‘Ministers must recognise the vital role of school and public health nurses’

As a long-term user of nappies, Simon argues that continence services should be split into two services to be truly sensitive of individual needs

As someone with cerebral palsy, I use nappies as a precaution against accidents and dribbles rather than anything else.

I use the term “nappy” deliberately because it is the term I choose although I know it goes against what most healthcare professionals believe is acceptable, which is “pad”.

The reality is there is no definitive answer to which term is universally correct as different users will prefer different terms. The trick is knowing which term is more likely to be preferred before they are offended that you used the wrong term, and believe me, I do find the term pad slightly offensive.

”The trick is knowing which term is more likely to be preferred”

I would like to suggest that there are broadly two type of users who use continence products, particularly the nappy style all-in-one pad.

The first group is what health professionals may regard as the traditional users, who tend to be people who experience continence issues in later life, and certainly in their adulthood. The keyword for what they appear to desire is discretion, as the wearing of ”pads”, as nurses often whisper, will carry a stigma. They may be finding it hard to come to terms with their need for pads, and would be mortified at the idea members of the public noticing they are wearing pads, and would be deeply offended if they were called nappies.

”They may be finding it hard to come to terms with their need for pads”

Therefore, it is important for continence nurses to be compassionate and sensitive of these concerns.

The second and less traditional user group are people with lifelong conditions who may have worn nappies for all or some of their lives for functional purposes. Their continence issues may be a small part of a larger range of issues, and their public appearance may be already so different, that wearing nappies adds no additional stigma. If they have worn nappies as a baby, when they were five, and 15, why would they suddenly be wearing pads at 18? To them, a pad is something without tapes. Instead of discretion, they may be looking for absorbency and reliability, preferring a larger dry bottom to a slim-looking wet one.

Both groups are very different and therefore need services to respond to them differently.

”Providing the wrong approach to the wrong users could result in offence”

Providing the wrong approach to the wrong users could result in offence and upset in what is a very personal issue. I do not want or need a continence nurse to offer me sympathy for the fact I wear nappies, as they are just a part of life.

Ideally CCGs should explore splitting their continence service into two services.

The first service would be the assessment and advisory service needed by new users. The second would simply be a long term delivery service and could even be replaced by Personal Health Budgets, so people can purchase their own nappies as they wish, including using cloth ones, as well as accessories.

It doesn’t matter if you call them nappies or pads, but what does matter is that you understand and respect the choices made by users.

I have always liked the term nappy to pad

Nappy, pad and pull up calling them all the same thing is confusing

yes, nappies is the best description. Pad suggests something just for women ie menstruation.

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Northamptonshire Healthcare NHS Foundation Trust