Full Episode Transcript

Nancy Treaster 

We both wish we knew how to handle incontinence better once it began.

 

Sue Ryan

We sure do. For Incontinence, we’ve actually created a five -part series because there’s a lot going on with this topic.

 

Nancy Treaster 

Yes, there is, and it’s coming.

 

Sue Ryan 

It sure is. In this series, we’re helping you so you can preserve your care receiver’s dignity. And we’re also helping you learn what to expect so you can be getting yourself prepared mentally, physically, and emotionally. The five, the five episodes in this podcast series are episode nine, preparing for incontinence episode 10, something we coined which is pre -incontinence and when incontinence first begins. Episode 11 is urinary incontinence and episode 12 is bed bound and bowel movement incontinence. And episode 13 is incontinence overnight.

 

We said we would talk about the good, the bad and the ugly. This can definitely qualify as the ugly. We’re focused on helping you understand what’s involved in cleaning your care receiver. We want you to know this isn’t an easy part of your caregiving journey. And we talk about it being mental, physical, and emotional. It really is. And it’s reasonable that we haven’t done this before. We don’t know what we’re doing. So there’s a lot involved with it. So when you’re going through this and you’re getting adjusted to it, we encourage you to reach out to others for support. Reach out to us, reach out to support groups, reach out to family members, reach out to loved ones, reach out to get support on this because it’s a big deal. It’s going to be a part of your journey for the remainder of your journey. And there’s a lot to it. You don’t know. So in this episode, we’re sharing three tips. Nancy, let’s get started.

 

Nancy Treaster 

Okay.

 

When incontinence starts and it comes to cleaning your care receiver, if you’re asking other people to watch your care receiver, you will be asking them to change them and clean them. And this is often a boundary that other people are not comfortable crossing. Matter of fact, we’ll talk later, it’s maybe a boundary that you’re not comfortable crossing. But this is the time where you want to, before you ask someone to watch your care receiver, you want to have a conversation about incontinence and whether or not that’s something that they’re comfortable taking on. In episode eight, where I interview Merritt, our oldest son, we talk about this topic. And I made the mistake of not asking him, was he comfortable with incontinence? And he had to tell me when the time came and I was asking for his support, he had to say, mom, I’m not comfortable if it includes, you know, changing dad. And it never crossed my mind to ask him. So lesson learned from me.

 

Nancy Treaster 

Take the opportunity before you ask someone to watch your care receiver to have the conversation. And you’ll definitely find there are more people who are not comfortable with it than there are who are comfortable with it.

 

Sue Ryan 

Because just like you, they haven’t done this before either. 

 

Nancy Treaster 

And it’s one of those things, as we’ve mentioned, this may be a line that you’re not comfortable crossing. So this is often an inflection point in people’s journey where they start looking at care communities or bringing caregivers into the home to help them.

 

Sue Ryan

Right.

 

Nancy Treaster

We’re going to talk throughout all of the incontinence episodes about disposable incontinence underwear. Now that’s a mouthful, so we’re not going to say that. We’re going to say Depend, a Depend, Depends or Depend like product. That may not be the product that you choose to use. Just know we’re just using a name so that we don’t have to say disposable incontinence underwear every time we’re having the conversation

 

Nancy Treaster

Okay, Sue, I think we’re ready for tip one. What about you?

 

Sue Ryan

All right, let’s go into tip one, which is leverage adaptive clothing. Adaptive clothing are ones that there are different ways to remove them. For example, they have snaps, have Velcro, they have magnets. Some of them have openings in the back, some of them have flaps. So they adapt to whatever your care receiver needs and the things that they’re challenged with. So as we’re beginning the process of changing our loved one who is incontinent,

 

We’re going to explore the different types of adaptive clothing for men and women that will support what they’re going through. And when you’re working with the adaptive clothing, it makes it easier, especially when, as Nancy mentioned, when you go into this Depend or Depend -like product, it’s important to be able to easily remove it and easily replace it. And often it’s not easy to get our care receiver to want to.

 

For example, take a skirt or a pair of shorts or pants off in order to have that process done. So the adaptive clothing is very, very helpful. They work great and they make changing a lot easier. And Nancy, you learned not all adaptive clothes are created equally. What is the tip you learned about that that’s so helpful?

 

Nancy Treaster 

So true and that’s all my husband wears now is to snap up the side shorts or snap up the side long pants. I wouldn’t use anything else once you’re completely in Depend-like products. It’s not worth trying to pull their pants down and get them off their legs and everything not worth it. It just creates more drama and makes a bigger deal out of something that you’re trying not to make a big deal out of. However, we’ll put in the show notes some of the products that I’ve really come to like a lot.

 

But long story short, I’ve experimented and tried new different products. And one of the things I learned is to be very careful because some of the adaptive clothing, for some reason, might snap all the way up the side to the waistband, and then the waistband doesn’t come apart. So I’m sure if you had a broken leg or something, that would be fine. you have to, if you’re trying to do what we’re trying to do, you need it to be able to snap all the way off, including the waistband. So just something to look

 

And another type of adaptive clothing is the underwear, the Depend like product for both men and women. And there are a variety of different brands of them. There are a variety of different styles of them.

 

Nancy Treaster 

That’s okay, it’s still the difference. I think we’re still under the concept of clothing.

 

Sue Ryan 

there are and it’s reasonable you wouldn’t necessarily know ahead of time. So part of the thing that they’ll begin with is they’ll begin, you know, like pull ups just like you have with underwear. And part of what Nancy, you and I both learned with our loved ones is the color can sometimes matter. Depend comes. You can get it in a gray or you can get it in the white for women. And my husband was used to wearing a dark brief and your husband was used to wearing a white brief. And so the adaptive part of that. Then the other part of it is it’s difficult sometimes to get that changed. And even when they’re doing the underwear and you’re using adaptive clothing, you want to get it off easily. And we, when you have a professional caregiver, they know exactly how to pull that and just rip it off right away. And when you try it that first time, it doesn’t rip it off and it’s frustrating for them.

 

Nancy Treaster

It’s the truth.

 

Sue Ryan 

So a couple tips with that when you’re looking at the Depend product, because you can actually have ones that fastened with Velcro and you can have the ones that pull up. Our recommendation if you have the ones that pull up is to have a pair of scissors where you can cut them off instead of trying to rip them off. Because unless you’re really good at ripping them off, it’s gonna make noise, it’s gonna be frustrating, you’re gonna be pulling against them, and that’s gonna be kind of more emotionally charged.

 

They’ve got medical scissors that have soft tips or rounded tips. And so there’s that. Then as they need more absorbency, there are different levels of absorbency. There are also pads, both for men and women, that you can put in to provide some additional absorbency. And so we talk in another, I think episode 13 about pads, different kinds of pads you can get to lay on them, but for the clothing that they have. So then there’s also the ones that with the strap or with the Velcro straps that they would wear that make it easy. You can just unfasten those. Two tips for this. These are underwear. I know we’ve said this multiple times and we will keep saying it because I promise you, Nancy, you promise as well. The consequences, if you call them diapers or pull-ups,

 

Nancy Treaster 

Yes, 13.

 

Sue Ryan 

It is not good. These are their underwear and we want that. That’s part of maintaining their dignity. And they also, there are times when based on medication or something, they may have loose stools. And so it’s very helpful to have a variety of them available to you based on what’s going on in their life at the time. So Nancy, what else can you add? Yeah.

 

Nancy Treaster 

Sue, one thing I learned on the Facebook support, dementia support website, support group, and it was a game changer for us, is we had my husband in large, men’s Depend. I think it’s medium large and large, extra large. So I think we had him in large, extra large. And of course, they lose weight lots of times as things progress. But either way, we definitely had a lot of leakage when there were loose stools. And someone on the Facebook page brought this topic up, never crossed my mind to even bring it up. And someone said, we had the exact same problem. We went down a size and it fixed the problem. Sure enough, I went down a size. Huge difference, huge difference. So it doesn’t stop every time, but it stops 90 % of the time. So huge difference. So the size of the Depend that you choose does matter.

 

Sue Ryan 

and it will change over time because they’re physique did. My husband lost 80 pounds during our journey together with his diagnosis, because he didn’t have free range access to food anymore. And so we kept adjusting what the size was that he wore for his Depend like product. So that was it. Yeah. So Nancy, let’s, let’s go on to the next tip, which is cleaning them and changing them.

 

Nancy Treaster 

So something to keep in mind.

 

Nancy Treaster 

Okay, tip two is about the cleaning products themselves that you’re gonna need. And we’re gonna start with the cleaning products specifically focused just on changing a wet Depend. And when we get to tip three, we’re gonna move on to physically how you change a wet Depend. The first thing that’s going to happen, and we’ve talked about this in other episodes, is that incontinence will begin most likely with urinary incontinence. And it will begin most commonly with them not getting to the bathroom fast enough. Think of it as reverse potty training. A two -year -old can’t get to the bathroom fast enough. They know they need to use the bathroom, but they just can’t get there fast enough. And same with your care receiver. Urine’s gonna run down their leg. At a minimum, they’re gonna wet the inside of their underwear when they can’t get quite there fast enough. So you’re going to be changing and cleaning not just their groin area but you’re also probably cleaning down their legs and such. A lot of people might start with just a warm washcloth for that part of the cleaning. Remember, anything you use, try to keep it warm. So a warm washcloth is a good start and just wipe up after they’ve had an accident. But there also are things called adult washcloths or adult wipes. They’re next to the Depends in the grocery store. Don’t use baby wipes.

 

Baby wipes are way too small. A lot of people don’t know about adult wipes, so they start with baby wipes and you’ll drive yourself crazy with little tiny baby wipes. None of these are flushable, just like the baby wipes aren’t flushable. These are not flushable, so you’ll just put them with the wet Depend. And keep in mind, some people even put these in the microwave before they help clean someone up. if you, -huh, yeah, for a few seconds, not for a long time. Good point.

 

Sue Ryan

For a few seconds. For a few seconds. Yeah, and what we did is I would keep them wrapped in a towel so that there wasn’t cold air getting on them. I was never really comfortable putting them in the microwave, although I’ve talked to enough people who do that they’re fine, but I kept them wrapped in a towel so they were at least like room temperature.

 

Nancy Treaster

And I don’t do either one of those. Every time I help my husband clean up, he goes, woo! So clearly, it would be nice if I would do something other than use it.

 

Sue Ryan

Yeah, because I have a care receiver who one time did the woo and it was a long time before he let me, you things like, no, no, And you would think when they’re having trouble remembering things, they wouldn’t remember things, but there are certain things that they, even when you don’t think they’ve got memory, they remember and he remembered that. So trust me, you want it more.

 

Nancy Treaster 

Yeah, be nice, be nicer than I am.

 

Nancy Treaster 

They do remember. Yes. And you’ll see when we get to episode 13, I use something else more commonly anyway than the adult wipes. I just use the adult wipes first thing in the morning. So just know adult wipes and adult washcloths is another option for you and try to keep those warm as best you can.

 

Nancy Treaster 

We did talk about the fact that this is often an inflection point with people. So tip three is going to be about cleaning your care receiver. We’re just going to cover cleaning a wet Depend or at this point. But if this is something that you kind of think, I’m not in for this, I can’t do it. Here’s a chance to listen to what it is and decide for yourself if this is something you can’t handle.

 

There are people who cut the line at cleaning a bowel movement. And so urinary incontinence comes first. It goes on for a few months before you ever get to bowel incontinence. So could be you’re okay with this part, but when we get to the next part, that crosses the line for you. Just understand what’s involved. So anything else on tip two, Sue, before we move to tip three?

 

Sue Ryan (19:52.96)

One of the things we may want to just restate, I think we may have said it at another time, is that we found that the incontinence for both our loved ones came at around three to three and a half years. And it was very similar for my dad at that time frame. That doesn’t mean that it will. The symptoms that we’ve said are, when they’re like, like you can tell they’re struggling to find the bathroom. They’re looking around. They might be holding themselves in the front and the back. Things that are signs that they’re, you that’s coming. But yeah, you’ve got a little bit of a runway. And so you’ve got time to have those conversations and start learning about how to do that. Yeah.

 

Nancy Treaster 

And for those who are interested in that. We cover that in episode 10, which is when incontinence begins, and a lot of the early signs to look for, because there are some early signs. It’s not just gonna happen all of a sudden one day, which is good. You’ll have a little bit of runway.

 

Nancy Treaster 

All right, so tip three, how are you gonna actually change a wet Depend? So first you’re going to want to have something underneath, first you’re gonna do this most likely while your care receiver is sitting down, and so you’re gonna want something underneath them. There are disposable incontinence pads, which you can buy that you can, that are, you can just sit someone down on. We suggest in,

 

Nancy Treaster 

one of our pre and preparing for incontinence and in the incontinence begins episode about how to protect your furniture. These pads are a great way to do that. Even if it’s not on something that you regularly are going to sit them that they’re going to sit down on, sometimes we’ll change a Depend on the side of the bed, put a pad down or towel down or something that’s washable or disposable because they could still they could be wet when you when you begin the changing process. As Sue said, once they’re sitting down, you’re going to well,

 

Nancy Treaster 

Lots of times we’ll take the adaptable clothing off while my husband’s still standing up and then get him sitting down with just his Depend on. If not, you can unsnap because these things snap all the way up the side or zip all the way up the side. You can take them off while they’re sitting down as well. And while they’re sitting down, you want to, you’re going to…

 

unfasten the Depend. Now that takes many different forms. If they’re wearing one that has a fastener on it, which a lot of people don’t do that early because their care receiver isn’t all that happy about having this on to begin with and they’re afraid they’re going to take them off, kind like some toddlers, you won’t put a, you’ll put a pull -up on because they start taking their, their diapers off. Same thing here. You know, lots of people start with pull -ups because they don’t want their care receiver to so easily be able to take their Depend off. But most people start with pull ups. So either way you want to unfasten. That sounds pretty easy, right? No, not so easy. So the Depends have a seam up the sides and up the sides. You can start and rip up the same. is supposedly and sometimes I can do it. Sometimes I can’t. 

 

Sue Ryan 

I like the way you, I like that little caveat you put in there.

 

Nancy Treaster

When you get an experienced caregiver in your home, they’ll do it like it’s nothing. What happens when you’re not experienced is you are pulling and struggling and ripping and it’s ripping up this way and that way and now you’ve turned an uncomfortable situation for them. They’re embarrassed. They’re ashamed. We’re trying to make it okay. Have a seat. We’re going to change your underwear. We’re trying to make it no big deal and now and now we’re making it a big deal because we’re ripping and tearing so

 

Sue Ryan 

And you’re frustrated. And you’re like, but you won’t rip.

 

Nancy Treaster

I use kitchen scissors. If that seems a little bit risky, get some medical scissors, but I keep them and I just snip up one side and snip up the other. And there’s not much drama involved in that.

 

Sue Ryan

So Nancy, I’ll interject a quick tip in there. One of the things that I learned in a support group is hire a caregiver, a professional caregiver while you’re learning to do this. in the beginning when you’re learning to do it, they already know. So even though we’re telling you and we’re doing this, you’re not practicing it on someone right now. So in the very beginning when you’re kind of flustered and you’re trying to figure this all out and…

 

Nancy Treaster

Good idea.

 

Sue Ryan 

You’ve watched our podcast and you’ve learned the things and you’re like, okay, I’ve got this. And then they won’t sit down or they won’t sit still. Bring someone in and have them work with you and have them be another set of hands. And then they can kind of explain and they can show you how these people to rip it up. And you’re like, yeah, all right. At any rate, it’s a great way for you to leverage a professional to teach you something.

 

Nancy Treaster 

I think I’m sure you’re gonna rip him up the side hopefully. Good idea.

 

Sue Ryan 

because it is different in the practice of it and the application of it because they don’t know that they’re supposed to sit still and wait and have you do all of those things. They’ve got other things they would prefer to be doing and it’s no different than a toddler other than the fact that a toddler is not as large as your loved one.

 

Nancy Treaster

That is true. And I also suggest that throughout this whole process, we’re telling them what we’re doing. Let’s go sit down right here so we can change your underwear. I’m going to take your pants off. I’m going to take your underwear off and we’re going to put some clean underwear on. Think of the look on your face while you’re doing it. Think of the body language that you’re using. Think of the language, the positive language. Thank you very much. That’s great. Let’s etc. So just keep in mind, we’re trying to make this as dignified of a process as possible.and with the least amount of drama as possible. And we want it to be no big deal. We’re trying to make this no big deal.

 

Sue Ryan 

And you’re also, as you’re giving those instructions, and you’ve brought this up before, very clear and only one at a time.

 

Nancy Treaster 

Yes, very clear and one at a time. Don’t rattle them all off. That’s a waste of time for sure. It’s a waste of your breath. All right, so they’ve sat down. We’ve successfully taken the adaptive clothing off. We successfully cut the sides of the Depend off. Now, before you try to take the Depend off, the easiest thing to do is take the new Depend and slip it over their feet and pull it up to right above their knees.

 

Sue Ryan 

Kind of move things backwards. Yeah.

 

Nancy Treaster 

because we want them to stand up once. So we’re gonna pull the new Depend up over their knees. You can put them over their knees and then ask them, say, okay, let’s stand up and help them or ask them to stand up. I usually help. And as they stand up, take the old Depends from behind.

 

Nancy Treaster

And it’s just wet. It’s not going to drip or anything. It’s completely absorbent. So don’t worry about it. You can hold it from the top and the front and the top and the back. It’s not that you’re not going to get urine on your hands. Honestly, it’s not a big deal. And you can just put it to the side. It can just sit on the disposable pad. This is not going to be a big mess. And then help them if they haven’t already pulled their Depend new Depend all the way up and you can sit them back down and then do the same thing with their new adaptive clothing and and pull those up and you’re you’re good to go You do not have to clean them every single time that you change their underwear You do need to give them a good cleaning in the morning when they’ve been sitting in it During the night and you will clean them really thoroughly when they have a bowel movement all around But you don’t have to do it every same every single time you change a wet Depend now. 

 

Sue Ryan

Well, there you go. Very good. Well, those are our three tips. So this is the third episode in our five part series on incontinence. And in this episode, we talk about the process of preparing and cleaning our loved one. have the three tips, leverage adaptive clothing, choose our cleaning products, and clean and change our care receiver when it is urinary incontinence.

 

In our next episode, episode 12, we’re going to be talking about changing a bed bound and changing. In our next episode, episode 12, we’re going to be talking about changing a bed bound care receiver. And we’re also going to be talking about how to change a care receiver who has had a bowel movement. So if you have tips you think others would benefit from, please share them on our Facebook page or Instagram page and you can find the links to them in our show notes. If you like the podcast, we ask a favor, would you please share it with others and give them the opportunity to learn as well? we’ve, okay, three, two, one. If you liked this podcast and found it valuable, please share it with others so they could be learning as well. You can subscribe and rate it as well. And the link is in the show notes, as well as the products we’re talking about. Remember, you’ll be able to handle this.

 

Nancy Treaster 

We’re all on this journey together.