BY COLIN ELLISON
I STRONGLY BELIEVE THAT DIAPERS SHOULD BE VIEWED NO DIFFERENTLY THAN OTHER FORMS OF MEDICAL EQUIPMENT TO MANAGE VARIOUS HEALTH PROBLEMS, MUCH LIKE EYE GLASSES, INHALERS FOR ASTHMA & WHEELCHAIRS
Nocturnal enuresis (the clinical term for bedwetting) affects millions of people all over the world in all age groups. Although some people can be cured of their enuresis by using alarms, medicines, surgery, or other treatments, there are a significant number of individuals who have not had any success in treating their bedwetting. In fact many adults wet the bed their entire life. The majority of individuals in this situation choose to wear some form of protective garments to bed. Unfortunately, for the most part, this group has been stigmatized for their decision to wear nighttime protection. There seems to be less stigma surrounding this issue than there used to be, and some evidence that this may be the case include an increase in the variety of brands and styles of incontinence garments currently available to deal with bedwetting and other forms of incontinence, as well as an increase in the number of companies selling adult diapers, particularly online. Still, a large number of people look down on individuals who choose or need to wear diapers to manage their bedwetting.
I have read a fair amount on this subject both online as well as in various childcare books, and almost all of the childcare experts and medical professionals (with a few exceptions – thank God there are some enlightened individuals) counsel against the use of nighttime diapers for older children, teenagers, and adults suffering from this problem. The garments most childcare experts and medical professionals recommend for older bedwetters are underwear style products such as pull-ups and “Goodnites.” In fact for marketing incontinence garments for older children, teens, and adults, the strategy used by these companies is to make people feel they’re wearing underwear like garments and downplay the fact that the garments are used for incontinence. This strategy is evident in both the packaging and commercials for the products. The packages and the commercials often say something along these lines—“looks and fits like regular underwear,” or, “underwear like design.” I’ve also noticed the following—the diapers that are manufactured and sold for adults, older children, and teenagers look and fit like baby diapers such as Pampers, Luvs, and Huggies and are called “disposable briefs.” This euphemism was coined years ago because no one wants to admit they’re wearing diapers! The same marketing tactic is used for reusable incontinence products. Frequently, we use language to hide from the reality of the situation. A couple other examples that spring to mind are the use of the term “running apparel” to replace the word “sneakers” and the word “landfill” to replace “dump.”
As a brief aside, I think this whole marketing strategy is extremely disingenuous and is a classic case of denial. There are several reasons why I think this is the case. First of all, the pull-on style undergarments marketed for older bedwetters (“Goodnites” being the most popular brand) look exactly like regular diapers, except they pull on like underwear as opposed to being taped or pinned on like diapers. In my opinion the tapes and pins should be viewed no differently than other methods of fastening clothes such as snaps, buttons, or zippers. Furthermore, it’s been pointed out by a number of individuals (including those suffering from incontinence) that, in general, traditional style cloth and disposable diapers tend to be more absorbent and provide better protection than pull-on style products for more severe forms of incontinence such as bedwetting.
Second, by emphasizing the appearance of the products instead of their function, we’re contributing to the negative perceptions surrounding the use of incontinence garments and thereby contributing to the stigma of incontinence itself. Instead, we as a society should be taking steps to decrease or eliminate this stigma.
Third, it’s hiding from the reality of the situation. It’s the equivalent of using a hammer on a screw when the most effective tool to use in this situation is a screwdriver. No matter what type of design is used for incontinence garments and how they look, it’s still not going to change the fact that they’re used for bedwetting or other forms of incontinence. So it shouldn’t matter whether the product is designed so you pull it on, tape it on, snap it on, fasten it with Velcro, or pin it on. It’s still used for the same purpose. No amount of tinkering with the design or the use if euphemisms to market the product is going to change this fact. I’ve noticed that this strategy is particularly prevalent with the design of bedwetting products for older children and teenagers as a trip to the local grocery store, pharmacy, Walmart, or Target will attest. Since the product is worn only at night, and therefore the child or teenager will be asleep while wearing it, it doesn’t make any sense that the youngster is concerned with how the product looks. I think we need to be more pragmatic about this whole situation and focus on how effective the garments are at keeping the person and bed dry, as well as how comfortable the products are, not on how the product looks or the image it has. Unfortunately, our society is very concerned with image and status, and for most people diapers have the image of being infantile.
While underwear style products do work for some individuals, as mentioned, diapers are the style of incontinence garments most suited for heavier forms of incontinence such as bedwetting. A large number of bedwetters wet profusely and/or multiple times during the night and, as a result, some bedwetters pee through the pull-on style products and soak their bedding and pajamas. In addition to the inconvenience of having to get up in the middle of the night to change sheets (sometimes more than once, which can effect a person’s sleep patterns), lying in wet clothing and bedding can have detrimental effects on the skin. In a situation such as this, it would be prudent to have the child, teenager, or adult sleep in diapers instead. There are pin-on cloth diapers, plastic pants (also called “rubber pants” by many people, even though this is a misnomer) and disposable diapers with tape tabs designed to fit older children, teenagers, and adults. But most bedwetters and people suffering from other forms of incontinence are eluctant to wear them because we’ve been conditioned for a long time to believe that only babies or very young children wear diapers. In my opinion, though, it could be argued that it’s more babyish not wearing diapers to bed. By not protecting themselves at night, the child, teen, or adult, is not taking responsibility for the problem, which is not handling the situation in a mature, responsible manner. A key part of being an adult is taking appropriate measures to manage health problems and, in some cases, we might not like the options available, but as grownups we learn to adjust.
Some pediatricians and other medical professionals maintain that putting an older bedwetting child or teenager in diapers can damage their self-esteem. There have been a number of theories put forward on the issue of diaper use with older bedwetters and how this might affect their self-esteem. One theory is that the child or teen might feel their parents are punishing them for wetting the bed. The thinking behind this is that he or she might feel that their parents are using the diapers as a way to humiliate them or shame them into stopping the bedwetting. Another theory is that due to the negative associations diapers have with the majority of people, the youngster might feel embarrassed or ashamed about wearing the diapers. As mentioned, many people view diapers as being “babyish,” and as a result, a large number of people in this age group will resist using diapers to deal with the issue. Finally, with some children or teenagers, the diapers might serve as a constant reminder that they are still not able to control their bladder at night, which could make them feel worse about the bedwetting.
Although I understand the reasoning behind these theories, I believe they miss the mark. As far as the first theory is concerned, it should be stressed to the older child or teenager that you are not putting them in diapers to punish or humiliate them, but to make them feel more comfortable at night, to help them maintain healthy skin. As mentioned earlier, not wearing adequate protection can have a negative effect on a person’s skin because lying all night in wet sheets and clothing just exposes more areas of skin to the negative effects of the urine), as well as to eliminate or reduce the amount of wet laundry that needs to be taken care of. Another reason to wear diapers to bed is to eliminate the smell that can result from nighttime accidents. In an article entitled “Pediatric Nocturnal Enuresis (Bedwetting)” published on the National Association for Continence website, in the section entitled “Practical Management Tips,” it mentions that odors can linger in a room even if wet bedding and clothing are taken care of in a prompt manner. Wearing diapers can help in this regard and this is another point parents can raise to the youngster who is having difficulty adjusting to wearing protection to bed.
Regarding the second theory, you should emphasize that there are people all over the world in all age groups who have to wear diapers either during the day, the day and night, or only at night for various reasons. Bedwetting (and other forms of incontinence) can be caused by many things, including diseases, a result of injuries sustained in automobile or other accidents, physiological and genetic problems, psychological trauma, as a side effect from different medicines, and many other factors. In some of these situations wearing diapers is the best course of action.
As far as the third theory is concerned, if the child or teenager feels that the diapers are a reminder that they still haven’t obtained nighttime control, I would approach the problem in the following way. I would tell them that even if they don’t wear diapers to bed, that’s still not going to change the fact that they wet the bed and therefore should not affect their feelings about the bedwetting. Second, I would suggest to them that wearing a diaper to bed would give them a sense of control over the situation, and even though they might still feel bad about the bedwetting, at least the diapers will make them feel more secure because they won’t wake up in wet sheets. This might make them feel a little better about the problem, whereas not wearing protection should make them feel worse. In my opinion, it’s more humiliating (not to mention uncomfortable and unsanitary) waking up in wet bedding and clothing, than wearing diapers.
Another thing that might make the older child or teenager feel more at ease about wearing protection is to point out that they only have to wear the diapers during the night, which means that no one but their immediate family will know they have them on. If financially feasible, the parents might want to consider taking the child or teenager to a mental health professional for counseling to deal with their feelings about the bedwetting. Many child psychologists have experience in this area and should be able to offer therapy designed to help them cope with the bedwetting and their use of protection to manage the problem. Over time, the therapist should be able to help them feel less ashamed about the issue by letting them know that this is a common problem, that many adults wet the bed as well, and that it’s not unusual for people to wear diapers to manage the problem. In fact, even though there is a tremendous amount of stigma associated with older bedwetters wearing diapers, it’s more common than people think. With some people (perhaps a large number), the convenience of using diapers to deal with the problem outweighs the embarrassment of wearing them. After all, if you need them, you need them. This is another good point a therapist can discuss in the course of therapy designed to help the older child or teenager (or adult dealing with bedwetting)—adjust to the use of diapers to deal with the issue, as well as other negative feelings the bedwetter might be experiencing.
The parents might also consider implementing some type of reward system to motivate the older child or teenager to wear diapers to bed. For instance, the parents could set up a system where the bedwetter will earn a certain number of points or gold stars every time they wear the diapers at night. They can then cash in these points at a certain time to buy some present they’re interested in, such as a video game, or some other thing they might like. The more nights they wear the diapers to bed, the more points they earn. The parents could also offer to increase their allowance a certain amount or have the youngster earn a certain amount of money. The same idea applies here as well—the more nights they wear the diapers, the more money they can earn. This is just one idea I have. Parents who have a bedwetting child or teenager who is embarrassed about wearing diapers might want to experiment with this idea to see if it works.
As mentioned earlier, although many people can be cured of their bedwetting using alarms, medicines, or other methods, there are cases of people who suffer from this problem their entire life. In fact what many people may not realize is that there are a significant number of adults who wet the bed. In these cases, it would be advisable to wear diapers to bed in order to maintain hygiene, to stay dry and comfortable, as well as minimize cleanup (it’s a hassle having to take care of wet laundry due to the fact that it’s so time consuming). In addition, it would be prudent for the adult to wear diapers to bed if he or she has a significant other so their partner stays dry. Wearing diapers at night demonstrates that the bedwetter is showing consideration to his or her partner.
As far as this issue is concerned, one of the main things that has puzzled me is this: why is it that the public and most medical professionals have no problem with babies, the elderly, special needs children, people with neurodegenerative disorders such as Alzheimer’s disease, Parkinson’s disease, cerebral palsy, multiple sclerosis, spina bifida, Huntington’s disease, or other medical conditions wearing diapers? Yet they feel that older children, teenagers, or adults that wet the bed are too old to wear them. We have a double standard regarding our opinions on who should use diapers. I strongly believe that diapers should be viewed no differently than other forms of medical equipment to manage various health problems, much like eye glasses, inhalers for asthma, wheelchairs, and other medical supplies. With that in mind, I contend that our attitudes on the use of diapers to manage bedwetting with older children, teenagers and adults are misguided. Also it seems that adult bedwetting carries more of a stigma than other forms of incontinence, which doesn’t make sense to me either.
One of the ideas that might help eliminate stigma in this area (which is taken from my Wiki How article How to Reduce the Stigma of Older Children, Teenagers, and Adults Wearing Diapers for Bedwetting) is to change the definition of a diaper. Most dictionary definitions define diaper as being a garment worn strictly by babies. If I were responsible for writing the definition of diaper found in dictionaries, I would say something along these lines: “An absorbent, waterproof, protective undergarment made of disposable or reusable material which is drawn up between the legs and fastened at the waist by tape tabs, safety pins, or other methods. It is designed for managing episodes of incontinence experienced by individuals of all ages including babies, young children before they are potty trained, as well as adults, in addition to providing protection for individuals that wet the bed.” In my opinion this describes the situation more accurately and also has the potential to make older children, teenagers, as well as adults, feel less self-conscious about wearing protection. Hopefully this article will get people to reevaluate their opinions regarding this matter.•
ABOUT THE AUTHOR:
Colin Ellison (the author’s pen name) is 47 years old and works in special ed as a student assistant. He suffered from nocturnal enuresis as a child and has experienced occasional bouts of bedwetting as an adult. He primarily uses adult-size, pin-on style cloth diapers covered with an adult size pair of plastic pants but, at times, also uses adult-size disposable tape-tab style diapers. Currently he is attending college, part time, studying homeland security. His interests are record-collecting and reading.
Tips on Managing Bedwetting
The author has a blog called “Tips on Managing Bedwetting” which lists several brands of pin-on style cloth diapers, plastic pants, and disposable diapers with tape tabs designed to fit older children, teenagers, and adults that wet the bed as well as places that sell these diapers. The address for the blog is: www.tipsonmanagingbedwetting.blogspot.com