How to Use Incontinence Pads, Pull-Up Underwear and Bed Pads: A Step-by-Step Guide

Most incontinence "product failures" aren't product failures. They're sizing errors, wrong-product-for-the-situation errors, or technique errors — all fixable in an afternoon. This guide walks through each product type, when to use it, and how to use it properly.

First: which product, when?

Situation	Product	Why
Mobile, self-toileting, light to moderate leakage, daytime	Pull-up underwear	Goes on like normal underwear. Preserves independence and dignity.
Overnight, or heavier needs, or assisted changes	Overnight briefs with soft lining	Higher capacity; tabs allow changing without standing.
Any night-time use, or extended bed rest	Quilted bed pads (as a second layer)	Turns a full linen change into a 60-second fix.

The most common mistake: moving someone into a tab-style brief because it's more convenient for the caregiver, when they could still manage a pull-up. This discourages toileting, damages confidence, and often accelerates functional decline. Keep someone in the least restrictive product they can manage for as long as they can manage it.

Sizing: get this right and most problems disappear

Measure the hips and waist. Do not size by weight alone. Weight charts are a rough starting point; two people at the same weight can be two sizes apart depending on body shape.

If they're between sizes, go down, not up. This is counter-intuitive and it's the single most valuable thing in this guide. Absorbency lives in the core, but containment lives in the leg cuffs. An oversized product cannot form a seal at the legs, so fluid escapes before the core ever absorbs it. Oversizing causes more leaks than under-absorbency does.

Re-measure after any weight change of about 5kg or more, in either direction.

Pull-up underwear: how to use it

1. Putting it on: step in one leg at a time, exactly like underwear, and pull up to sit at the natural waist — not low on the hips. A low-sitting pull-up leaves the back coverage too low and leaks when seated.
2. Check the leg cuffs. Run a finger around each leg opening to make sure the elastic gathers are turned out, not tucked in. Tucked-in cuffs are the number one cause of leaks in pull-ups, and it takes two seconds to check.
3. Smooth out bunching at the front and back. Folds channel fluid sideways.
4. Change every 3–4 hours during the day, or sooner if wet. Don't wait for saturation — skin damage begins well before the product reaches capacity.
5. Taking it off: most pull-ups have tear-away side seams. Tear the sides rather than pulling it down over the legs — far cleaner, especially with soiling.

For independence: if the person is managing their own changes, keep a supply somewhere private and easy to reach, with a lined bin nearby. Not having to ask is a large part of maintaining dignity.

Overnight briefs: changing someone in bed

Set up before you start. Have everything within reach: clean brief, pH-balanced cleanser or wipes, barrier cream, gloves, a disposal bag, and a fresh bed pad.

1. Explain what you're doing, every time, even if you're not sure they understand. This is the difference between care and something being done to a person.
2. Put on gloves.
3. Undo the tabs and fold the front of the brief down and under, soiled side inward.
4. Clean front to back — always, and especially for women, to reduce urinary tract infection risk. Use a pH-balanced cleanser or wipes rather than soap and water; soap strips the skin's protective acid mantle and makes irritation more likely.
5. Roll them toward you onto their side, supporting the shoulder and hip. Roll the used brief up and remove it. Clean the back thoroughly.
6. Check the skin while you have access — look at the tailbone, hips and buttocks for redness that doesn't fade when you press it. Persistent non-blanching redness is an early pressure injury and needs a clinician, not a wait-and-see.
7. Pat dry. Do not rub — older skin is thin and tears easily. Dry completely, especially in skin folds.
8. Apply barrier cream or film to the areas that contact the product.
9. Position the clean brief: with them still on their side, place the back half under them and tuck the near edge underneath. Roll them back over it, then bring the front up between the legs.
10. Fasten the tabs: bottom tabs first, angled slightly upward; top tabs second, angled slightly downward. This is what creates the seal. Snug, not tight — you should fit two fingers under the waistband.
11. Turn the leg cuffs out with a finger around each leg opening. Again: tucked-in cuffs leak.
12. Gloves off, bag the waste, wash your hands.

Quilted bed pads: the layer most people skip

A bed pad sits on top of the fitted sheet, under the person, covering hip to mid-thigh — the area where leaks actually land. They matter for two reasons:

• Time. A minor overnight leak with a bed pad in place is a 60-second swap. Without one it's a full strip-and-remake at 3am, with the person moved out of bed, awake, and cold.
• Sleep. Disrupted sleep worsens confusion, mood and fall risk. Anything that lets a leak be handled with minimal disturbance is doing real clinical work.

Using them properly: quilted side up, absorbent side toward the person, waterproof backing down. Tuck the sides under the mattress if the design allows, so it doesn't shift during the night. Smooth out wrinkles — a fold under someone who can't reposition themselves is a pressure point.

What not to do

• Never stack two briefs. The outer product's waterproof backsheet blocks the inner one from breathing, trapping heat and moisture against skin — the exact conditions that cause dermatitis. If one correctly-sized product isn't lasting the night, you need a higher-absorbency product, not two.
• Don't use a brief as a bed pad substitute, or vice versa. They're engineered differently.
• Don't restrict fluids to reduce accidents. This is intuitive and it's harmful. Concentrated urine irritates the bladder and makes urgency worse, and dehydration in older adults causes confusion, constipation, urinary tract infections and falls. Unless a clinician has specifically instructed fluid restriction, keep fluids normal and adjust timing instead — most fluid earlier in the day, less in the two hours before bed.
• Don't skip the barrier cream because the skin looks fine. It's preventive.
• Don't flush any of these products. Bag and bin.

The three-step skin routine

Every single change, no exceptions:

1. Clean — pH-balanced cleanser or wipe, front to back, gently.
2. Dry — pat, never rub. Completely, including skin folds.
3. Protect — barrier cream or film on all contact areas.

This routine is the difference between healthy skin and incontinence-associated dermatitis, which is painful, can progress to open wounds, and is far harder to treat than to prevent.

When to call a healthcare professional

• Redness that doesn't fade when pressed, or any broken skin
• Pain, burning, cloudy or strong-smelling urine, or new confusion — all possible signs of a urinary tract infection, which in older adults often presents as confusion rather than the classic symptoms
• A sudden change in continence — this is a symptom with a cause, and the cause is often treatable
• Blood in the urine or stool
• Leaks that continue after you've corrected sizing and technique

And the point worth repeating: incontinence is not an inevitable consequence of ageing. It's a symptom. Urinary tract infections, constipation, medication side effects, prostate conditions and pelvic floor weakness are all common, identifiable causes with real treatments. Products manage the situation — they shouldn't replace getting it assessed. Where pelvic floor weakness is the cause, targeted exercise, sometimes with a pelvic floor trainer, improves or resolves a great many cases.

Find the right products

Browse our Care Supplies range, or contact us if you'd like help working out sizing or which product fits your situation.

---

This guide is general information and isn't medical advice. Any new or changing continence symptom, skin damage, or suspected infection should be assessed by a GP, continence nurse or other qualified healthcare professional.