Containment Devices—A Paradigm Shift?

Cathy Milne, APRN, MSN, CWOCN
Lisa Corbett, APRN, MSN, CWOCN
Tracy Houle, APRN, MSN, CWOCN

Once upon a time, public forums about containment devices, such as diapers, were limited to discussions regarding babies. Society pushed the envelope a bit and we started seeing television and magazine ads referring to “potty training.” Discussions about adult incontinence of either fecal or urinary effluent, however, were still considered taboo. In the past year, in smirking adolescent-like fashion, the popular press reported several stories that acknowledged a secret world, one in which people use containment devices to collect incontinence episodes.

The first story reported on a female astronaut allegedly using a diaper to avoid rest stops while driving from Texas to Florida to confront a romantic rival. While the astronaut’s lawyer denies this, investigative reporting revealed that NASA employees commonly use diapers to contain incontinence episodes that often occur during takeoff. A long wait for a shuttle launch, coupled with gravitational effects on the bladder, makes containment devices mandatory. Our taxpayer dollars are conserved by a low-cost product that protects million-dollar space suits! Finally, a positive spin was presented on containment devices.

Later in 2007, the press reported that a prominent senator allegedly enjoyed wearing diapers while visiting prostitutes. Even though the use of an incontinence containment device was denied by the senator, the public and press alike would not let this story fade quickly. Unfortunately, any positive press for containment devices gained was soon lost.

Incontinence is a symptom of a pathophysiological problem. Clinicians, just as they do with other disease states, manage its symptoms until a cure is found. We see our patients attempt to cope with the devastating social, economic, and psychological effects of incontinence by using containment devices. Although their use is not an ideal situation, containment of urinary or fecal effluent is obligatory until symptoms are controlled or cured.

Although, as professionals, we can make a compelling argument that diapers, or pads, or fecal pouches should be used judiciously, our patients often feel otherwise. They look to us for advice on products that “hold more,” “reduce odor,” or “don’t show under clothes.” Our patients look to us to remove the embarrassment of using a containment device.