Protecting Beds and Chairs

• Using Covers
• Using Bedpads and Chairpads
• What are the Advantages and Limitations of Washable Bedpads?
• How to Choose a Washable Bedpad

Using Covers

Covers to protect mattresses, pillows, blankets, duvets and sleeping bags are available in a range of sizes, styles and fabrics. These help to minimise leaks and stains, reduce laundry and save on replacing worn bedding. (You can also buy waterproof pillows and duvets.)  Check the labelling: some are not guaranteed to be 100% waterproof.  Some are flame-retardant - a must for residential and nursing homes.

Mattress covers can be made to measure. Some fit like a fitted sheet, others go all the way round the mattress, like a duvet cover.

Plastic (PVC) covers are easiest to find and cost just a few pounds. But they can make you sweaty and after several washes can become hard, crackle and split. It is worth paying more for better quality, such as "breathable" water-repellent fabrics. These allow body sweat to evaporate and so are more comfortable. Expect to pay around £30 for an all-round mattress cover for a double bed, and around £15 for a sleeping bag cover.

To reduce smells and to make covers last longer, sponge and dry them thoroughly before putting on clean bedding.

It is a good idea particularly for men and boys who sleep on their backs to protect the bedding under and over themselves. Put the covers between the pillow and pillowcase, duvet and cover or below the blankets. A lightweight, non-water-repellent fabric is the most comfortable.

Using Bedpads and Chairpads

You can use bed and chair pads as a back-up to body-worn pads or by themselves, depending on the frequency they will come into use and other factors. Bedpads are placed on top of the bottom sheet and under your waist and thighs. They are generally similar in width to a single bed, but they may be used on double beds too. (Men who like to sleep on their backs and are using bedpads as their only protection, may tend to wet the top bed sheet.)

There are both disposable and washable (re-usable) types, as described below. In the following two sections we set out their advantages and disadvantages, and then suggest how to choose a washable bedpad to suit you.

Generally, disposable bedpads are used as a back-up in case a body-worn product leaks as they tend not to work well when used as sole protection. They vary greatly in their quality, thickness and absorbency. Some are sealed on all four sides, others on only two. Some are "quilted", which may assist urine distribution.

Washable bedpads can be washed and reused many times. Some are designed to absorb large quantities of urine, keeping the skin dry, so that you can sleep undisturbed for several hours. You will need to sleep naked below the waist so that your skin is in direct contact with the top "feel-dry" surface of the pad. The urine passes through this to the soaker layer and is held there. The third layer is a waterproof backing, which may also be covered with fabric on the underside. Usually the three layers are sewn together, but sometimes the water-proof backing comes as a separate sheet. Some bedpads have flaps at the sides which can be tucked under the mattress to help keep them in place. These are especially recommended for restless sleepers.

Washable bedpads are mainly useful for people with urinary incontinence, but they are not generally recommended for people with faecal incontinence because of staining. Sprays and ointments may also cause stains and should anyway be applied sparingly so as not to interfere with the urine passing through to the absorbent layer.

Access to good washing and drying facilities is vital if you are using washable bedpads. In hospitals and nursing/residential homes it is unwise to introduce reusable bedpads without first discussing the laundry arrangements with all concerned. In the community, it is important to ensure that an outside laundry service is available or that somebody in the household is ready, willing and able to take on the laundry, preferably with an automatic washing machine and a tumble drier. Contingency plans for washing and drying machine breakdown should be made from the start.

Laundry turn-around times and the frequency of the user's incontinence will determine the number of bedpads which need to be purchased. Users who are incontinent most nights will need about ten bedpads in hospital, about three in their own home, and somewhere between five and ten in nursing or residential homes.

Costs: Disposable pads are sold by the hundred for anything from £10 to £25, and in 25s for around £6. Washable pads mostly cost around £15 to £30 each depending on size and quality, and you will need at least three to allow for washing and drying time.

Chairpads follow the same principles, but are smaller and less absorbent. Washable pads are available in plain and patterned fabrics for different types and sizes of chair, including wheelchairs, and most cost around £8 to £12 each.

What are the Advantages and Limitations of Washable Bedpads?

Needs, situations and priorities vary and so reusable (washable) bedpads are ideal for some people and inappropriate for others. Here are the main issues to consider:-

Advantages of washable bedpads

• Freedom from the continual chores of disposal and re-ordering which go with disposable products.
• Freedom from the anxiety that supplies may not arrive in time or be adequate in quantity.
• If reusables are laundered with care, they may last a long time and so work out cheaper per use than disposables.
• If they are still dry in the morning, they can be used again without washing.

Limitations of washable bedpads

• Washing and drying reusables is time-consuming and heavy work and some users/carers find laundering soiled bedpads distasteful. Some dislike having soiled bedpads about the house ("back to nappy buckets").
• If a tumble drier is not available, the inconvenience of damp bedpads draped round radiators, or the unreliability of the weather which may make hanging them on the garden washing line impractical, may argue against their use.
• Initial outlay is high and expensive mistakes can be made if the product turns out not to suit the user(s).
• Who pays for the laundry? If the bedpads are being used in the community, the family will generally pay. Drying costs can be especially high: a typical bedpad takes about 45 minutes to tumble dry.
• Some users don't like sleeping unclothed below the waist.

How to Choose a Washable Bedpad

There are lots of different washable, reusable bedpads on the market. Here are some of the main factors to consider in making your selection:-

Integral or separate water-proof backing? Some people find it fiddly using a bedpad with a separate water-proof backing. However, if they get damaged, separate backings can be replaced without the expense of having to buy a whole new bedpad. Pads without a waterproof backing dry more easily.

Tuck-in flaps? Tuck-in flaps are very effective at keeping bedpads in position on single beds. Products without tuck-in flaps which have a non-slip backing also stay in place. Bedpads with flaps are available in single- and double-bed sizes.

What about size? In general, the wider, longer and thicker a bedpad, the less it is likely to leak - although thickness is not a completely reliable indicator. However, the trade-off is that bigger products are usually more expensive, take longer to dry, and are heavier to handle during laundry. For these reasons, it is best to avoid the bigger products unless the user is heavily incontinent.

Which materials? Manufacturers who use cotton or poly/cotton facings generally claim good dry comfort, while those using polyester claim their products have good wet comfort and keep the skin drier. In practice, individual preferences vary. Absorbent cores are usually made from rayon and/or polyester. There is no evidence that either material is superior to the other. A variety of plastic backing materials is in use. In general, the softer, more compliant materials are better at keeping the bedpad in place but they are not so durable.

Some companies have a "domestic" version of their product with a softer plastic, and a "hospital" version with a more durable backing which will withstand the fiercer conditions of bulk laundering.

What about quilting? In most bedpads the facing and absorbent layers are quilted together to stop the facing from forming uncomfortable creases and to reduce rubbing which can form uncomfortable balls of fibres between the two layers. However, beware of hard stitching if skin damage is a real threat.