Tuesday, March 1, 2022

The Taboo Behind the Taboo of Incontinence


It's an issue the majority of people don't want to discuss and when they do talk about it they do so in hushed tones. Cheryle B. Gartley, president of the Simon Foundation for Continence says “Bedwetting is a closet issue within the closet issue of urinary incontinence. There is such stigma attached to adult bedwetting that most people don't even ask for help.”   The clinical term for it is nocturnal enuresis and though most people associate it with children and adolescents, there are a significant number of people who deal with this issue their entire life. Adult bedwetting may be more prevalent than people realize but due to the stigma surrounding this condition the exact figures may never be known. Many people perceive wetting the bed as being infantile behavior, says Dr. Elaine Ducharme, a Glastonbury, Conn., clinical psychologist who’s worked with several patients with enuresis. “I try to help my patients understand that this is a medical issue and that they’re not alone,” says Ducharme, who has a background in nursing. “But it’s a tough issue for many adults because of the sense that ‘grown-ups don’t do this.’”            

The National Association for Continence (NAFC) has this to say regarding adult bedwetting: “Adult bedwetting. It's a rarely talked about condition, but is one that affects many people. In fact, NAFC receives more visits to the adult bedwetting pages than any other pages on our site. People struggle with this condition for all sorts of reasons – spinal cord injuries, neurological diseases, and even stress can cause bedwetting. And sometimes there can be seemingly no cause at all, which makes it all the more frustrating to address. Most people who wet the bed are desperate for a solution. They find it deeply embarrassing, and it greatly affects their quality of life, as they are constantly dealing with keeping things clean and worried about how it will affect current or future relationships.”      

This article discusses my experiences with adult bedwetting. I have several reasons for writing this article. One reason is to provide suggestions on how to tell your significant other you wear nighttime protection because you wet the bed. The fact that you have to wear protection to bed is a very difficult topic to broach with your loved ones, but there are ways to discuss it in a way that can put both you and your loved ones at ease – using humor is one way to do this. Another is to discuss what I feel are the most effective forms of protection to manage nighttime urinary incontinence (if you're sharing the bed with someone else you want to make sure they're protected too). The final reason is to offer suggestions on how we  can alleviate the stigma surrounding wearing incontinence garments to manage bedwetting – there is a great deal of stigma associated with wearing diapers to manage incontinence, especially with those individuals who suffer from bedwetting – many people call diapers “babyish” - and there is a brief section in my article that discusses one possible way we can alleviate this stigma. 

I wet the bed throughout my childhood and still have nighttime accidents as an adult. I'll turn 52 this June and although part of me feels embarrassed and ashamed about having this problem, another part of me manages to have a sense of perspective and a sense of humor about it. Most adults in this situation wear protection at night to maintain comfort, hygiene, and make clean up easier. Some of these individuals feel ashamed about having to wear adult diapers to bed. This can be particularly embarrassing for those who wear disposable tape tab style diapers as they have to deal with the tell tale crinkling sound the diaper makes under their PJs as they move around, caused by the plastic outer cover of the diaper.                  

Perhaps one of the biggest challenges facing adults that have a bedwetting problem is telling their boyfriend or girlfriend they wear protection to bed – after all it can be quite daunting telling your significant other you have to put on jumbo size pin-on cloth diapers and plastic baby pants or jumbo size Pampers before going to bed. This is a terrifying prospect for most individuals but it helps to be able to laugh about it and there are a number of ways individuals can use humor to cope with the situation. This advice may also be helpful for parents  of an older child or teenager who may be having difficulty adjusting to wearing diapers to manage their bedwetting.         

I sleep in adult size prefold nighttime cloth diapers fastened with diaper pins and covered with an adult size pair of pull-on plastic pants (also known as “vinyl pants” - vinyl being a type of plastic) to protect my bed at night. As a brief aside (and to clear up some confusion) these pants are also called “rubber pants” by some people even though this is a misnomer - “rubber pants” were the style of baby pants worn over pin-on style cloth diapers before the advent of vinyl and plastic in the late 40s and were made out of actual rubber. At some point people started using the term “rubber pants” as a generic term for the waterproof pants used by mothers over their babies diapers. As a result, a lot of people used the term “rubber pants” even when referring to plastic pants. This seemed to catch on with incontinent adults as well, as some of them also use the term “rubber pants” when talking about plastic pants. 

For those who may not be familiar with this style of diapering, pin-on cloth diapers with plastic baby pants worn over top were the style of diapers and waterproof pants traditionally used by parents on their babies for many years. They make adult size versions of the pin-on style cloth diapers and plastic baby pants and although some consider pin-on style diapers and plastic pants old fashioned, these diapers and waterproof pants are an excellent choice for managing heavier forms of incontinence such as bedwetting. For additional absorbency you can add diaper liners (also called “diaper doublers”) to the diaper. Currently I use the Leakmaster brand diaper liner made by Adultclothdiaper.com.

I've also used adult size disposable diapers with tape tabs (or “disposable briefs”) to manage my bedwetting. “Disposable briefs” are form fitting disposable undergarments that look and fit just like baby diapers such as Pampers, Luvs, and Huggies – they have an “hourglass” shape, tape tabs for fastening the garments, elastic leg gathers to prevent leaks, a waterproof outer cover made of cloth or plastic, and many also have elastic waistbands also designed to prevent leaks. As with cloth diapers you can also add liners to the disposable diapers to increase absorbency.   

In addition to wearing diapers to bed, it's also a good idea to have the bed covered with some type of waterproof sheet – even though it may not happen that often, diapers occasionally leak, and it's good to have something put into place for those just-in-case moments. There are a wide variety of waterproof covers in both reusable and disposable form. There are disposable underpads, flannel/rubber sheets which has a flannel top bonded to rubber on the botttom, and vinyl sheets (more commonly called plastic sheets). The vinyl sheets come in both zippered, which fits around the whole mattress, and fitted forms. I have a fitted 7 mil vinyl mattress cover which I purchased from Adultclothdiaper.com (also known as All Together Enterprises). Although this cover is more expensive than most, it's made of the thickest vinyl on the market which makes it more durable than other vinyl covers. I place the vinyl sheet directly under the fitted top sheet. In order to keep the fitted  sheet from sliding off the plastic I use 4 sheet straps in each corner of the mattress to hold the fitted sheet down. The brand is Sheet Suspenders, which come in a pack of 4.

 One of the purposes in writing it is to offer some tips on how to approach your loved one about having to wear overnight protection to manage your bedwetting. This can be a nerve-racking prospect for most people, but there are ways to make it easier to have a conversation about it. The following are some things you can say to your partner or friend to break the news of your bedwetting and use of protection in a lighthearted way: 

  • “I have a problem with bedwetting and I need to wear a diaper to bed. If I don't wear protection at night the bed will be flooded so bad the local government will have to declare a state of emergency for my bedroom and they'll have to call in FEMA.” 
  • “I wet the bed every night and have to wear diapers and plastic pants at night. If I don't wear  them to bed we'll have to put some sandbags around the bed.” 
  • “I predict there's going to be flash floods tonight so I better put on my diapers before going to bed.”   
  • “I haven't told you this yet but I wet the bed. I need to wear diapers at night so we don't wake up with a rainbow in the room 
  •  “I wanted to let you know that I wet the bed every night. To manage it I wear adult diapers to bed – it's either that or wear a raincoat to bed.”                 
  • “I have to tell you something – I wet the bed. I found the best way to manage it is by sleeping in adult diapers. At first I thought about wearing a life preserver or life jacket to bed but decided to wear a diaper instead.”    
  • “I'd like to talk to you about a medical condition I've had since I was a child. It's very embarrassing to talk about but I've managed to keep my sense of humor about it. I have to wear diapers and plastic pants to bed because I have a bedwetting problem. Otherwise we'll need to buy a wet vac to clean up the bedroom in the morning.” 
  • “I have a problem with wetting the bed and wear diapers to manage the problem – this way we don't have to buy some canoes  to row our way out of the bedroom in the morning.” 
  • “I need to talk to you about a health problem I have. I wet the bed every night and wear adult size diapers to manage it. This is the best way to deal with the issue. The only alternative is to buy flood insurance.”    
  • “Do you remember the song “Raindrops Keep Falling on My Head”? My theme song is “Raindrops Keep Falling from My Bed.”      
  • “I have to talk to you about a medical problem I've dealt with for a long time. It's called nocturnal enuresis which is the clinical term for bedwetting. I wear diapers to keep me and the bed from getting waterlogged.”   
  • Here is another humorous way to break the news that you have to wear diapers and plastic pants at night because you wet the bed – you can say something along these lines: “Our local theater group is doing a play on Paul Bunyan and here are some props from the play. These are Paul Bunyan's baby   clothes: here's his diapers and here's his baby pants.”      

These are just some of the things you can say to ease the situation and help you cope with the problem. They can also be used to tell a young child that mommy or daddy wears diapers because they still pee the bed. It's extremely difficult if not impossible to keep bedwetting a secret from other members of the family – especially with younger children. After all, young children being the curious individuals they are, are natural explorers and it's only a matter of time before they notice plastic pants drying on the clothes line or adult size Pampers in the bedroom. Or after the parent diapers himself or herself before going to bed the child or children may barge in the bedroom and see mommy or daddy diapered. It's good to be prepared for this type of contingency. Young children as many people will attest, are not noted for their subtlety and often don't hesitate to say immediately what comes to mind -  so when your 5 or 7 year old daughter asks “Daddy why are you wearing plastic underwear – do you pee in bed?” or “Why is daddy wearing jumbo size Pampers – does he wet the bed?” it's good to be able to respond in a funny manner. Keeping the bedwetting and diaper use discreet is even more tricky on vacations. This is why it's good to have a sense of humor about this and hopefully the suggestions offered will help – you may think of additional things to say to your loved ones. Here are a few ways to respond to a young child after they discover you wear protection to bed - “You know how they use dams to prevent cities and farmland from being flooded – well the diapers and plastic pants I wear to bed are like a dam that prevents the bed from being flooded when daddy pees at night”, “If daddy doesn't wear diapers and plastic pants at night it'll be like Niagara Falls in our bedroom”, finally you can say this - “Daddy is a superhero and the diapers and plastic pants give me superpowers – in my case the powers to keep both myself and the bed dry.”       

Hopefully over time we can eliminate the stigma associated with using diapers to manage bedwetting with people of all ages and get over our hang-ups in this area. One way to do this is change our ideas and conceptions about diapers. I believe one important step to take in changing our attitudes in this matter is to redefine the word diaper. Most definitions of diaper define it as being a garment worn by babies. If I were responsible for writing the definition of diaper found in dictionaries I'd write something like this:  "An absorbent, waterproof, protective undergarment made of either reusable or disposable material which is drawn up between the legs and fastened at the waist by tape tabs, diaper pins, or other methods. It is designed to be used for several purposes: for managing episodes of incontinence experienced by babies and young children before they are potty trained; for providing protection for children, teenagers, and adults that suffer from incontinence due to various medical conditions; as well as providing protection for children, teenagers, and adults that wet the bed."             

It helps to have a sense of humor about it which includes being able to take some good natured ribbing about it as well as the ability to laugh at yourself.  Even though you might feel depressed about your bedwetting and using protection to deal with it keep in mind you're not the only one – there are plenty of us in the same leaky boat!