Before you measure
- Explain what you are doing and why, in simple words: "I am going to measure your hips so that we get a size that fits comfortably." Ask permission.
- Choose a private, warm place, with the door closed, and keep the person covered as much as possible with a towel or sheet.
- Use a soft, flexible tape measure, such as a tailor's tape. A string and a ruler also work.
- Measure over thin clothing or underwear, not over thick trousers or a bulky product, which gives false numbers.
- Have the person stand if safe, holding a support, or lie on their back if standing is difficult. Do not rush. See dignity in intimate care: words, privacy and consent.
- Write the numbers down, with the date and the unit, either centimetres or inches. Many charts use both.
The key measurements
1. Waist. Measure around the natural waist, the narrowest part of the trunk, usually just above the navel, with the tape snug but not tight. Breathe out normally. If the abdomen is large, measure around the widest point at the level where the waistband of the product will sit.
2. Hips. Measure around the fullest part of the hips and buttocks, with the feet together, keeping the tape level and not sagging at the back. This is often the most important measurement, because the product must wrap around the fullest area.
3. Which one to use. Most size charts give waist and hip ranges. If the two measurements fall into different sizes, go by the larger one, usually the hips. Never choose a size by the smaller number.
4. Weight and height (optional). Some charts also include weight. Use it as a cross-check, not as the main guide, since body shapes vary.
5. Leg circumference (for tricky cases). For very thin or very large thighs, measuring the upper thigh can show whether the leg openings will fit.
6. Note the shape. A large abdomen, narrow hips, a heavy lower body or an unusual shape may need a different size or style than the chart suggests.
Reading a size chart
Find the manufacturer's chart on the pack or website. It will typically list sizes such as small, medium, large and extra large, each with a range of hip or waist measurements in centimetres and inches, and sometimes a weight. For example, a size might list a hip range from one number to another.
- Find the row where your measurements fall.
- If you are between two sizes, consider the type of product. For tab-style briefs with adjustable tabs, the smaller size may fit snugly if the person is thin, while a heavier person may need the larger. For pull-ups, which have less adjustability, choosing a size that is slightly too small can dig in; choose the larger if in doubt, then check the fit, and review after a few days.
- Different brands run differently. Do not assume that medium in one brand equals medium in another; use each brand's chart. When changing brands, re-measure.
- Gender-specific styles may be shaped differently. For men, extra absorbency is positioned at the front; for women, towards the centre and rear. Unisex products suit many people.
- Plus sizes and bariatric sizes exist for larger bodies. Ask the pharmacist to order them if they are not on the shelf.
- Very small or petite sizes exist for slender people.
Checking the fit once it is on
After fitting a product, check:
- Waist: snug, with room for two fingers under the waistband, not digging in, not gaping at the back.
- Leg cuffs: gathered, sitting close to the skin, not folded inwards, and not cutting a groove. The elastic should be pulled out to the outside so that it forms a barrier.
- Crotch: the absorbent core sits centrally between the legs, not bunched or twisted.
- Tabs (briefs): lower tabs angled upward, upper tabs angled downward, fastened evenly on both sides, with the product symmetrical.
- Hips and back: no gaping at the back, a smooth fit without folds.
- Comfort: the person can sit, stand and lie without pinching or rubbing.
- Skin check: no red lines or marks after an hour or after removal.
- Discretion: the product does not show excessively through clothes.
Signs of the wrong size
Too big: - Gaps at the legs or waist. - Sagging, sliding down or bunching. - Leaks at the sides or back, especially when sitting or lying. - Dry, unused areas at the top while the bottom is soaked.
Too small: - Red marks or grooves at the waist and thighs. - The tabs barely reach, or the pants are hard to pull up. - Edges folding inwards, or the product tearing. - Complaints of discomfort or tightness. - Skin soreness and rubbing.
If you see these signs, re-measure and try another size, and consider a different style.
Special situations
Bedridden people. Measure lying down, on the back, with knees slightly bent if possible, around the fullest part of the hips. Use briefs with adjustable tabs, which are easier to fit lying down. The person may lie on the product's centre, so the back panel must be high enough to cover the lower back and prevent leaks while lying; see how to change an adult diaper in bed.
People with swelling. Leg and abdominal swelling (oedema) can change measurements through the day. Measure at the largest, and review if swelling changes. Tell the doctor about new swelling; see swollen legs in older adults.
Weight loss or gain. Re-measure every few months, or whenever clothes fit differently, as unintentional weight loss may show on the product; mention it to the doctor.
Very thin or frail people. Skin is delicate; choose a snug but soft fit, and watch for gaps at the thighs. Petite sizes or specially shaped products may work better.
Larger bodies. A fold of skin can trap moisture; keep skin dry and use breathable products. Use bariatric sizes where needed.
Contractures or stiff hips. If the legs cannot be separated easily, briefs that open flat are usually easier than pull-ups.
People who stand and walk. Check the fit while standing and walking, since products shift.
Men. Make sure the penis is positioned downwards within the product, which helps direct urine into the absorbent core and prevents leaks at the waist; ask the nurse to show you.
Women. Ensure the product is centred, with no folds in the groin.
Fixing leaks: a checklist
When a leak happens, run through: 1. Is it the right size? Re-measure. 2. Are the leg cuffs pulled out, not tucked in? 3. Is the product positioned correctly, and centred, with the tabs symmetrical? 4. Is the absorbency enough for the time and the volume? Consider a higher absorbency, or more frequent changes. See managing incontinence at night. 5. Is the product changed often enough? Check how long it stays on. 6. Is the person lying or sitting in a way that causes leaks, such as on the side or sitting leaning forward? 7. Is the product damaged, or poor quality? Try a different brand or batch. See spotting fake or poor-quality care products. 8. Is something else adding to the problem, such as constipation, a urinary infection or new medicines? See a doctor; see urinary tract infections in older adults: atypical signs. 9. Is the mattress protected? Add underpads and a protector; see underpads: disposable and washable options and mattress protectors for incontinence.
Buying and stock
- Buy a small pack first to test the fit before stocking up.
- Keep the packaging or a note of the brand, size and chart.
- Re-check the size each time you change brands or if your parent's weight changes.
- Store products in a cool, dry place, away from damp, which affects absorbency, and keep them out of sight if privacy matters. Avoid storing near the stove or in leaky places during monsoon.
- Do not reuse products.
- Budget: buying the right size reduces waste and leaks; see an incontinence products budget: what a month costs.
When to ask a professional
Ask a continence nurse, pharmacist or doctor to measure and recommend products if you are unsure, if the person has an unusual body shape, skin problems or heavy loss. Ask for help if leaks persist despite correct size, or if skin is red, sore or broken; see incontinence-associated skin damage: prevention and care. Seek urgent medical help for fever with confusion, blood in urine, inability to pass urine or severe pain.
Equipment mentioned in this guide
Frequently asked questions
Which measurement matters more, waist or hip?
Hips are usually more important. If waist and hip fall in different sizes, choose the size for the larger measurement.
What if my father is between two sizes?
For adjustable briefs, try the smaller size if he is thin and the larger if he is heavier, then check the fit. For pull-ups, choose the larger if in doubt and review.
How often should I re-measure?
Every few months, when changing brands, or if weight or swelling changes.
Why is the pull-up leaking at the legs?
Often the size is too big, or the leg cuffs are folded in. Re-measure, re-fit and check absorbency.
Can I measure someone in bed?
Yes. Measure around the fullest part of the hips with the person lying on their back, using a soft tape and keeping them covered.
Sources and further reading
- International Continence Society, guidance on absorbent product selection and fit
- National Institute for Health and Care Excellence, CG171 Urinary incontinence and pelvic organ prolapse in women: management
- Global Incontinence-Associated Dermatitis Expert Panel, best practice principles
- World Health Organization, World report on ageing and health (2015)
Tags: measure adult diaperadult diaper sizepull up sizehip measurementincontinence product fitdiaper leaksIncontinence and hygieneAdult tape briefsHealthy ageingElder care
This article is for general education and is not medical advice. Speak to your doctor before changing your exercise, diet or medicines.
