If the child, adolescent, or teenager is embarrassed about wearing the diapers and plastic pants to bed there are a number of different ways you can encourage them. First, you can stress how much more comfortable it will be waking up in a dry bed. Second, you can have them go to different online forums (with a younger child it's a good idea to supervise them while they are doing this) and talk to people suffering from similar conditions. There are many online forums dealing with bed-wetting and other incontinence issues. Sometimes it helps to have a sympathetic ear and to realize there are other people in the same boat.
Third, you might consider ordering a large or extra large, adult size pair of plastic pants and/or diapers. By showing the youngster an actual adult size pair of plastic pants or diapers which is a size that is larger than what they would wear, it might help them feel better about wearing diapers to bed. By actually seeing an adult size it emphasizes the fact that adults wear them to bed also. This will help them more psychologically as opposed to just seeing something on a web site.
Fourth,you can explain to them that people have different needs in terms of managing their incontinence-that's why they have so many different styles of incontinence garments. There are different levels of incontinence-some wet more than others. You need to stress to the youngster that what works for one person might not be as effective for another. Fifth,emphasize to the child or teen that they are only wearing the diapers at night. Unlike during the day it is much easier to conceal the use of diapers at night.
In some circumstances however it might be difficult to be discreet about the use of diapers particularly if the parents are using cloth diapers and plastic pants to manage the bed-wetting. I would like to digress for a moment and discuss this briefly. If the bed wetter has siblings it's inevitable that they're going to notice either diapers in the laundry or plastic pants hanging up to dry on the clothesline. Or if the bed wetter shares a room with a sibling it's impossible to hide the diaper use from their brother or sister. If this is the case it's imperative that the parents let the other children of the household know that any teasing about the bed-wetting or diapers and plastic pants will not be tolerated and will result in punishment.
On a related note there is also the possibility of friends of either the bed wetter or sibling finding out about the bed-wetting when they come over to visit. There are some precautions that you can take to prevent this from happening. If the youngster uses cloth diapers and plastic pants you can put the diaper pail in the laundry room before the friends come over. And if you're worried about them accidentally discovering the diapers and plastic pants you can put them in a special bin (which you can purchase from Target or Walmart) and either label the bin "school papers" (or something similar) or take the bin out of the room before the friends come over and put it back after they leave. Plastic sheets can also be a concern due to the fact that some of them make a crinkling or rustling sound which can be discovered if friends sit on the bed. I have read and heard about this happening in some cases,however this can also be remedied. You can take the waterproof sheet off before the friends come over and put it back on again before going to bed or put extra cloth sheets over the protective sheet to muffle the sound of the plastic. It should be mentioned that while this is a possibility with some plastic sheets if the youngster has the bed covered with a rubber sheet this won't be a concern.
At this point I would like to get back to suggestions on how to motivate an older child or teenager who is reluctant to wear diapers to bed. The last idea I have is to implement a reward system designed to encourage the child or teen to wear diapers to bed. You can offer to increase their allowance by a certain amount. You could also say that if they agree to wear the diapers to bed for at least 6 months they can earn a certain amount of money per month such as $20.00(or whatever amount the parents can afford and are willing to pay them). If they don't wear the diapers and plastic pants to bed you can deduct a dollar for each night they don't wear them. In addition to having a specific amount they can earn per month, if financially feasible it might be a good idea to purchase a present for them which you can give them after the 6 month trial period. Or they can earn a specified number of gold stars or points per month which they can cash in for presents. Again they will be deducted a gold star or point each night they did not wear the diapers to bed.
I think that verbal praise is an important part of the reward system. There is always the possibility that some older children and teens might get discouraged and not put on the diapers some nights. If this is the case it's very important to encourage them. Remind them of how proud you are for trying them out and also remind them of the reward system. I would say something along these lines: "We're real proud of you for trying the diapers and plastic pants out. I realize that it's no fun wearing them but just keep in mind the advantages of wearing them-you'll wake up nice and dry. Also remember that the more nights you wear them to bed the more money you'll make. I know it's hard but try to hang in there."
I think that in order to motivate them to wear the diapers to bed for the long term it's important to have some small rewards they can earn along the way while waiting for the big reward at the end. It's my contention that after the 6 months is up they'll feel so accustomed to wearing them and so comfortable wearing them that they will want to wear the diapers to bed of their own volition and not need rewards anymore. After 6 months they'll most likely realize how comfortable it is to wake up nice and dry.
In combination with using a reward system there are certain scripts(as the mental health professionals say) that a child, teen, or adult can say to themselves in order to feel more comfortable with the idea of wearing the diapers and plastic pants to bed. For example he or she could say something like this to themselves: "This is just a garment designed to absorb urine and prevent it from getting myself and my bed wet. Wearing this is no reflection on my maturity. In fact by taking the appropriate precautions in dealing with the situation I am acting more mature. It doesn't matter what most people think. I am doing what's best for me in my particular situation and circumstances" or "I'm just wearing these at night-no one but myself and my family know I have them on. I'm asleep while I have them on so it's not like I'm going to notice them much anyway except when I put them on at night and take them off in the morning. It's like having a tooth pulled under anesthesia-I won't even notice it."
Finally another thing a person could say is the following: "Everyone's body develops at different rates-some people are potty trained later than others and some wet the bed later than others. My bladder has just not developed enough where I can stay dry at night unlike during the day. I wore diapers during both the day and night to protect me when I was a baby so why should it be any different now-I still have the problem of wetting. Just because I'm older doesn't mean I still don't need them. Besides they make diapers and plastic pants in my size so there must be a need for them-I am not the only one who wears them for bed-wetting."
If the child is younger you can tell them to play a little game. You can tell them to imagine that the diapers and plastic pants are a like dam and the bed is like a city. The dam (in this case the diapers and plastic pants) keeps the city (in this case the bed) from being flooded. Or they can pretend they're a superhero and the diapers and plastic pants give them special powers-in this case the power to prevent their bed from getting wet. Finally they can look at the diapers and plastic pants in the same way as a raincoat.
I'd like to wrap this section up with an example of how concerns over both the issues of maintaining discretion when using diapers and the negative image of diapers can adversely effect a person's self-esteem. In this part I'd like to mention the difficulties faced by the individual with coming to terms with wearing diapers to bed and what a person could tell him or herself (what the professionals call positive self talk) to overcome the distress associated with these difficulties or at the very least minimize the distress. Although the person in question was talking specifically about his objections to wearing cloth diapers and plastic pants to bed I feel my suggestions are applicable to the use of disposable diapers also.
When reading about the teen's difficulties I was struck by how poignant it was and how sad it is that other children and teenagers feel the same way. The teen feels that certain aspects of the diapers make him feel like a baby. The pins, the bulk of the diapers between the legs, and the sound of the plastic as he moved around were triggers in his mind that made him feel this way. As mentioned many older children and teens probably feel the same way but instead of viewing these aspects in a negative light it is conceivable to put a positive spin on the situation-instead of seeing the glass as half empty with the right attitude one can see the glass as half full. For instance the bulk of the diapers can be looked at as an advantage - it provides more absorbency and therefore better protection. Regarding a teen's embarrassment about the rustling of the plastic pants as they move around it's important to remember that since the diapers are worn only at night this shouldn't be a concern. The parents should let him or her know that it's not unusual for a certain degree of noise to be associated with some diapers. Instead of viewing the plastic as negative the person can view it in a positive light-it makes the diapers waterproof which keeps the user dry and comfortable. If however the bed wetter shares a room with a sibling and is concerned that the sibling will notice the crinkling sound the diapers make when he or she moves around in bed that concern can be addressed beforehand by the parents.
As mentioned the parents should let all siblings of the bed wetter know that any teasing regarding the bed-wetting and diapers will not be tolerated and the parents will punish those involved. As far as the safety pins are concerned these should be viewed no differently than other tools for fastening clothes such as snaps, buttons, or zippers.
In terms of siblings and bed-wetting there is one other point I'd like to bring up. There are cases where an older child might wet the bed and the younger sibling or siblings don't have this problem. This can be a blow to the child's ego and if the parents have the child wear diapers to bed it can make him or her feel more self-conscious and embarrassed. If the child expresses concerns about this it's important for the parents to have a discussion with the child. The parents can stress to him or her that it frequently happens that children develop at different rates and this type of situation happens all the time. If the child doesn't seem concerned about it I wouldn't even bring it up-it's very possible that he or she hasn't even thought about this but if you bring it up then they will be concerned. In terms of the siblings of the bed wetter and how they react to the fact that he or she still wears diapers to bed I'll reiterate what I've said before-the parents should have a discussion with the siblings of the bed wetter (both older and younger) and tell them in no uncertain terms that any teasing about the bed-wetting and/or diapers will not be tolerated.
Finally I would tell the child who wets the bed that plenty of adults also have problems with bed-wetting and they wear diapers at night too. Many of them probably feel the same way. I've read about cases where one or more parents have bed-wetting problems but their children don't. The parent originally feels embarrassed about wearing diapers to bed but many times the children are supportive of their parents. This is another point that should be brought up to the older child, adolescent, or teenager that needs to wear overnight diapers.
At this point I would like to discuss the following. I feel this particular topic dovetails in with the concept of self-esteem. Although this is not a common occurrence I felt it needed to be addressed. As mentioned I have done a fair amount of reading on both bed-wetting and the use of diapers to manage it and in my readings I've ran across situations in which babysitters and parents of children that wet the bed had to get the children ready for bed. A friend of mine years ago told me of a situation where she had to babysit a 6 year old boy and she had to diaper him before he went to bed. I figured at that age he was potty trained and just needed the diapers for a bed-wetting problem. This was the days before pull-ups and "Goodnites" so she had to use tape-on disposable diapers. The child threw a fit and refused to let her put the diapers on him which I can't say as I blame him. I don't think the child had any cognitive and/or physical impairments that prevented him from putting on his own diapers so I was kind of puzzled why it would be necessary for her to be involved in getting him ready for bed. Most older children are very self-conscious about this issue and by diapering them you might embarrass them.
I'm not a pediatrician or developmental psychologist so I'm not an expert on this,but there are certain cognitive and physical tasks-such as putting on pants, tying shoes, etc. that can be accomplished at a certain age by children that are not developmentally disabled. Putting on one's own diapers would seem to fit into this category also. My intuition tells me that above the age of 3 or 4 a child should be taught how to diaper themselves. If the child incorrectly fastens the diapers and it causes the diapers to leak the parents can teach them the correct way to put on the diapers. They can do this by laying the diaper on the bed, have the child sit in the diaper,and once the child is correctly positioned in the diaper explain to them how to draw the diaper up between the legs,how to place it around the waist,and how to fasten the tapes. After the child puts the diapers on the parents or babysitter can check to see if the child fastened them correctly. If not the child should do the refastening not the parents or babysitter. The child will eventually get the hang of this and in time will not need the parents or babysitter in the room to supervise them.
At this age children are starting to get very self-conscious about these issues and you don't want to embarrass the child. With that in mind it's good to teach them to be self-sufficient in this area as soon as possible. Disposable diapers are pretty simple to put on. Pin-on diapers might be a little trickier for some children but I believe that they can also be mastered. Many parents might be worried that a younger child might accidentally stick themselves with the pins. I spoke to a woman from a company that manufactured and sold pin-on diapers for older children to get her take on the situation and she told me that for a child of 7 or younger they might need help from their parents whereas if the child was older than 7 it might depend on their development. As in the case of the disposable diapers the parents should lay the diaper on the bed, show the child how to fold it correctly, have them sit in the diaper,make sure they're correctly positioned in the diaper, show the child how to fasten it around him or her, and how to safely pin the diapers on. As before the parents or babysitter can check to make sure the child put the diapers on correctly and if not have them do the diapering again. As far as the plastic pants are concerned they can also put them on by themselves.
It's very important for parents to teach their child to be independent in this area otherwise they'll feel ashamed and this will adversely effect their self-esteem,perhaps for a long time. I've read about a case where the parents diapered their older child who wet the bed in front of the whole family in an attempt to shame him into stopping. There are many other things I've heard parents do to shame their child into stopping bed-wetting but out of sensitivity to my readers I won't mention them. These practices are despicable and a form of child abuse. In terms of diapering older children that wet the bed,it seems that the situations described above are atypical but even though this is the case, my friend's experience concerned me and it made me feel that this issue needed to be addressed.
There are a couple other points regarding discretion that I'd like to talk about. The first has to do with various caretakers of the bed wetter. These include babysitters,relatives,friends of the parents, and other people along these lines. Many children who wet the bed and have to wear diapers for the problem dread when their parents go out for the evening. If the parents have a good relationship with the caretakers and they feel comfortable discussing the issue of the bed-wetting and diaper use with them and they feel the caretakers will be understanding about it,this shouldn't be a concern. If however they don't feel comfortable discussing this issue with the babysitter or other caretakers and the parents feel they won't be understanding about it,then it's advisable to make sure the protective garments are laundered(if the parents are using garments such as cloth diapers and plastic pants) and made available to the child beforehand;that way if the child wakes up wet in the middle of the night and has to change,he or she can be discreet about it.
If the parents are considering hiring a nanny to take care of their child or children and one of them has to wear diapers for a bed-wetting problem,the parents might want to discuss this with the agency and perhaps during the interview with the nanny also. Most nannies have dealt with these types of problems in the past therefore they should be very professional regarding this issue. The second point has to do with spending the night at other peoples houses(such as a friend's house) and going away to camp. Again if the parents have a good relationship with the parents of the friend and feel comfortable discussing this problem with them this shouldn't be a concern. There might be a place that the child can use to change into their garments before going to bed and after waking up in the morning.
As far as camps are concerned there are a couple of programs geared toward individuals that suffer from nocturnal enuresis and other incontinence related issues. One of them is called Camp Brandon for Boys in New York state,the other is Camp Kirk in Canada. There might be other camps out there of a similar nature. In order to find out you can do a Google search. You can try using the following key words-(or key words of a similar nature) " camps with programs for disabled/special needs youth" or " camps with programs for bed wetters." The contact information for Camp Brandon for Boys is-14 Jerry Drive, Plattsburgh, NY 12901,Phone:(518)570-5184. The contact info for Camp Kirk is 1083 Portage Rd., Kirkfield, Ontario KOM 2BO. Phone:(705)438-1353.They also have an off season address and phone number- 115 Howden Rd.,Scarborough,Ontario M1R 3C7. Phone: (416)782-3310 These might not be an option for many people so in this case the parents need to talk to the head of the camp program and find out what types of provisions are available for youth that wet the bed. For example if the parents use diapers and plastic pants for their bed wetter are there facilities available to wash the diapers and plastic pants?
In terms of the youngster staying away from home there is one other scenario that I'd like to discuss and that's concerning boarding school. The advice I gave for parents sending their child to camp applies here also-the parents need to talk someone at the school beforehand and ask them what type of provisions are available for the bed wetter.
Colin Ellison
