Reasons for the Stigma Surrounding Diaper Use in Older Bed wetters and How to Reduce the Stigma
Unfortunately there is tremendous stigma associated with diapers. Most people view diapers as babyish. This is the main reason most older children,adolescents,teenagers,and adults are reluctant to wear them to bed. In fact most of them wouldn't be caught dead in a diaper. Older children,adolescents,and teenagers are at a point in their lives where they want to become more independent and in their minds diapers represent a stage in their lives when they were more dependent on their parents.In their view wearing diapers to bed is regressing.Although I sympathize with this view,to a large extent I think it misses the mark.
One of the hallmarks of independence is the ability to take care of one's self-this includes managing health problems. I feel that by wearing diapers to bed the youngster is taking responsibility for the situation which is a very mature thing to do and is what adults do. In fact it could be argued that the youngster is acting more like a baby by not wearing diapers to bed. By not wearing the appropriate protection to bed they are absolving themselves of responsibility and they are in effect saying they are helpless to control the situation.
We all know what the function of wearing a diaper is,so it shouldn't make a difference whether you're 2 or 102 the purpose is still the same. Unfortunately when you mention the word diaper to most people the image that immediately comes to mind is that of a baby. Most people think that a diaper and plastic pants are something to be outgrown like a high chair or a bib(of course they make bibs for adults also so even this image is wrong).
Due to the stigma surrounding diaper use in older children,teenagers,adolescents, and adults the diaper manufacturers seem to be placing a stronger emphasis in many cases on the appearance of the garments rather than functionality or as artists might say they're emphasizing form over functionality. Tying in with this concept is the emphasis on discretion. Some of the ways the manufacturers seem to be doing this are by the introduction of underwear like products,garments that are less bulky so they can't be noticed under clothes, and the design of diapers with a cloth like(also known as a nonwoven) outer layer.
Since a significant number of people suffer from daytime incontinence I can certainly understand this but there are a large number of people who suffer from bed-wetting as well, and in these particular cases we should use whatever type of garments are necessary and not be concerned with how a product looks or its image since it's only worn at night anyway. Granted there are companies that manufacture diapers for both daytime and nighttime use but I think that the stigma surrounding diapers has colored the diaper manufacturers in a negative way and this might prevent them from manufacturing,marketing, and selling products that truly meet the customers needs.
As far as the introduction of the underwear like products are concerned I think these serve more of a psychological than a protective function for the bed wetter because for all intents and purposes they're diapers. Because they pull on like underwear as opposed to taping on this seems to help a person more psychologically. While this may be the case in many situations they don't work as well as diapers.
The same with the introduction of diapers with a cloth like outer covering. Again this is an example of a product that is more underwear like as opposed to diapers with a plastic outer covering. Of course there is the possibility that these types of diapers could have been introduced because they're more cost effective for the manufacturers to produce,they're more breathable and therefore presumably more comfortable to wear,and they're theoretically healthier for the individual's skin,or it could be for all these reasons. However considering that there are companies that make both styles of diapers I suspect that the introduction of this style is due more to aesthetic reasons and that the diaper manufacturers feel these will be less embarrassing to wear. Furthermore some people have commented that the diapers with a cloth like outer layer are actually more uncomfortable to wear and in fact provide less effective protection than the disposable diapers with a plastic outer covering.
I've heard of cases where people have used the disposable diapers with a cloth like outer cover for bed-wetting and leaked right through them. While this doesn't happen with everybody, people should have the option of buying diapers with a plastic outer covering if that's what they prefer and if that's what works best for them. A number of people seem to be disappointed with the fact that most diaper manufacturers are moving away from making diapers with a plastic outer covering. Perhaps customers should write or call the diaper companies and complain about this. In many cases companies do respond to consumer criticism.
As I said before people should have a wide variety of products to choose from due the fact that people have different needs and preferences in this area and I'm not against people using pull-ups,disposable diapers with a cloth like outer covering, or other products of a similar nature if that's what they prefer and if they offer adequate protection for the user however as mentioned previously this isn't always the case. What I am against is this emphasis on discretion and image at all costs as opposed to manufacturing, marketing, and selling products that will most effectively manage a person's bed-wetting.
The trade-off between image and protection is made by large amount of people unfortunately and I believe that many of these people will suffer as a result. To me I would think it would be much more satisfying to use a product that might be considered “babyish” by most people but offers better protection than to use a product that is considered more “dignified” but that leaves the wearer and bedding drenched. In a situation such as this a person has to ask him or herself how much is it worth to them to wear a product that has a better image versus a product that will offer more effective protection and therefore provide more comfort.
People who are reluctant to wear diapers to bed because most people feel they are strictly for babies need to keep in mind the old saw “what is popular is not always right,what is right is not always popular.” There was a time when most people thought the earth was flat,slavery was an acceptable practice,and the sun revolved around the earth but we now know these views are incorrect. I believe that in time we'll become more informed(and as a result more enlightened) about this issue also. Furthermore there are plenty of companies that manufacture and sell plastic pants,pin-on cloth diapers,and disposable tape-on diapers for older children,adolescents,teenagers,and adults that wet the bed so this is a very common problem. This is another thing that people need to consider.
Most pediatricians,child psychologists,and other medical professionals advise against using diapers in older bed wetters because they feel it might hurt the youngster's self-esteem and self-image. In fact one book I read said the following- “I've known parents that have kept their children in diapers at night as late as 7,8,9,and even 12 years of age but wearing diapers makes a child feel like a baby” and “diapers are a symbol of babyishness.” Maybe there are some children and teenagers who actually want to wear diapers to bed but they feel that their parents will look down on them for requesting this because the youngster realizes that most people feel diapers are for babies only. And since many books and other sources suggest that only babies wear diapers that's probably why there is such reluctance to use them for bed-wetting. In other words it's possible that many people feel ashamed about wearing diapers to bed not because they actually feel that way but because the professionals do and they believe that they should feel this way also.
This wouldn't be the first time we are cowed by what the experts say as Stanley Milgram's experiment and other psychology experiments so vividly demonstrate. Parents could feel the same way also-they might want to use diapers for their bed wetter or want to grant the child's request to wear diapers to bed but they too might be influenced by what the authorities say.
This raises an interesting question-is the fact that diapers have such a negative image by most of society the result of assimilating the opinions of most medical professionals,or is the negative opinion of diapers by most medical professionals influenced by how the public feels-the proverbial chicken or egg debate. How much of our attitudes regarding diaper use by older bed wetters is influenced by cultural attitudes,parents and other relatives,medical professionals,and other factors?How and to what degree do these factors interact with each other?I think it would be interesting to study this issue in depth.
By gaining better insight into how these ideas developed we might have a deeper understanding of why we have such negative attitudes regarding this issue which in turn might significantly reduce the stigma associated with using diapers to manage bed-wetting in older children,adolescents,teenagers,and adults.
To get back to self-image older children and teenagers are particularly sensitive and concerned with self-image and the image that diapers conjure up in most peoples minds are babies. Commercials also stress this. For example the ad for Huggies pull-ups has the following motto-”I'm a big kid now!” the implication being that only babies wear diapers. I have heard urologists,pediatricians,and other medical professionals(who in my opinion should be more sensitive and also should know better regarding this issue) claim that putting an older child,teen,or adult in diapers at night makes them feel undignified but to me it's more undignified waking up in pee soaked sheets and clothing!
It would be interesting to see how developmental psychologists feel about this issue. We tend to have certain preconceived ideas about our child's growth process and if they deviate from that in the slightest we become alarmed. For example children should talk by a certain age,they should read by a certain age,they should walk by a certain age,etc. And while it is true that we should have reasonable parameters established for theses situations in order to rule out the possibility of cognitive and/or physical problems,the same reasoning shouldn't be applied in my opinion to the use of diapers and plastic pants for the management of bed-wetting in older children,adolescents,teenagers,and adults.
Frequently we feel pressured to use socially accepted methods to resolve various medical issues but in some cases it's a good idea to consider alternative approaches and this may entail using methods that a large majority consider unorthodox or not accepted by the mainstream. A case in point is the following. In the May-June 2007 issue of AARP magazine there was an article on Naomi Judd. It talked about how the traditional treatments that were used by her doctors to treat he hepatitis were not working so she tried various non traditional methods which are not fully accepted by western medicine such as biofeedback,aromatherapy,and meditation. It turns out that these methods worked.
I think that the use of diapers to manage bed-wetting in older children,adolescents,teenagers,and adults is another example of a management technique that is not fully accepted by most medical professionals and the public. Just like Naomi Judd had the courage to try alternative approaches to manage her disease people must have the courage to use alternative methods to manage bed-wetting.
I think we need to reevaluate our attitudes on diaper use for older bed wetters for two reasons. As mentioned previously in some cases the pull-ups and “Goodnites” aren't as effective at protecting both the youngster and the bed. The second reason is that it makes the person who has no other option but to wear diapers to bed feel they are somehow inadequate. This in turn can lead to feelings of low self-esteem,low self-worth,and subsequent depression.
In going over the literature and opinions of many professionals regarding diaper use in older bed wetters one thing sticks out in my mind-the status quo has a negative opinion of diaper use. The literature and opinions are very consistent regarding this issue-most people believe you shouldn't keep a bed wetter in diapers past the age of 4 or 5.After that the majority of people feel you should use pull-ups or “Goodnites” only.
It's my firm opinion that we have a double standard regarding this particular form of incontinence. For instance we seem to have no problem with the use of diapers for developmentally disabled children,the elderly with incontinence,and people suffering from disorders such as cerebral palsy,multiple sclerosis,Alzheimer's disease,Parkinson's disease,or other ailments, but if you suggest putting an older child,adolescent,teen,or adult with a bed-wetting problem in a diaper people think you're barbaric and should be driven out of town on a rail.
There is a saying that goes something like this- “Nothing is good or bad but thinking makes it so.” While this is not the case for everything-torture,murder,rape,and stealing are inherently bad-there is nothing intrinsically shameful about wearing diapers to bed. Wearing diapers to bed after the age of 4 or 5 is considered shameful because we have been conditioned to think this way for years. It would be interesting to see how other cultures feel about this issue but unfortunately I suspect they feel the same way we do. From what I understand the Japanese,British,and most Europeans are even more uptight about this issue.
There are many different reasons I feel most parents don't use diapers to manage bed-wetting with both teenagers and older children. The next few sections discuss this. I believe that one of the reasons for our negative reactions toward older children being in diapers at night stems from attitudes left over from potty training. Many parents try to motivate their child during this stage with praise such as “we're so proud of you,you're becoming a big kid now!” While these parents might have good intentions(of course we all know the road to hell is paved with good intentions),unfortunately they use the same approach with an older child or teenager who still needs diapers at night .Children and teens still in diapers at night see the commercials for Huggies pull-ups and might remember what their parents told them about diapers during their potty training years and then feel ashamed about using diapers for their bed-wetting. In addition many parents try to motivate their child to achieve night dryness by claiming that only babies wear diapers. I think this puts a lot of pressure on a child and most likely will exacerbate the situation.
Children grow at different rates-just as some children walk sooner than others,talk sooner than others,and learn to read sooner than others,some need diapers at night later than others. In my opinion a different approach is warranted. The parents need to encourage their children by letting them know that peoples bodies develop at different rates and there is no shame in using diapers to manage the bed-wetting. I would remind the child that people of all ages have problems with wetting the bed and many of them also wear diapers during the night.
A second reason for peoples negative feelings toward older children still being in diapers could be the fact that parents used to use cloth diapers and rubber pants for their babies. This meant lots of work for parents especially before the advent of washing machines. In this circumstance parents felt compelled to get their children out of diapers as soon as possible. If an older child had to wear diapers to bed for bed-wetting the parents might have been upset about the prospect of having to spend years washing diapers and rubber pants. Subsequently many parents used the shaming approach to try to get them out of diapers.
Over the years we've become more enlightened about this issue(although we still have a long way to go in my opinion) and most people realize that this approach doesn't work and in many cases can make the situation worse. That being said the people who had the bed-wetting problem when they were younger remember their parents using this approach with them and they might use this technique with their children also.
A third reason for our negative attitudes regarding this stems from our attitudes toward various milestones in a person's life. Most cultures have certain expectations of when we're supposed to achieve certain things-we're supposed to get a driver's license by a certain age(I know a woman who is 24 who still does not have a driver's license),we're supposed to graduate from high school by a certain age,etc. Nowhere are our cultural expectations more deep-seated than with bed-wetting and diaper use and if a person needs diapers past the age that is considered socially acceptable by most people we instill in them the idea that they should feel ashamed.
To get back to parental attitudes toward diaper use I wonder if one of the reasons most parents are so adamant about getting their child or teenager out of night diapers is that a part of them feels ashamed about it. It's a very competitive world out there and every flaw a child might have is looked at as something that must be hidden or fixed at all costs. The prevailing attitude among many parents is that their kids must be perfect at everything because any sign of imperfection is viewed by society as a sign of weakness. There is immense pressure for parents to make sure their children go to the best schools,to participate in numerous after school activities because it looks good on their records,play sports,etc. Imagine if it got out that 18 year old Susan is still in diapers and plastic pants at night? So much for going to Harvard!
Parents are also competitive with one another and unfortunately some hyper competitive parents use their children as pawns either consciously or subconsciously in this competition. They feel that any flaw the kids might have is a reflection on their parenting skills and might make them look bad. “What would our friends and neighbors think if they found out our 15 year old son still wears diapers and plastic pants at night? How embarrassing!” We need to grow up! Everybody has some flaws-that's what makes us human! The only thing we can do is accentuate our strengths and do the best we can to work on our flaws and try to improve ourselves but we shouldn't obsess about our weaknesses.
A fourth reason for our negative feelings concerning using diapers to manage bed-wetting has to do with our emphasis on self-image. Although this is a universal concept this concept is especially important in the U.S. Most of our ideas of self-image unfortunately tend to be rather superficial. We're very concerned with status,power,image,and success and these four things are inextricably linked in many people's minds with having a strong self-image. A large number of people believe that wearing diapers represents the opposite of all four of the qualities in which people feel a strong self-image consists of .In particular a significant number of people believe wearing diapers represents a feeling of being powerless,no doubt due to the fact that most people associate diapers with babies. Many people of course view babies as the paragon of powerlessness. Because of this view a large number of people develop a negative self-image if they have to use diapers for bed-wetting.
A fifth reason is that some people believe that by putting the child in diapers for bed-wetting you in essence “are giving them permission to wet the bed” or that “it's okay to wet the bed.” Believe it or not I've heard some people say this and I think it's one of the most ridiculous things I've ever heard. Since the purpose of having the child or teenager wear diapers at night is to keep the bed dry I think it sends the opposite message-that it's not okay to wet the bed. In no way can putting a child or teenager in a diaper for a problem they can't control be construed as “it's okay to wet the bed.” I think it sends the message that the parents are going to make their children as comfortable as possible until a cure is found. Or if the treatment options currently available don't work or are not viable for some reason, they're going to have them wear diapers because it's more healthy for the child and it makes them more comfortable.
Diapers should not be the first option used for bed-wetting, but by the same token they should be used if all alternatives have been exhausted or are not desirable or feasible. To me diapers should be viewed no differently than sanitary napkins for women.
A sixth reason why most people are so against older bed wetters remaining in diapers at night is group think. People in general want to conform and with that tendency comes the fact that people go along with the prevailing wisdom without questioning its validity. They internalize it and it becomes so ingrained in their thinking that they can't imagine anything else. We're like fish in water-it becomes so much a part of their life and environment that they don't even notice it. The fact that the majority believe in something is no guarantee that it's right. History shows that in many cases it is the minority or a sole visionary who is right and the majority wrong.
Finally we tend to put too much credence in what experts say without questioning its validity. I 'm not suggesting that we shouldn't listen to anything the experts say but we should keep the following points in mind: experts frequently have conflicting opinions which could mean either that they in fact have opposite opinions on certain issues or that the issue is complex and they need to undertake more research in order to make a definitive conclusion or come to a consensus.
Second, there have been many situations where the experts were later shown to be wrong. Childcare is no exception. For example it was originally thought that playing Mozart would have a positive effect on an unborn child's brain development. This theory known as the “Mozart Effect” was later shown to be false(who knows-after further research and an improved understanding of cognition they might change their minds again-this has also happened with certain things) With this in mind it's conceivable that our current opinions about using diapers to manage bed-wetting are wrong also( I strongly believe that this is the case and that our thinking on this issue is completely misguided) although with how entrenched our attitudes our regarding this issue it might take a generation or more to overcome this inertia and reconsider our current attitudes concerning this situation.
A seventh reason why most parents use pull-ups or “Goodnites” instead of diapers for their youngster's bed-wetting may be that they're not aware of the different brands and types of products out there to manage bed-wetting. As mentioned previously there are many choices available to manage one's bed-wetting. Also some styles might not be used as much because of generational differences. For example,although some younger parents use pin-on diapers and plastic pants for their babies, most younger parents are probably not familiar with pin-on diapers and plastic pants since they're not as popular as they once were. The parents who do use pin-on cloth diapers and plastic pants for their babies might continue to use them if their child or children who wet the bed since the parents are familiar with them but parents who don't use them or are not familiar with them might not use them unless their friends,relatives,or other people recommend them. Second,even if parents are aware of the different choices out there to manage their child or teenager's bed-wetting it's very time consuming sorting through all this information in order to make an informed decision about the best type of product to buy. There's a bewildering array of products out there to deal with bed-wetting and it can be quite daunting learning about all the different products out there.
That's where the role of medical professionals comes in to play. I think urologists, pediatricians,and other medical professionals should have some basic knowledge of the different types of diapers available to manage bed-wetting and the advantages and disadvantages of each. While they obviously can't have an encyclopedic knowledge of this they can apprise their patients of the basic styles of cloth diapers such as as pin-on diapers,pull-ons,snap-ons,and Velcro; and disposable diapers such as tape-on diapers and pull-ons.
They can also inform them about the different types of waterproof pants such as plastic pants and the different types of waterproof sheets. If possible they should also have a list of several companies that sell both kinds of diapers and a list of websites(such as bed-wetting forums, incontinence organizations,and other resources) .These organizations can provide further information not listed in the physicians office such as additional companies that manufacture and sell incontinence products,information about bed-wetting support groups,etc.
I was reading that in the U.S. and other countries they have wound,ostomy,and continence nurses. From what I understand wound,ostomy,and continence nurses(abbreviated wocn nurses)perform the following functions: they inform patients of the different types and brands of products available to manage incontinence;the different ways some products may effect the skin such as causing diaper rash and/or other problems; what types and brands of skincare products to use if this is the case- Desitin,A&D ointment,powder,petroleum jelly such as the Vaseline brand,lotions,etc.;the pros and cons of different absorbent products;in addition to the different companies that sell incontinence products in order to help guide the patient in making a decision about what type of products to purchase based on their current needs.
I think this is a good thing that we have these types of specialists-after all it's very time consuming trying to find out this information on your own whereas a nurse or other medical professional specializing in bed-wetting and other incontinence issues can find the information more rapidly and efficiently due to the resources they have at their disposal. It's my belief that if more people become aware of the different diapering methods out there to manage bed-wetting more people might use these products thereby decreasing the stigma associated with older children,teenagers,adolescents,and adults wearing overnight diapers. The medical community can play a big role in the reduction of this stigma by informing both parents and patients of these options.
A second way to reduce the stigma associated with using diapers to manage bed-wetting in older children,adolescents,teenagers,and adults is to have talk show hosts discuss this on their shows. I think this would be a perfect topic to discuss on Oprah. Due to the nature and depth of the material she could make it a two or more part series on her show. She could invite experts on bed-wetting to discuss what it is,the age groups effected,adult bed-wetting,different cures and treatments for it and the advantages and disadvantages of each,the best ways to cope psychologically if it can't be cured,and the different types of protection to manage bed-wetting.
As far as protection is concerned the experts would discuss the different diapering options available to manage bed-wetting and the advantage and disadvantages of each. Some of the options discussed on this segment would be cloth diapers such as pin-on,pull-on,and other types, disposable diapers such as tape-on and pull-on,the various types of waterproof pants such as plastic pants,and the various types of waterproof sheets. I think it's important to mention all these options for two reasons. One, it'll make parents aware of options to manage their youngter's bed-wetting they might not have known about or if they did know about them they might not have considered them before. Two,by doing this more people might consider using these different types of garments thereby decreasing the stigma surrounding them.
Oprah has a lot of clout and influence and I believe that people such as her(and other celebrities) could help lessen the negative image of bed-wetting and diaper use. I guarantee after this episode of Oprah diapers would sell like hot cakes- department stores such as Walmart and Target and food stores such as Giant couldn't keep them on the shelf .By both doctors and celebrities recommending diapers this might have a snowball effect. For instance someone who uses diapers for their bed wetter because doctors or celebrities recommended them might in turn recommend using diapers to their friend/friends who have children with bed-wetting problems thereby increasing the number of people who use diapers to manage bed-wetting. The subsequent increase in the number of people using diapers to manage bed-wetting will do more to decrease the stigma associated with using diapers for bed-wetting.
We as a society have matured as far as many medical issues are concerned. For example there is less stigma surrounding mental illness and other medical problems,but unfortunately bed-wetting and the use of diapers to manage it is an issue that remains taboo. We are very stubborn regarding this issue. Most people for a variety of reasons do not want to budge regarding this issue. I suspect that in the future we will loosen up about this issue to a certain extent,but I also think there will always be people who view this in a negative light no matter how persuasively we argue the merits of wearing diapers for bed-wetting.
One of the major reasons for the stigma of diaper use in older bed wetters has to do with our thoughts and feelings on the issue of dignity. Many older children,adolescents,and teenagers feel undignified about wearing diapers to bed. To a large extent our concept of dignity is shaped either consciously or subconsciously by people we admire such as sports figures,entertainers,and heroes. We have this idealized image of them and we tend to extrapolate that image to all aspects of their personal lives. Because of this perfect image we have of them we couldn't imagine them having a problem like bed-wetting. Of course we must remember that these individuals are human also and are subject to the various health problems that everyone else has. In fact many famous stars such as Suzanne Sommers, Johnny Carson,and Michael Landon(to name a few) experienced bed-wetting when they were growing up.
I also feel that are ideas about dignity go hand in hand to a large degree with our feelings about independence-being able to take care of yourself and run your own life. As mentioned earlier diapers represent to many people a return(at least symbolically) to a state when their parents took care of them which is a blow to a child or teenager's ego. Adults who have to wear diapers to bed also feel this shame. Many people find it very difficult to get past this feeling of shame and unfortunately some people can never get past it. Although most people find it undignified wearing diapers and plastic pants for bed-wetting,personally I think it would make a person feel more undignified laying all night in pee soaked bedding and pajamas!
Dignity also relates to a feeling of control which in turn relates to are sense of self-esteem and how self-confident we feel about ourselves. When we are self-confident we have a feeling that we are in control of our lives and that in turn makes us feel more dignified. Again by wearing diapers to bed we feel a lack of control which in turn makes us feel less self-confident. This in turn erodes our feeling of dignity. This is the case with many other medical problems as well. For example a person who has to wear a cast for a broken leg or a person who has to take insulin shots for diabetes might feel either consciously or subconsciously that he or she doesn't have control. The cast or needle represents the feeling of a lack of control. The same is true for wearing diapers and plastic pants to bed. Of course every person is different in the degree in which they have these feelings and their ability to overcome these feelings.
One thing that we must realize however is that we should not be defined by our illness. The fact that a person has to wear diapers to bed is only a part of who that person is. A person's dignity should be measured by the fortitude they exhibit in dealing with life's adversities and how well they treat other people. If a person has to wear diapers to bed and they deal with it with a sense of grace and humor then the fact that he or she needs diapers at night should not detract one iota from their dignity.