Choosing the Best Continence Products for Bedbound Individuals

Caring for bedbound individuals presents specific challenges, especially when managing incontinence. Whether caused by illness, disability, or age-related decline, incontinence in immobile persons must be approached with compassion, strategy, and careful planning. Proper continence care protects skin health, promotes comfort, maintains dignity, and reduces caregiver burden.

Supporting Continence Where Possible 

First and foremost, immobility does not always mean incontinence. If a person retains bladder or bowel control, they should be supported to maintain continence through appropriate toileting options, such as:

• Hoisting onto a commode
• Use of bedpans or handheld urinals Encouraging continence helps preserve dignity and reduces the need for products that may increase the risk of skin breakdown or infection.
  

When Continence Products Are Required

If continence aids are necessary, choosing the right product is vital. The wrong product can lead to discomfort, odour, skin damage, and reduced quality of life. The following considerations can guide product selection for bedbound individuals.

Assess Individual Needs

Before selecting any products, a comprehensive continence assessment should be carried out. This includes:

• Identifying incontinence type (urinary, faecal, or mixed)
• Determining severity and frequency
• Using bladder and bowel diaries to track patterns

These insights allow for personalized care planning and may also reveal underlying factors (e.g. fluid intake, diet, or medications) contributing to incontinence.

Absorbency Requirements

Absorbency is critical for managing leakage, protecting skin, and maintaining comfort.

• Light to Moderate Incontinence: Reusable products, liners, or smaller pads may be sufficient.
• Heavy or Total Incontinence: All-in-one slips or briefs with higher absorbency are more suitable. These are often combined with absorbent bed pads or furniture protectors.

Look for products with:

• Superabsorbent polymers or materials
• Leak guards
• Moisture-locking cores

Skin Health and Product Breathability

Immobile people are at higher risk of incontinence-associated dermatitis (IAD) and pressure injuries. To minimize this risk, continence products should:

• Be breathable to allow airflow
• Have moisture-wicking layers to keep skin dry
• Be free from fragrances and hypoallergenic

Additionally, skin checks during each change and consistent hygiene routines help prevent irritation and breakdown.

Fit and Comfort

Poorly fitting products lead to leaks, chafing, and discomfort. To ensure a good fit:

• Measure hip and waist circumference and select products based on those measurements, not size assumptions.
• Choose anatomically shaped products with contoured designs and leak barriers.
• Opt for products with resealable tabs and elasticated waists for easier changes and better adjustment.

Ease of Use and Accessibility

For bedbound individuals, the product must be easy for care providers to apply, remove, and check:

• All-in-one slips: Ideal for bedbound users as they can be applied while rolling the person side-to-side. Resealable tabs allow for discreet checks and changes without full undressing.
• Bed pads: Provide a secondary layer of protection for bedding. Always consult an occupational therapist before using these with pressure-relieving mattresses, as some pads can reduce the mattress’s effectiveness.
• Disposable under pads: Useful during hygiene routines, but avoid leaving them under people as they are non-breathable and can increase moisture and heat, leading to skin damage.

Odur Control

Odour can affect a person’s comfort, dignity, and overall wellbeing. Many continence products are designed with built-in odour control systems that:

• Inhibit the formation of ammonia
• Neutralize unpleasant smells

Prompt changes and proper hygiene routines further support odour management. Some products feature wetness indicators, and tracking toileting patterns using diaries can help schedule changes at optimal times.

Other Key Considerations

Hygiene and Skin Care

• Use pH-neutral cleansers that moisturise and protect the skin.
• Avoid talcum powders or fragranced products.
• Apply barrier creams thinly to vulnerable areas when indicated.

Regular Skin Checks

• Inspect the skin during every product change.
• Report redness, irritation, or breakdowns to a healthcare professional. Repositioning and Pressure Relief
• Encourage or assist with regular repositioning to reduce the risk of pressure injuries.
• Pressure-relieving equipment (e.g. specially designed mattresses) may be necessary—consult an occupational therapist.

Diet and Hydration

• Encourage adequate fluid intake to support urinary and bowel health.
• Promote a balanced diet rich in fibre to maintain healthy bowel function.
• Limit bladder irritants like caffeine, alcohol, and certain foods.

Preserving Dignity

• Provide care calmly and respectfully, using sensitive language.
• Protect the individual’s privacy at all times, and involve them in decisions where possible.

Involving the Healthcare Team

• Work with a multidisciplinary team (MDT) for an individualised plan of care, including nurses, continence specialists, physios, occupational therapists, and dietitians.
• Encourage caregivers to raise concerns and seek professional guidance when needed, for example, if infection, constipation, or skin damage is suspected.

Final Thoughts

Choosing the right continence products for bedbound individuals is about more than just absorbency. It involves understanding the person’s unique needs, ensuring skin protection, maintaining dignity, and supporting carers. With an individualised, compassionate approach and the right products, caregivers can significantly improve the comfort, health, and quality of life for those in their care.