Absorbent Products for Adolescents and Young Adults
By The National Association For Continence
Incontinence products are a multi-billion dollar industry. Half of the shares of this market are in absorbent products. The National Association For Continence (NAFC) recently interviewed two staff members at care centers to learn more about the use of absorbent products as a management option for developmentally delayed and other special needs adolescents and young adults who have bladder and/or bowel control problems. Deborah Rasmusson, director of vocational services at Sunshine, a nonprofit organization that provides residential, vocational and family support services to people with developmental disabilities in Maumee, OH, and Tasha Wigington, RN, director of nursing at Truman W Smith Children’s Care Center in Gladewater, TX, were interviewed by NAFC.
There are many types of absorbent products. Some examples of these products are liners, pads, fitted briefs and protective underwear. Disposable and reusable versions of these are available. If urine and bowel control is unpredictable these products are a good way to help manage the problem.
When asked what performance characteristics to look for in absorbent products for the developmentally delayed and other special needs adolescents and young adults, both directors gave similar answers. “For our residents, we look for a high level of absorbency,” said Wigington. “We find that often a resident may retain or hold urine for some time and when the individual finally does urinate, they void a substantial amount of urine. A high level of absorbency is needed to handle that amount of urine.” Rasmusson said, “Our greatest challenges are finding products that can actually contain the urine and fecal matter.” Both Wigington and Rasmusson emphasized the importance of skin care. Even though many of the individuals that these two centers care for are young, their skin is still susceptible to problems. Moisture barrier creams should be used to protect the skin from moisture. Furthermore, paying attention to allergies, such as allergies to latex, is important as well. For those with latex allergies, there are latex-free options available.
Consideration toward the feelings of the person who wears these products is essential in their total wellbeing. “We’ve found that a product with a soft breathable outer covering rather than plastic is more comfortable for the wearer and does not make noise when the individual moves which proves increased dignity for the wearer,” said Rasmusson. Wigington urges, “Consider the dignity level of the person you are caring for. Wearing absorbent products can have an emotional effect on patients.” Buying products with a cloth-like outer layer and considering the dignity of the individual during changes are important aspects to consider when selecting absorbent products.
As Rassmusson suggests, breathability of an absorbent product contributes to its comfort for the wearer. A column in this month’s issue of Ostomy Wound Management Journal discusses the importance of breathability in absorbents. “Breathability is measured by the rate at which water vapor passes through a fabric or other shield. It is measured in grams of water vapor per square meter of fabric per 24-hour period and often simply abbreviated as ‘g.’ Sports apparel designed to direct water away from the body as an athlete perspires…typically is labeled to indicate relative breathability, with mid-range considered 5,000 g and the best materials having 20,000g. Such measures also can be applied to absorbent products worn for managing incontinence."¹ Breathability contributes to comfort and functionality.
Some characteristics of products should be individualized for each person. There are special issues in choosing the right product for the individual. Many different types of fasteners on absorbent products are offered and not all types serve each individual well. “Caregivers might look for products that fasten strongly and cannot be easily pulled off. We have residents with involuntary movements or seizure disorders and strong fasteners are especially important for them,” said Wigington. “We do have individuals who wear pull-up style briefs. These are very helpful for the staff that changes these garments when the individual is standing or lying down,” said Rasmusson. Many parents and caregivers wonder which is better for their child - diapers or pull-ups. One study concluded that "diapers and pull-ups have different strengths and limitations and both meet the specific needs of the individual children."²
The ideal fit of the garment needs to be determined for each person. “Fitting individuals with the right size is necessary for optimal performance. Many absorbent products come with fitting guides with measurements but often these do not work for our residents due to contractures, spinal deformities or hip displacement. It is often a matter of trial and error to determine the correct size for the individual,” said Wigington. Rasmusson said, “Finding the right product and fit for each person, based on their particular needs and issues, takes more time but we feel it is worth it and results in better care for the person.”
NAFC asked both of these health care professionals what they feel is important to know when choosing absorbent products. At Sunshine, Rasmusson and the rest of the staff look for products that improve the quality of life for the people they serve. The products must reduce urinary tract infections, odor and skin breakdown issues. For Wigington it is important to achieve optimal performance of the product through high absorbency and the best fit possible. Should you be considering a daycare or residential facility for a special needs child or young adult in your family, be sure to ask about the facility’s continence care program to insure a protocol is in place with appropriate guidelines for absorbent product selection for those individuals with bladder or bowel control problems.
¹Muller N. Continence Coach: Product performance characteristics to protect skin integrity. Ostomy Wound Mange. 2011;57(4)16-17.
²Macaulay, Margaret; Pettersson, Lena; Fader, Mandy; Brooks, Rodney; Cottenden, AlanSection Editor(s): Krissovich, Marta MS, RN, CNS, CCCN. A multicenter evaluation of absorbent products for children with incontinence and Disabilities. Journal of Wound Ostomy and Continence Nursing. 2004;11(4)235-244.
