Single Caregiver Method to Donning Adult Disposable Briefs for Dependent Patients Out of Bed

There are 2 main type of adult disposable briefs, each with their advantages and disadvantages. Patients would usually purchase the pull-up kind that resembles regular underwear and not have to manage adhesive sticky tabs on the sides/wings. In the hospital, you would often encounter the “diaper” style that does have the sticky tabs. I have come to appreciate the “diaper” style because of its versatility in fit, adjustment, and ease of donning and doffing. You’re probably thinking, ease of donning? Yeah right. Keep reading to see why.

When the patient is able to assist somewhat, the underwear “Depend” style briefs are often easier both for the patient and you, the caregiver. Just like pants, they just need to be pulled up over the bottom.

The downside to this style is:

  • They have to be a near-perfect fit (or they would fall off when standing and walking.)
  • They require ripping or cutting if unable to doff past the thighs.
  • When seated and the patient is dependent level, they are difficult to don and require weight shifting and ultimately are unable to be completely donned past the posterior bottom without a depression lift from the armrests.

If your patients wear “diaper” style adult disposable briefs that have side adhesives, this has the advantage of:

  • Size not having to be perfect because the wings can spread out and adhesives can be adjusted to size. Of course, too small of size would not accommodate a larger sized patient, but a larger sized adhesive-style brief could accommodate a smaller sized patient.
  • Easy to doff one side at a time by pulling off the adhesive without the need to tear or cut the brief off.

The major challenge of adhesive-style briefs is donning them in general, and especially for more dependent level patients.

My normal procedure for patients while seated would be to:

  1. Open the side wing flaps to allow for extended size.
  2. Eyeball the size of the brief and place one of the two sticky tabs from each side slightly larger than it needs to be.
  3. Assist the patient in threading each leg through the holes.
  4. Pulling the briefs up to the knees.
  5. Assist the patient in standing.
  6. With one free hand, pull one side over the bottom.
  7. Switch and use the other free hand to pull up the remaining side over the bottom.
  8. Readjust the adhesives to tighten them and allow them to stay on (either while patient is standing or after they are seated).

Of course, this method assumes you feel safe enough to free one hand to assist the patient. If the patient has poor standing balance and requires both of your arms for assistance, you would normally need a 2nd caregiver to assist with pull-up.

So what is the lifehack that allows a single caregiver to don “diaper” style hospital adult disposable briefs instead of at bed level?

  1. Grab one size larger adhesive-style briefs, e.g. XL extra-large.
  2. Spread all the wings fully.
  3. Lay it out on the wheelchair or chair so that when a patient transfers there, they would be sitting on the disposable brief the way they would be wearing it.
  4. Tuck the side wings for the backside behind each armrest (using the armrest to hold the wing in place and prevent shifting).
  5. Transfer the patient onto the brief that is on the wheelchair/chair.
  6. Pull the side of the pad and the side wings over the front genitalia.
  7. Assist the patient in weight shifting to allow you room to reach the wings from each side (left & right) and stick on the adhesives.

I have used this method consistently and been able to do this myself, especially in a wheelchair with some planning ahead.

Some issues you may encounter:

  • If a patient does a poor transfer onto the wheelchair/chair, they may shift the brief out of place and wrinkle it.
  • You may not be able to find or reach a portion of the brief after the patient has transferred onto it. Try using the largest size available so that the “wings” protrude further out to the sides.
  • Have the patient perform weight shifts to the left/right/anterior so that you can find the brief.
  • You can try removing armrests to allow easier access to the brief.

I like this method because it allows me to don adhesive style adult briefs without extra help. It saves me the time of finding an extra caregiver. This may be helpful for you if you do not have the option of help from a 2nd caregiver.