Adult & patient care

Sizing incontinence products by absorbency, not by guessing

Absorbency bands, fit, skin health and how to work out true cost per resident day.

Departments: Medical Consumables & Patient Care

Incontinence products are usually bought on unit price and usually reordered because the last box ran out. Facilities that switch to assessing absorbency and fit per resident almost always find they use fewer products, change linen less often and treat less skin damage — at a lower total cost, even where the unit price went up.

Fit is decided by hip and waist, not by body weight

Sizing by weight alone is the single most common error. Two people of the same weight can need different sizes because the product has to seal at the leg and sit at the waist. Measure the hip at the widest point and the waist, and use the manufacturer's size chart for that product range — charts are not interchangeable between brands.

Signs the size is wrong:

• Leaks at the leg with the pad still dry in the middle — too large, or wrongly positioned.
• Red marks at the waist or thigh — too small.
• The product sags away from the body — too large, or absorbency exceeded.
• Leakage at the back when lying down — the product is not pulled far enough through.

Absorbency is a separate decision from size

Manufacturers publish absorbency bands, usually from light through to maximum or overnight. Match the band to the actual pattern of loss, not to the largest available:

• Light — stress or occasional loss, mobile person, frequent changes.
• Moderate — regular daytime loss with assistance available.
• Heavy — substantial loss, or limited mobility.
• Maximum or overnight — extended wear where changes are not practical.

Over-absorbent products used all day are wasteful and bulkier than they need to be. Under-absorbent products are changed twice as often and generate laundry. Most facilities need two or three bands in stock, not one.

Product format follows mobility

• Pull-up pants preserve dignity and independence for people who use the toilet with prompting or assistance. They support continence rather than replacing it.
• All-in-one briefs with tabs suit people who are changed lying down, because they can be applied and adjusted without standing.
• Shaped pads with net pants work where absorbency needs to change through the day and the carer wants flexibility.
• Bed pads protect the mattress but are not a substitute for a correctly fitted product. Disposable suits variable need; washable is cheaper where laundry capacity exists.

Skin is the outcome that matters

Prolonged moisture, friction and pH change break skin down. Specify products with a breathable backsheet, change on assessment rather than on a fixed clock, cleanse with a pH-appropriate product rather than soap, and apply a barrier product where skin is at risk. A zinc-based barrier cream and cleansing wipes belong in the same order as the pads.

Costing it properly

Work out cost per resident per 24 hours, including the pads used, the bed pads, the laundry generated and the carer time per change. Run a two-week trial on a small group before you standardise. A product that costs more per piece and halves the change frequency is usually the cheaper product, and it is always the better one for the resident.