I've heard parents say that it's okay if an older child,adolescent,or teenager doesn't want to wear diapers to bed provided they take care of the wet clothes and bedding but I think that sends the wrong message. I think it sends the message that it's okay to be unsanitary. As mentioned previously it's unsanitary and unhealthy(not to mention uncomfortable) to lie all night in wet sheets and clothing. The following analogy might help. If a youngster has a cut you would have them put on a band-aid in order to prevent blood from getting on their clothes and on other stuff in the house in addition for sanitary reasons. Wearing a diaper to bed should be viewed no differently-the diaper is a band-aid for a bladder control problem. Or if the youngster was going to go out in the rain the parents would see to it that they wear a raincoat or use an umbrella to keep the child from getting wet. All of them are waterproof and all of them serve the function of keeping the individual from getting wet.
The bottom line is that people do not like getting wet and take the appropriate precautions to prevent that from happening. Setting aside concerns of being unsanitary and uncomfortable for the moment,even if the child or teen did offer to wash their own sheets and garments it should be mentioned to them that it is much more time consuming and a lot more work to wash a whole bunch of wet sheets,blankets,and pajamas than to wash the wet diapers and plastic pants.
Right now I'd like to touch on the following. Many parents might be wondering if they should require their older child, adolescent, or teen to wear diapers to bed if all methods to cure the bed-wetting have failed and they leak through the pull-ups or “Goodnites”. The consensus seems to be that the child or teen should be involved in the selection of what type of garments to wear to bed. While I agree with this theory in principle,in practice it might not work out all the time. The reasoning behind this theory is that by letting the child or teen be involved in the decision making process they will feel more in control of the situation thereby improving their self-esteem which in turn will make them feel less embarrassed.
Many children,adolescents,and teenagers feel babyish about bed-wetting and a large number of people feel that by forcing them to wear diapers to bed you are taking the decision about how to deal with the bed-wetting out of their hands thereby making them feel even more like a baby. I can certainly understand this point of view but in many situations parents make decisions for their older child or teenager that are in their best interests but they don't like. Wearing glasses and braces are just two things that come to mind. If it were up to the youngster they wouldn't wear glasses and braces at all. Is it such a stretch to apply the same reasoning to the use of diapers to manage bed-wetting? Besides I would think it would be less embarrassing and stressful for the child or teenager to wear diapers to bed than wear glasses or braces-after all since the diapers are worn only at night their friends won't notice them whereas with the glasses or braces they will.
While it is good to grant children and teenagers more autonomy as they get older in order for them to be a more confident and responsible adult there are certain types of knowledge that only come with experience. Choosing an appropriate incontinence product is one of them-there's a lot of trial and error involved in choosing an incontinence product that works well. There are many factors involved in choosing an appropriate incontinence product-the type and level of incontinence,whether your incontinence is during the day,night,or both,how absorbent the product is and how effectively it protects the individual,how durable a product is,a person's budget,how discreet the products are,how certain products effect an individual's skin,whether or not a person has the time and/or desire to wash diapers and plastic pants,etc. While adults have the capability to weigh these decisions and are able to make a sound choice in the matter,many children and teens don't have the maturity,knowledge,experience,and ability to make an informed choice in this situation. Their decision about what type of incontinence product to wear to bed will be influenced by what they perceive the image of diapers to be rather than how well the product keeps them dry at night.
Parents are in a better position to judge what type of product will be best at managing their youngster's bed-wetting. They know how much the youngster wets at night and have experience in dealing with diapers when the youngster was a baby so they're familiar with how absorbent and effective various diapers are. This puts them in a better position to evaluate how well a particular product will work in protecting both the youngster and the bed. If a child or teenager's current bed-wetting product is not offering adequate protection and if after weighing all options the parents come to the conclusion that pin-on diapers and plastic pants,tape-on disposables,or other garments will be better at keeping the youngster dry at night then the parents should have the final say in the matter.
The same is true with any medical issue. If the youngster is being treated for a certain illness and the method currently being used is not solving or adequately managing the problem then it's time to consider alternative courses of action and ultimately the adult due to their life experience is best qualified to make that decision. A diaper should be viewed no differently than other medical equipment for managing various medical problems such as an inhaler for asthma,a wheelchair for paralysis,a hearing aid,a cast for a broken arm,etc.
One of the other things that puzzles me is this-children wore diapers when they were babies to protect themselves from wetness why should that change when they get older? The parents are in effect saying- “ well you're still wetting yourself but you're getting too old to still protect yourself.” Although the parents should have the final say in the matter I don't think they should be cruel or callous about it. Also there are cases where parents have used diapers to try to shame the child or teen into stopping the bed-wetting or as a form of punishment. I find this practice reprehensible and a form of child abuse.
To get back to how to approach the older child or teen about wearing diapers to bed I think the parents should be gentle but firm. Some parents are from the “my way or the highway” school of parenting and while that approach might be necessary with some youngsters and in some situations and circumstances I feel that it's not warranted in this case. The parents should put themselves in the youngster's place-they should be empathetic and help them realize that it's in the youngster's best interest to wear the diapers to bed. As I said you need to emphasize to them that people of all ages wet the bed and many of them use diapers at night otherwise they wouldn't manufacture so many different sizes. Again I would tell them that since there are so many different styles of diapers-tape-on,pin-on,pull-on,etc that must mean that there are advantages to some of them with certain people and in certain circumstances. I would stress to them that although wearing diapers might be unpleasant,the alternative,waking up in cold,soaking wet sheets is a lot worse.
I would tell them the reasoning behind why you chose one type of diaper over another. You can talk to them about the different types of diapers available to manage bed-wetting and the advantages and disadvantages of each. For example some people have problems with side leakage because they move around a lot at night,some people urinate more profusely than others at night,etc. and some brands and types of diapers are more effective than others at dealing with these particular problems. In addition some styles of diapers are more durable than others.
Finally parents might choose a particular brand or style of diaper due to financial reasons. For instance I read about a parent who had an older child with a bed-wetting problem and he was a very heavy wetter. Originally he used pull-ups to protect the child but due to the level of incontinence he had to use three or more per night. The parent had limited financial means and couldn't afford to spend the money on the amount of pull-ups required so he switched to plastic pants and pin-on diapers. These are just some of the reasons for choosing one type and brand of diaper over another. With just about any type of consumer purchase there are some brands and products that are more effective than others for various problems and situations,more adequately meet a consumer's needs,etc. and diapers are no exception.
I think it's important to discuss why you chose a particular style of diaper to manage the youngster's bed-wetting for the following reasons: it shows that you're sympathetic because you're taking the youngster's feelings about wearing the diapers into consideration,it shows that it's not some arbitrary decision designed to belittle or degrade the child or teenager,and it shows that you have the youngster's best interests at heart. As one book on adolescent psychology put it- “As the adolescent pushes for autonomy,the wise adult relinquishes control in those areas in which the adolescent can make reasonable decisions and continues to guide the adolescent in areas where the adolescent's knowledge is more limited.” In my opinion the choosing of an appropriate product to manage bed-wetting would fall into the second category. Adults have more life experience. This life experience makes them more effective at controlling their emotions and not letting them get in the way of making major decisions particularly regarding health care.
Bed-wetting is a very touchy issue with most older children,teenagers,and adolescents and as a result they probably won't be as objective as parents in choosing the most effective product to manage their enuresis. Due to youngsters concerns with self-image their choice of what type of product to wear to bed will be dictated more by this criteria than on how well the product protects them at night.
As mentioned earlier it's good for the parents to talk to them about all the different products out there to manage bed-wetting and the advantages and disadvantages of each that way if there is a disagreement about what type of product to wear to bed the parents can go over why they are requiring the child or teen to wear one product versus another. For example,it might be the case that the child or teen wants to wear one kind of product(say pull-on cloth diapers) whereas the parents feel that pin-on cloth diapers and plastic pants would be the best option. If that's the case the parents can say something along these lines: “I know you would prefer to wear the pull-on diapers instead of the pin-on diapers but there are several advantages with the pin-on diapers. You move around a lot at night are a very heavy wetter. Also you tend to sleep on your side. The pin-on diapers are more effective at dealing with these specific problems because they're thicker than the pull-on diapers and you're able to customize the material in the pin-on diapers whereas with a pull-on diaper by putting more material in the diaper it causes it to bunch up. It might take some time to get used to the pin-on diapers but in the long run you'll be much happier because these will protect you much better than the pull-on diapers which in turn will make you more comfortable. Your mother and I came up with a reward system to encourage you to try these out for awhile. We think you'll be real happy with this idea and we'd like to discuss it now.” Again by doing this it makes the child or teen feel much better about the situation as opposed to the parents saying “you're wearing pin-on diapers and plastic pants to bed because we say so!”
If the child or teen is reluctant to wear a certain type of product to bed the parents should definitely hear them out and then work with them in trying to overcome their anxiety. This requires patience,warmth,and encouragement. I would also say something along these lines: “I realize you're getting older and you might feel that by us making the final decision in this matter we're treating you like a baby or little child but we have a lot of experience in these matters and the products we chose for you to wear to bed offer the best protection. These will make you feel a lot more comfortable at night then the other products you wore.” To get back to my earlier analogies about wearing a cast,glasses,or braces,it's kind of awkward and unpleasant at first,but eventually a person gets used to them and the person realizes they're for his or her own good. The same is true for wearing diapers and plastic pants for a bed-wetting problem
By discussing the reasons behind your decision about what type of diapers to wear for the bed-wetting you are helping them in a very significant way-you are saying that you acknowledge their concerns about wearing the diapers and this makes it more likely they will not feel you're treating them like a baby because you respect them enough to discuss why you are having them wear a specific type of diaper at night. It's my feeling that this discussion with the child or teen in conjunction with using the reward system previously discussed will help them feel less apprehensive about the prospect of wearing diapers to bed.
I would also mention that there are situations where parents purchase diapers for their parents with incontinence issues such as with a parent suffering from Alzheimer's disease and there are instances of married couples who deal with bed-wetting and the spouse of the bed wetter suggests that they wear diapers to bed. In the case of the bed-wetting spouse,while there may be some initial embarrassment at the thought of wearing night diapers,the bed wetter realizes that it's only fair to the person sharing the bed with them and eventually gets used to them. By mentioning these scenarios to the child or teen it helps them realize they are not alone and will help them feel less embarrassed about their parents putting them in diapers at night. They'll be able to say to themselves- “If parents purchase diapers for their parents and the husband or wife of a bed wetter suggest they wear diapers to bed then I guess it's not so bad that my parents are encouraging me to wear diapers to bed also.”
The last thing I'd like to mention with regard to the older child,adolescent,or teenager who might be having a hard time accepting diapers for bed-wetting is the following. The parents should let him or her know that it is not uncommon to feel this way. Many incontinent adults have difficulty accepting diapers also but over time they come to terms with this. As mentioned before it would be a good idea for the child or teen to talk to other people in a similar situation.
In conjunction with the techniques previously mentioned to help the youngster accept the diapers it might be necessary for the youngster to speak to a mental health professional(if financially feasible) to help them adapt to wearing the diapers to bed. It's my contention that by using all of these approaches together-the reward system,discussing the reasoning behind your choice of a particular type of diaper,the positive self-talk,parental encouragement when the child gets distressed and/or discouraged about the diapers,speaking to a mental health professional,and mentioning the fact that adults get other adults to wear diapers to bed,they'll be able to internalize the positive psychological aspects of these strategies. This in turn will help them cope with the thought of wearing diapers,it will help them by dispelling the negative self-image they might have of themselves due to wearing diapers to bed ,and they'll feel more confident about themselves because they'll be protecting themselves more effectively which will help improve their self-esteem.
I realize that what I've just said goes against the prevailing wisdom espoused by most pediatricians,child psychologists,and other professionals but I think it's time we reevaluate our current attitudes toward the management of nocturnal enuresis and look at this issue in a whole new light.
How one copes with wearing diapers to deal with bed-wetting is a very personal issue. Some people don't have any problem whatsoever wearing diapers to bed and are even glad to wear them because of the security and comfort they provide,whereas others need a significant amount of coaxing and encouragement to use them. Parents should not get discouraged if this is the case. It could take several months or more(depending on the individual) for the youngster to feel completely comfortable wearing nighttime diapers.
Although it might take awhile for the youngster to get used to wearing the diapers to bed,over time the child or teen will realize how much more comfortable and secure they'll make he or she feel. At this stage they won't have any problem putting the diapers on before going to bed. It'll be second nature to them. Like brushing their teeth they'll view wearing the diapers as just another part of their nighttime routine.