"My parent won't wear adult diapers and it drives me nuts!"
This is a common topic for caregiver conversations. And I sympathize. However, the fact that the word "diaper" is used makes me wonder if the adult child's approach could be softened.
Therefore the first thing I suggest to the caregiver in question is that he or she practice the following exercise. I suggest that they say, out loud, "I will not use the word ‘diaper' in front of my parents unless I'm talking about a baby." Repeat as many times as needed, but get it down pat.
Change Your Vocabulary
Incontinence is a sensitive topic. Adults often rebel against the word "diaper," for good reason. The word "diaper" implies a piece of clothing used for a baby or toddler yet to be toilet trained. What adult would take kindly to this word when it's applied to them?
To take it one step farther, think about this. If you are a forty or fifty-something woman who has had children, you have probably, on occasion, suffered from "stress incontinence," meaning that you've leaked a little urine during a cough, sneeze or huge laugh fest. Perhaps you've even used a panty protector "just in case." How would you feel if your husband or friend referred to this little protection as a "diaper"?
Okay. First point made. Diapers are associated with babies. No adult, no matter how disabled, should be treated as though he or she were a baby.
This may seem like nitpicking, but please, call it a brief. A pad. Anything you want. Just make the word adult sounding and respectful, and you'll have mastered tip one on how to get your parent to wear incontinence protection. I ask you to do this not only for the elder, but yourself. Using respectful words will help keep your brain wired correctly, reminding you that you are caring for an adult who deserves to be treated as such, no matter what his or her disabilities.
See a Specialist
I'm aware that just changing the word you use isn't going to completely solve the problem. However, if you want to stir up a fight with a bull, just wave a red cape. The same could be true with an elder and the word "diaper," so I wanted to make that a strong point.
Most likely, you've taken your elder to the doctor to get assurance about this issue. After testing to determine the type of incontinence, there may be minor surgical procedures, lifestyle changes and even medications, that can help with incontinence. Even if you've taken this step, sometimes a second opinion from a urologist is a good idea, as well.
Now that you are using respectful terms, and you know there's no medical intervention that can help, what else can you do?
Getting the Elderly to Wear Incontinence Briefs
If your elder still has pretty good cognitive ability, but prefers to live in denial about this somewhat humiliating turn of events in his or her health, appeal to natural vanity. After all, it's basically our vanity that keeps us in denial about many aging issues. Our culture is guilty of ageism to the extent that many people go to extremes to appear as though they are winning a battle over nature when it comes to aging issues, even though we never really will win this one.
Certainly, incontinence is very difficult to accept. However, if you, or a third party, can convince your elder of the truth – that it's much more embarrassing to smell like urine because you ignore leakage, than it is to wear proper protection that can be changed frequently, you may get somewhere.
Talk to a Doctor or a Friend
Just like many other issues with our parents, the incontinence issue may be better approached by a non-family member such as an old friend or a doctor. Why? Because it's hard enough for people to accept that they can't control their urine when approached by a doctor or a friend who has the same issue, but has learned to treat it with a light heart. But not quite as humiliating as it is when they get the message from a son or daughter.
The elder changed our diapers when we were babies. Wrapping one's mind around the fact that Mother Nature has pulled this cruel reverse behind their back, so to speak, is devastating. Getting the "how to cope" directions from that wet-behind-the-ears twerp the elder raised is often just too much to handle, so natural defenses kick in. Hearing the news from a friendly doctor or another elder – say another male who has had prostate surgery ending in incontinence issues – can soften the blow just a bit. Some of the elder's defenses may be down, and he may be more willing to listen.
Diminished Sense of Smell
A diminished sense of smell, which is common as we age, can result in the elder not being aware of the urine smell. This can add to the denial factor in that they don't feel that the leaks that dry on their clothing are really a factor in their social acceptance. If possible, the same person who tackles the main issue of denial may want to use the idea that a person wants to "smell fresh," and frequent changes of clothing, combined with incontinence protection can help with that.
Depression is a Contributing Factor
When people don't go out socially, they can get so they don't pay attention to their appearance. Even a normally upbeat person may think on a quiet Saturday, "Gee, I'm not doing a thing outside the house today, so I'm not even going to take a shower."
Multiply that thought a few times over, add some depression due to health issues and fewer social opportunities, and you may come up with a depressed elder who isn't even aware of the passage of time from one shower to another, or one clothing change to another – or one toilet visit to another. Depressed people need to be evaluated by a doctor, which brings us back to the fact that a visit to one or more specialists may be in order if your elder won't wear incontinence protection. If the urologist doesn't see anything he or she can fix, and the family doctor or a good friend can't convince the elder to wear protection, perhaps a mental health checkup is in order.
When All Else Fails, Let Them Work it Out
Good luck with your mission. I'm aware that there are times when none of the above will work. Sometimes, people will do what they will do, and unless they are deemed legally incompetent, you may not be able to change a thing. Do what you can to get medical help, treat the person with respect and dignity, and then let go.
Time may take care of the very things you pushed so hard to correct. Sometimes, when we leave people alone to work out their problems, they stop resisting and tackle the issues head on. However, if the situation is extremely dire, call the local adult social services. A welfare check may be needed.
