cleaning a gigantic mess before I could even dream of coffee. My mother was diagnosed with Pick's Disease last year and LBD this past January. As her sole caretaker, I'm at my wit's end and look forward to your input and experiences. Thank you.

Sid Schwab said...

This blog is truly a gift to caregivers. I love the wonky aspect of it. You need to get wide notice. My mom is well into the forest of Alzheimer's, as well as pretty much totally dependent on help in all movement. In addition to being heartbreaking, the logistics are daunting in all things.

On a specific note, I understand disposable diapers are a major landfill issue in addition to the problems you address. I gather degradable materials are in wider use, although I assume the plastic liners are still a problem. On the other hand, especially in the adult situation, they're pretty much indispensible.

Eric, AKA The Pragmatic Caregiver said...

First off, everybody wave to Sid.... he blogs at surgeonsblog.blogspot.com and I admit to cribbing *shamelessly* from his writing style and link habits. He's got a great, twisted sense of humor, and I can personally attest to his considerable professional talents. If he thinks this humble collection of uninformed-but-field-proven effluvia is a gift to caregivers....well, I hope they kept the receipt. Still, I blush from such flattery.

Back to diapers.

Really, the worst part about disposables in the waste stream is transporting human fecal matter through the streets. I would *much* prefer such things move through the sanitary sewer system than landfills.

You might be surprised about the construction of the state-of-the-art products; most adult products no longer have plastic film coverings, relying on spun-bonded or other non-woven fabric coverings. They're no more biodegradable (in fact, you want to avoid degradation in landfills) than the original Pampers, but they are surprisingly underwearlike.

Oddly, the products we've found used in hospitals are *light years* behind the consumer-targeted products - more bulky absorbents that hold less, plastic films, non-reclosable fasteners. We bring our own - the CNAs are incredibly grateful. (Note to self: blog about the Hospital Survival Kit in the trunk of the car one of these days)

Launderable products use a lot of hot water and energy - I think environmental activists have pretty much resigned themselves, with infant diapers, that it's a draw. With adult products, due, to, the, um, volumes involved......and the nature of the substances....oh, god, is this what my life has come to? *deep cleansing breath*

We looked at the launderable products (mostly disposable inserts into washable carriers), and they're quite suitable for a non-ambulatory person who has no say in the matter, but they're essentially dignity-destroying for the moderately-capable. One system we looked at had *fishnet mesh* panties with what resembled maxi-pad inserts. Horrifying.

Cal needs something that looks like underwear, so he'll know what to do with it. The only problem I've got with the existing product performance is that you have to hike them up over the navel - you cannot wear them like Jim Palmer's favorite scanty Poco bikinis, circa 1981. Once we figured this out (that they should be snug at the crotch, and not just around the leg holes), the problems stopped.

Dementing diseases are horrific; they sap the life out of everyone involved in the care, they cost people everything they worked their whole lives for, and the treatments are essentially futile in 80+% of cases. We're "lucky" with Cal; his form of dementia is surprisingly treatable, and the progression may be slowed with optimized medication. I'll post more on this some time when I'm feeling reflective. Still, regardless of the etiology, it's a full-time gig on top of our lives and could remain so for another eight years or so. Here's to hoping that what we've figured out can be practical and useful to someone else, or at the very least amusing.


Anonymous said...

For many years, my husband & I took care of his grandmother as she slipped further & further into dementia. I remember the search to buy her a phone, a simple phone without extra buttons & (confusing) functions to replace the one with a mute button that defeated her (just like the microwave story you told about your father). Reading your entries brings this painful history back. I wish you well and applaud your strength & caring. Thanks for creating this blog to share it with us.

Anonymous said...


I got a great laugh out of your March 5 reply here. Sad, but true. Especially your being horrified with the *fishnet* system...welcome to a woman's world!

BTW, I keep my survival kit in the back seat. Anyone breaking into my car would be severely disappointed.

I look forward to your blogs. Linda

ps. I was checking out the comments while the pygmy bears have you tied up.