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Mom is now (unhappily) ensconced in her new community - she was transferred from rehab Mon evening. I am trying to figure out if "pull ups" are the same as incontinence underwear? Are Depends pull ups? Or are those Always brand "lady underwear" the same as adult pull ups?


I knew from the mountains of stinky laundry and evidence on some chairs at my mother's home that she was having incontinence issues. The hospital and rehab put her in "pull ups." She also developed C.diff somewhere along the line, which was supposed to have resolved before she was discharged from rehab but she is having diarrhea again. So I need to purchase the correct item but the facility uses some generic products they buy in bulk and all the nurse told me was to get some adult pull ups. (I don't want to pay $79/mo for the community to provide them until I see if that is cost-effective.)


Mom is not totally incontinent - she much prefers the toilet if she gets help to get her to it in time, so she doesn't need a super absorbent item.


Can anyone recommend a brand that is comfortable, affordable and good for medium urine incontinence but will also catch any C. diff issues? Mom is 5'3 and 120 pounds now, so pretty small. Thanks!

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Hi Chicagoannie21,
Pull-ups and incontinence underwear are the same (Depends and Always are pullups). "Briefs" are what most of us consider diapers, the kind with tabs on the sides.

I'm not sure what to tell you about which ones to buy since your Mom can make it to the bathroom sometimes. I buy Depends for my Mom as she's incontinent of urine all the time, but when she had diarrhea they didn't absorb that very well .

I have ordered products from Carewell and I think I saw some products that mentioned they worked well for stool incontinence, but I'm not positive because I've been looking at so many sites and products to find the best value. The choices are daunting, for sure, and you might have to use trial and error to find the right fit.

I didn't know until lately that there was such a thing as booster pads to go inside pullups either. you might not need that now but you might in the future. I had been making slits in Poise or Tena pads for extra absorbancy and accidentally came across the booster pads.

Good luck with finding the right product!
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BurntCaregiver Nov 2020
If you use the Depends brand "briefs" which are diapers, I would put a Poise pad in it as well for the clients I had who were also stool incontinent. It really helps. I had a bedridden client who was totally invalid. What I found worked the best for her and prevented skin breakdown, was along with the Depends brief, I used to use a trimmed down infant diaper as a liner. Baby diapers are made from different material then adult ones. They are super absorbent and stay dry no matter what.
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I most certainly recommend Depend name-brand disposable pull-ups. In my experience with clients that have mild incontinence these are the best ones.
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I don't know your local brands but for light problems a Poise pad may be enough (in regular underwear).

Move to pull-ups if the underwear is getting wet. Start with the lightest/cheapest. They may have a waist measurement on the pack as a size guide.

Pullups with a booster pad insert can be used too. Changing the booster insert as needed. I think boosters are cheaper.
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Mom was having some bladder "leakage" and ocassional accidents mostly at night when she would get scared to walk down the hall. I found urine in the waste basket in her room. But still used regular briefs, never wet the bed

When she moved to memory care, after a few accidents, They asked me to bring pull ups. She still goes to the bathroom, but has some mobility issues, walks slowly and I think with new place didn't leave enough time to get there.

I bought her the always discrete boutique, since they at least look pretty, like underwear, and don't sound crinkly. They've said they work well. Walgreens seem to run them on sale often.
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Like others, brands such as depends work well. But the continuing diarrhea is worrisome as C-Diff can recur. I would suggest that she be tested again to see is she requires additional treatment for this. It is a nasty bug and sometimes difficult to get rid of. The cost of incontinence briefs will mount over time. Depends is the most accessible brand and it can be purchased in bulk cases at stores such as Costco and Sam Clubs. What ever the brand, care for the skin is important, washing, drying at changes.
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Chicagoannie21 Nov 2020
The community is retesting mom for C.diff - no results yet. I appreciate all the information everyone provided! There are so many products and options out there and I didn't want to buy the wrong thing and make her potty issues worse. She is very embarrassed about the diarrhea.
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We have found the Assurance brand at Walmart and Sam’s club to be as good as the Depends and much cheaper!
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We have also found Assurance to be a good brand (Walmart). Sometimes my mother wets the bed through the Assurance pull-ups so at nights we have had to add a liner to them which we purchased from a medical supply store. We also place a ‘pee pad’ between the fitted sheet and mattress pad. Saves loads of laundry that way. Good luck and God bless.
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First of all $79 a month is too much for pull ups, especially if your mom manages to make it to the bathroom in time.
But if she is needed help to make it to the bathroom then believe me, she won't be making it there in time because they can take up to 15 minutes or even longer to come and help you.
They usually keep residents in pull ups so they don't have to worry about getting them to the toilet in time.
There forever, the loved one will usually poop and or pee in their pull ups before they get to the toilet.
Juse hope they don't leave your loved one in wet or soiled diapers for very long or she will end up with a rash or worse.
Sad but True.
You should deffiently have a Camera installed in her room so you can keep an eye on what really goes on.

What you are told and shown can be totally different than what actually goes on.
Prayers.
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Pull-ups are disposables, but shaped like ordinary (if capacious) briefs. They can be torn down the sides for removal without having to take them down and over the feet.

There are also washable inco' briefs, which are padded and reinforced underwear. Their advantages are that: they are more economical to buy; they are ecologically more acceptable; they are made of ordinary fabric materials but with highly absorbent layers, so they feel more like standard panties to wear. Their disadvantages are that they won't cope as well with very high volumes/fecal issues as disposables do; and of course they can't be removed so easily; and of course although they can be laundered at high temperatures they're not actually going to be sterile.

Until your poor mother can be helped to get rid of her C diff, I should go for the disposable pull-ups - all of the big brands such as Tena and Depends make them, in various shapes and sizes. These won't stop her using the toilet as normal, when she's able to, because you can just pull them down like ordinary knickers, and if they're clean and dry there's no reason not to pull them straight up again once you're done.

Points to look for (if you're being picky) include properly made seams, a soft feel to the fabric, not too much excess "frill" fabric at leg holes and waistband, and an even stretch to the elasticated part. As in everything, do beware the false economy.

[Personal note: I am also very grateful to those manufacturers who make it clear which is the front and which is the back. Not all do! - and you feel a right numpty if you get it wrong and your poor client looks like she's wearing a codpiece... :/]
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Please look at the aisle in your grocery store (Walmart, Target, all the pharmacies...). There are many types of adult incontinence products. She will need ones that are disposable, pull-up style, that can handle fecal material as well as urine. Depends is probably the first company to make these items, but now there are more companies out there as well as "generic" store brands as well. Consider taking your mother's waist and hip measurements as well as weight to help with determining her size. She may have to have her disposable underwear changed up to 8-10 times a day if she is still have diarrhea or has more urinary incontinence.
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Have you spoken to her insurance company. My mothers are paid for. The doctor had to order them as a prescription. Most are glad to do that.
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Ruthmarie2 Nov 2020
Does Medicare cover? My insurance only covers if Medicare covers. Thank you so much
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Countrymouse covers it well, the only thing I have to add from personal experience with my mom is you may need to try several brands until you find the one your mom likes best, personal preference applies for disposable underwear just like it does for cotton. Then once you find the type that works for her you can look for them in bulk, my mom likes Depends brand now so I purchase them by the case at Costco when they are on sale and now that she needs the nighttime type which they don’t sell I have found that having them on auto delivery from Amazon is working really well.
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we use assurance (walmart brand), economical and efficient
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My mother's incontinence is severe (soaks the bed at night). I found a brand (Tranquility) disposable underwear on Amazon that holds more ounces of liquid than most other brands. They provide the needed security she needs at night and she wakes up less frustrated about wetting the bed. If her incontinence is not as severe, they make different levels of absorbency.Not sure about the C. diff issues. We have not had to deal with that.
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DebN8or Nov 2020
See my answer above. Good luck!
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I tried a number of different product before finding the 'better' one for my husband who has both kinds of incontinence. What works best for one person - does not necessarily work for another. I've not found the perfect pull up but manage quite well with the ones we are now using. Sometimes it's best to have two product lines - one for daytime and one for nighttime.

I would also like to suggest getting the 36 x 30 (some are a little bigger and some are a little smaller) disposable pads. If something soaks through, it is much easier to change a pad than the sheets on the bed (in the middle of the night) - as the rubber/plastic type mattress cover is below the sheet. There are different products available on Amazon for a reasonable rate. I like the one with the adhesive tape on the back. They lightly attach to the bottom sheet and don't move around as much as the ones without the adhesive.
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I call them "Briefs" (not pull-ups as those are for children.) I have found they run small in sizing and waist/hip ratio matters. I buy M/L size for my mom of shorter height and less weight than your mom. They do not leak. Generic brands are fine. What are your cdiff concerns? Do you mean no leakage briefs? My mom is night time incontinent and rarely daytime. I try to alternate with regular cotton underwear daytime only as briefs can cause UTIs due to moisture trapped.
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Chicagoannie21 Nov 2020
See...that was my issue...the message left for me was "she is wearing pullups" and I was like what is that for an adult? I had 5 kids - I remember pullups. Staff should call them "adult briefs" or "incontinence briefs" so families know what to buy, especially if we cannot see our LO in person due to possible contagion! I did order her more cotton panties for when the diarrhea clears up. The she can just wear the briefs at night. Thank you :)
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Cdiff must be treated with medication or it will linger in their system, sure to return. Vancomycin is most common pharmacutical treatment. Did rehab center give her the proper meds for it? If so, what med was used? She needs a Dr prescription once again if cdiff has returned.
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Snowcat60 Nov 2020
I disagree with the use of vancomycin. The side effects are horrendous and cure nothing. A good spore probiotic is where I would begin. With antibiotics they just further destroy the gut micro biome. Also vancomycin is well known to cause permanent deafness.
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Good info below about c diff.
For adult incontinence the pull on underwear comes in all sizes and absorbencies. My aunt is satisfied with the Amazon brand Solimo disposable underwear but she only occasionally has accidents. Mainly these give her a bit more time to get to the toilet.
Mom has big urinary incontinence issues and occasional diarrhea. She uses Tena overnight and the Tena super absorbency disposable underwear.
Your mom may use small in either brand. Both are the pull on kind.
You can try out smaller packages from the grocery store to start with.

I highly recommend a daily probiotic for her gut help. Her facility physician would probably agree. Get her to eat some yogurt everyday.
Good luck!
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Have you given any thought to an external catheter? I got one for my mom - we only use it at night, with a disposable bed pad underneath, and Poise pads during the day. It has made a HUGE quality of life difference - hers and mine!
I believe Medicare now covers the cost (we bought ours before Medicare approved), and cost of disposable wands are supposed to be covered soon.
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HI,
Ok.. on the underwear issue. Pullups....they are called pullups because they are put on just like your normal underwear.... and pulled up. In home healthcare, we use the pullups when the patient/client is still walking. When you use these with bedbound patients... we have found very more difficult to use. When the patient/client is no longer walking, we normally switch to "diapers".

Then there are the other kind.... we call those diapers ONLY to differentiate them from pullups. FYI... I DO NOT call them diapers in front of my patients because most likely would offend them. These are put on like diapers for infants because the front is brought up between the legs. The back part has those sticky tabs that then come around to the front ----that then stick to the front part.

Here is something else that I have found that works... and helps ease the work of the caregiver and cheaper.

For the male----buy those pads that women use during the menstrual cycle. Wrap one around the penis. You can figure out which way works the best. Some of these pads are very absorbent and hold a ton of urine. Also the runny feces. When my patient/client has "the runs", I put these pads over his anus to catch the "runs". You might need 2 to cover that area. ..and then have the diapers/pullups over that. These pads much of the time are the ONLY thing that gets dirty and therefore the only thing you have to change and .......saves money, too!

For women ----place the pad from the back to front, between her legs. Also, you can do the same for her if she has diarrhea.

You may end up using 2-3 pads inside the pullup/diaper to catch whatever and then all you may have to do is change those pads. Much easier than having to change the pullups or diapers with all that rolling of the client that has to be done to accomplish that feat.

God bless you. Hugs... from a caregiver of 30 years.
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Chicagoannie21 Nov 2020
Omgosh...such great information - thank you! The pad idea for "the runs" makes sense. I know mom doesn't want to be messing up her bed and having staff do more difficult cleanups. I can see the usefulness of those pads for the men, too. God bless you too, and thank you for your sensitivity in not saying "diapers" around your adult patients. The smallest kindnesses make a difference!
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Imho, my late mother used washable underwear with pad inside. You probably would need more protection for your mother in the form of pull-ups and not feminine pads. My mother, too, was missing/not making it to the toilet. Prayers sent. Countrymouse gives a spot on response! Thank you, CM.
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I have found that Sam's club products are not only the least expensive but also comfortable and effective. A box of 80 large pull ups only cost @$29. We use adjustable briefs (diapers) at night and also use pads to stretch the wear of the pull ups. She still goes through about 6 pull ups a day. Totally 100% incontinent. We order them online from Sam's. Free home delivery. Far cheaper than anything on Amazon or anywhere else.
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I try to get my 90-yr-old mother to have a bathroom visit about every two hours or so throughout the day. She wears pull-ups (Tranquility brand for daytime and Tena Overnight at bedtime). I also have a quilted cloth pad beneath her bottom sheet and a paper pad on top of the bottom sheet for additional protection. She is always wet after sleeping through the night but so far the urine has never reached the sheets/mattress. She is 5'3" and 107 lbs. but likes the LG size in both brands. These brands are not the least expensive, but they seem to work for Mom.

By the way, I always refer to these items as her "undergarments". They are, indeed, disposable undergarments. And I always make sure she applies a barrier cream after cleansing herself with an aloe wipe.
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My 94 year old mom has been using pull-ups for about 6 months. She didn't want to but I finally talked her into it. She worries about the cost - and they are expensive. My saving grace was that Humana Insurance gives the client $75/3 months for anything from their order book online or they ship one to you, and I ordered the pull-ups from there. She loves this brand, which I can't remember the name, but it is the only one they carry. I hope you can use this - it is saving me tons of money. My mom put a huge pad in the pull-up to have it last through the day. Your mom might try that but check the smell during the day. She wore these up to 1 week ago when she could no longer get up out of bed and we had to switch to diapers which are easier once you get used to them. And don't EVER call them diapers.
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As far as the way I term the products there are 3 basic types.
1) Pads. These line underwear and can be used for leaks. NOT good for someone that is incontinent. Good for only urine and just leaks.
2) "Pull-Up" There are any incontinent product that replaces underwear and is great for someone incontinent or may not make it each time they have to use the bathroom. Good for Urine and Fecal incontinence. Good as long as a person is mobile
3) Tab type brief (commonly called Diapers but I do not think that term is appropriate for adult incontinence products {my opinion}) there are good if the person is bedbound or is not real mobile. They are not quite as "comfortable" as the underwear type BUT much easier for a caregiver to get on and off if the person is in bed.
There are also pads that can line anyone of the products. They do not have a fluid resistant backing so they boost the absorption of any of the products. Do not use regular "pant liners" with a fluid resistant backing as they will not allow the main product to absorb fluid and you will end up with leaks.

Finding a product that will fit correctly is the biggest problem.
If mom is in a facility I sure would not spend money on expensive or "high end" products because they WILL be used on other residents and mom will be put in someone else's product when she runs out.
Typically a facility should be checking and possibly changing a brief every 2 hours so figure how many may get used in a facility VS at home. For that reason as well I would not buy the ultra expensive ones.
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The softest I’ve found is the brand at Sam’s!!!!
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