Choosing Incontinence Products by Situation

Questions to ask first

1. How much leaks, and how often? A few drops, a damp patch, a soaked pad, or complete loss of the bladder? Is it urine, stool or both? 2. Is the person mobile? Can they stand, walk and use the toilet? Can they dress and undress? Do they need help? 3. When does it happen? Day, night, on exertion (coughing), with urgency, or unpredictably? 4. What is the skin like? Healthy, sensitive, red, broken or at pressure-sore risk? 5. Who is helping? Is the person independent, or is a carer changing them? What can the carer manage? 6. Where? At home, in bed, in a chair, out and about, on a trip? 7. What does the person want? Comfort, discretion and independence matter. 8. What is the budget and laundry capacity? See an incontinence products budget: what a month costs.

Also consider: has the cause been assessed? Products manage leaks; they do not treat the cause. See incontinence in older adults: causes and types.

The product toolkit

• Pads and liners: small absorbent pieces worn in underwear for light to moderate leaks, with an adhesive strip.
• Pull-up pants (protective underwear): absorbent pants for moderate to heavy leaks, mobile users.
• Tab-style briefs: adjustable, high absorbency, for bedbound people, heavy leakage and night; see pull-ups or briefs: choosing the right product.
• Booster pads: extra absorbency placed inside a brief or pull-up, used when advised.
• Washable protective underwear: reusable underwear with built-in absorbency, for light to moderate leaks.
• Underpads (disposable or washable): sheets for bed, chair or wheelchair; see underpads: disposable and washable options.
• Mattress protectors: waterproof, breathable covers; see mattress protectors for incontinence.
• Urinals, bed pans and commodes: toileting aids; see urinals for men and women: bedside use, bed pans: types and how to use them and commode chair guide.
• External or indwelling catheters: medical devices, only on a doctor's advice; see catheter care basics for families.
• Wipes and barrier creams: skin care; see wipes and perineal hygiene done gently and barrier creams and skin care under pads.

Situation 1: occasional light leaks while active

*Example: a few drops when coughing or sneezing, or a little after the toilet.*

• Product: a small pad or liner, or washable protective underwear.
• Fit: fixed to underwear with the adhesive strip, with the wide end towards the back for women, and a men's shield shaped for men.
• Change: when damp, or a few times a day.
• Skin: wash and dry daily; avoid scented products.
• Also: pelvic floor exercises; see pelvic floor exercises for older adults.
• Mistakes: using sanitary towels for menstruation, which are not designed for urine and may leak, smell and irritate; using too-thick products that show.

Situation 2: urgency and moderate leaks, mobile and independent

*Example: cannot always reach the toilet in time, leaks of a cupful or more.*

• Product: pull-up pants of moderate absorbency, or a larger pad with netting pants.
• Fit: correct size from waist and hip measurement; see how to measure for adult diapers and pull-ups.
• Why: pull-ups look like underwear, allow independence and can be pulled down quickly.
• Also: timed toileting or bladder training, easy clothing, lit routes; see bladder training and timed toileting.
• Mistakes: choosing too small, which digs in; too large, which gaps.

Situation 3: heavy leakage or bowel incontinence, mobile

• Product: high-absorbency pull-ups or briefs with leg barriers and a breathable cover; briefs may be easier for cleaning after a bowel accident.
• Change: promptly after a bowel movement.
• Skin: barrier cream as advised; see incontinence-associated skin damage: prevention and care.
• Also: treat constipation and diarrhoea; see bowel incontinence and constipation in later life.

Situation 4: bedbound or chair-bound, needs help

• Product: tab-style briefs of the right size and absorbency, with wetness indicators if available.
• Bed protection: a breathable waterproof mattress protector and an underpad.
• Chair or wheelchair: a disposable or washable seat pad, with a pressure-relieving cushion; see pressure care in a wheelchair and gel cushion for pressure relief.
• Toileting aids: commode where possible, bed pan if not; see bedside commode and urinal routines.
• Technique: how to change an adult diaper in bed.
• Skin: check every change; use a pressure-relieving mattress if at risk; see preventing bedsores at home and air mattress for pressure sores.
• Mistakes: plastic sheeting against skin, stacking pads, wrinkles in sheets, leaving a person wet.

Situation 5: night-time

• Product: high-absorbency overnight briefs or pull-ups, an underpad and a mattress protector.
• Toileting aids: a urinal or commode within reach, with a night light; see managing incontinence at night.
• Routine: a toilet visit before bed; modest evening fluid changes only if the doctor agrees.
• Change: on waking, and after a bowel movement.
• Mistakes: daytime products at night, no bed protection, no night light.

Situation 6: dementia

• Product: pull-ups that look like underwear, if the person accepts them, or briefs if bedbound; wetness indicators help carers; easy clothing.
• Approach: call them underwear, introduce gently, and check for discomfort; the person may remove pads, so choose a good fit and watch skin.
• Also: prompted toileting, cues and a recognisable toilet; see incontinence and dementia: routines and reassurance.
• Mistakes: scolding, using restraints, forcing.

Situation 7: going out or travelling

• Product: a pull-up or brief of suitable absorbency, with spare products, wipes, bags and a change of clothes; see going out with incontinence: a practical bag list.
• Toileting aids: a portable urinal, if used.
• Clothing: loose, dark, elastic waists.
• Mistakes: too few spares, no bag, not planning toilet stops.

Situation 8: after surgery, a fracture or during illness

• Product: briefs or pull-ups for temporary use, underpads, a urinal or commode; follow the surgeon's instructions on positioning; see bed pans: types and how to use them.
• Also: a catheter may be used by doctors in some cases.
• Skin: protect pressure points; keep dry.
• Review: reduce products as the person recovers; do not keep using them unnecessarily, since recovery of independence matters.

Situation 9: diarrhoea or infection

• Product: disposable briefs and underpads, frequent changes, and careful hand hygiene.
• Skin: barrier cream and gentle cleansing.
• Hydration: drink fluids as advised; see diarrhoea and dehydration in seniors.
• Medical review for persistent diarrhoea or fever.
• Laundry: hot wash, or use disposables; see disposal, laundry and odour control.

Situation 10: sensitive, red or broken skin

• Product: soft, breathable, well-fitting products; change very promptly; avoid plastic-backed products when possible; use an underpad instead of stacking pads.
• Skin care: gentle cleansing, a thin barrier cream, no powders; see barrier creams and skin care under pads.
• Medical: see a nurse or doctor for rashes, blisters or open skin.
• Mistakes: thick creams under pads, scented wipes, hot water.

Situation 11: hot, humid climate

• Product: breathable, cloth-like products with good airflow; lighter bedding; frequent changes.
• Skin: keep dry, wash and pat; see summer heat and bedridden care.
• Storage: keep products in a dry cupboard.

Situation 12: women and men differences

• Women: products with absorbency across the centre and back; postmenopausal skin is thin and dry.
• Men: products with extra absorbency at the front; position the penis downward in briefs; male guards and shields suit light dribbling.
• Unisex products suit many people; choose by fit.

Fit and care checklist for any product

• Correct size from measurements.
• Leg cuffs pulled out and not folded in.
• Waist snug but not tight.
• Product centred, no twisting.
• No double-padding.
• Changed when wet or soiled, and at regular checks.
• Skin checked and cleansed at each change.
• Disposed of properly.

When products are not enough

If leaks persist despite the right fit, if skin is breaking down, if smell is strong or if the person's needs have changed, review with a nurse or doctor. Consider further assessment, a toileting plan, a commode, a catheter in selected cases or specialist advice. See when to see a doctor about bladder or bowel changes.

Dignity and choice

Let the person take part in choosing, within safety. Try small packs of different styles. Keep products out of public view, and use respectful words; see dignity in intimate care: words, privacy and consent and talking about incontinence with a parent without shame.

When to ask a professional

Ask a continence nurse, pharmacist or doctor to recommend products, show how to fit them and check skin. Ask for a review when the situation changes. Seek urgent help for fever with confusion, blood in urine, no urine for many hours, severe pain, deep or spreading sores; call 112 for emergencies.