Summary: If you’re helping someone change an adult incontinence pad in bed, it’s natural to feel unsure at first. Prepare what you need, protect their privacy, clean and dry the skin gently, and fit the pad according to its instructions. Any help with turning must follow the person’s individual moving-and-handling plan.
Watch Jo Cleary demonstrate continence care in bed. Follow the person’s individual care and moving-and-handling plan. Watch the video on YouTube.
Supporting a parent or partner with intimate care can take some getting used to. You might worry about hurting them or making them feel embarrassed. This guide brings together the practical steps and the small things that help someone feel listened to and respected.
Before changing an incontinence pad: what to prepare
Explain what you’re going to do, ask for the person’s agreement and find out how they’d like you to help. Give them time to do anything they can comfortably manage themselves. If they’re distressed or ask you to stop, pause and talk with them about what would help.
Make sure the room is warm, close the door or curtains for privacy and have a towel or sheet ready to keep them covered. The NHS advice on helping someone keep clean has more on respecting preferences and independence during personal care.
Gather everything in this checklist before you start so you can stay with the person throughout the change.
Have everything ready so the person can stay comfortable and covered.
Wash your hands before starting. Use disposable gloves for contact with urine or bowel motions, and an apron where needed, following the person’s care plan. Gloves don’t replace handwashing.
If the person cannot turn safely, has painful joints, pressure damage or medical equipment, or needs two people to help them move, get individual advice before attempting a bed change. Ask their care team or local council about an Occupational Therapist’s assessment. The NHS guidance on moving and handling someone safely explains how to get training and equipment advice.
How to change an adult incontinence pad in bed
The general routine is to remove the used pad, clean and dry the skin, fit a fresh pad and check the person’s comfort. The steps below describe a pad with fastenings. Other products, including pull-up pants and shaped pads, have different fitting instructions.
Jo Cleary’s video above provides a demonstration, but it doesn’t replace an assessment of the person you’re supporting. Before starting, make sure you know how any turning will be managed and who needs to help.
1. Remove the used incontinence pad
Explain each step as you go and only uncover the area you’re working on. Undo the fastenings and, as the pad is removed, fold the used side inwards to contain soiling.
If turning is needed, follow the person’s agreed moving-and-handling plan with the assessed equipment and number of helpers. Don’t pull them by their arms or improvise a turning technique. If you’re unsure, stop and ask their care team for guidance.
2. Clean and dry the skin gently
Follow the person’s skin-care plan, using suitable wipes or a gentle cleanser. Clean from front to back, keeping bowel soiling away from the genital area, then pat dry rather than rubbing. This continence pad fitting guide from NHS Supply Chain (PDF) also covers cleaning direction and disposal.
Check for soreness or broken skin. Before handling the clean pad, remove used gloves, wash your hands and put on a fresh pair as needed. Follow the care plan for any recommended skin protection.
3. Fit the clean incontinence pad
Check the size and absorbency, then follow the manufacturer’s instructions to position and fasten the pad. Any further turning must follow the same individual moving-and-handling plan.
Check for folds, gaps around the legs and fastenings that dig in. The pad should sit securely and comfortably. Ask the person how it feels rather than relying on appearance alone.
4. Settle the person and dispose of the used pad
Help with clothing, replace any dirty bedding and make sure the person is comfortable in their agreed position. Keep anything they need within reach.
Bag the used pad and dispose of it through the appropriate waste arrangements. Never flush pads or wipes. Remove protective equipment and wash your hands with soap and water when you’re finished.
How to clean the skin and reduce soreness
Skin that’s left damp for a long time can become fragile and sore. Gentle cleansing, careful drying and suitable skin protection can help. Avoid harsh soaps and scrubbing, and follow any advice about caring for skin folds.
If a barrier cream or film has been recommended, use it as directed. Check with a Nurse, Pharmacist or continence professional before introducing a new product, as some creams can affect pad absorbency.
What skin changes should you look out for during a pad change?
Look for changes each time you help with a pad change, including:
- Persistent red, darker or discoloured patches
- Soreness, burning or tenderness
- Cracks, blisters, weeping or broken skin
- Changes in warmth or texture, especially where colour changes are harder to see
Ask the person’s GP or District Nurse to assess new or persistent changes. Don’t assume every sore area is caused by moisture. These guides explain skin damage from moisture and pressure sore symptoms and when to get medical help.
Choosing the right incontinence pad size and absorbency
Size and absorbency are different. A bigger pad doesn’t automatically hold more urine, and a poor fit can cause leaks or discomfort. Check the manufacturer’s measurements and fitting instructions, as products vary.
If you’re regularly changing wet clothes or bedding, check:
- Size and fit: Are there gaps, folds or tight areas?
- Absorbency: Does the product suit the person’s assessed needs?
- Product style: Is it practical for their movement and the help they need?
- Skin products: Could an unsuitable cream be affecting absorption?
A continence professional can help review ongoing leaks. Mersey Care NHS advice on fitting continence products explains why fit and compatible skin products matter. The NHS guide to incontinence products outlines the options and how to ask about your local continence service.
How often should an incontinence pad be changed?
Follow the person’s individual care plan and the product’s instructions, including its wetness indicator if it has one. Change a pad immediately after bowel soiling. Don’t leave someone in a leaking pad or with damp, uncomfortable skin while waiting for a set time.
There isn’t one changing schedule that suits everyone. This NHS protocol for continence pad care (PDF) gives examples of product-specific wetness indicators and when to seek advice. Ask for a review if the current routine isn’t keeping the person comfortable.
Common mistakes when changing an incontinence pad
These reminders bring together the main points for a more comfortable, respectful change.
A few small changes can make the experience more comfortable and respectful.
When to ask for professional continence care support
If someone has started having accidents, needs increasingly frequent changes or has ongoing leaks, speak to their GP or local NHS continence service. Pads help manage leakage, but they don’t replace an assessment of its cause or a discussion about treatment.
Get advice about pain, sore or damaged skin, or difficulty moving in bed. A Nurse, Occupational Therapist or appropriately trained care team can help adapt the person’s care plan. If there are signs of a pressure sore with hot or swollen skin, pus, a high temperature, or severe or worsening pain, ask for an urgent GP appointment or contact NHS 111.
If bowel leakage is also an issue, NICE guidance on faecal incontinence in adults recommends individual assessment and advice on products, cleansing and skin protection.
Getting help with continence care at home
Helping someone with intimate care can become harder as their needs change. That might mean arranging a visit for a particular routine or reviewing the support already in place.
You don’t have to work everything out at once. The aim is a routine that feels manageable for you and helps the person you’re caring for stay comfortable, involved and respected.
If you’re finding it difficult to manage a loved one’s personal care, we’re here to help you explore your options. Our Caregivers can support with everyday routines, including washing, dressing and continence care, while helping your loved one feel comfortable and respected at home.
You can also read more about our continence care at home and personal care support.
External references
- NHS: Incontinence products
- Bradford District Care NHS: Skin damage from moisture
- NICE: Faecal incontinence in adults, recommendations
- Mersey Care NHS: Continence product care and fitting
- NHS: How to help someone you care for keep clean
- NHS: Moving, lifting and handling someone else
- Tees, Esk and Wear Valleys NHS: Adult incontinence care advice and support protocol (PDF)
- NHS: Pressure ulcers (pressure sores)
- NHS Supply Chain: Continence pad fitting guide (PDF)
Unique Senior Care is a regulated provider of live-in and visiting care. This general guide does not replace an individual continence, skin-care or moving-and-handling assessment.
Jo joined Unique Senior Care as a Carer in 2011, transitioning from a nursing background. With 25 years of experience in health and social care, including mental health and children with disabilities, Jo has embraced numerous growth opportunities within the company.
Passionate about learning and development, Jo earned a Level 5 Diploma in this field and is committed to equipping teams with the skills needed for outstanding care.
Jo’s qualifications include advanced training in people handling, risk assessment, safeguarding, basic life support, first aid, health and safety, and dementia care. Jo has also completed numerous workshops and CPD courses, such as the SCIE’s Co-Production webinar.
These accomplishments reflect Jo’s dedication to fostering a culture of safety and excellence in care.