A Program To Deal With Adult BedwettersThe Program
B.D. (Bed-Wetter Discipline) is a discipline regime whereby a chronic adult bed-wetter is returned to diapers using various techniques of humiliation, embarrassment, and creative shaming. It should be undertaken only after other methods have failed. It is assumed that medical treatment has proven unsuccessful.
Responsibility for managing the problem is taken over by caregivers or their designees in a manner that emphasizes practicality and convenience while ignoring the concerns of the bed-wetter. It is understood that a loss of independence, privacy and dignity is inevitable on the part of the bed-wetter, however the gains of the program more than justify these insignificant embarrassments.
Types of Diapers
Although disposable diapers may be considered more convenient, for the purposes of this program, cloth diapers and plastic pants are preferable for the following reasons:
1. They allow the bed-wetter to feel wetness after urination.
2. The bulk between the legs serves as a constant reminder to the bed-wetter that he is wearing diapers.
3. Cloth diapers necessitate the use of accessories such as diaper pins, plastic or rubber pants, baby powder, and diaper bags. For the purposes of humiliating the bed-wetter, the use of these items is more desirable. Extra diapers can be added to increase absorbency, prevent leaks, and to add bulkiness under outer clothing when out in public. In addition, cloth diapers can't easily be hidden under night clothing such as onesies or pajamas.
Adult-sized cloth diapers are available in several styles; a pre-fold pin-on type is recommended (about two dozen) along with cloth baby diapers for use as liners/inserts. Adult sized plastic or rubber pants are easily obtainable, both in snap-on and pull-on styles. They are available in plain white, semi-transparent, pastel or nursery prints. Nursery print plastic pants are highly recommended and readily available also. If pastel plastic pants are to be used, pink is the recommended color. Six to ten pairs of assorted plastic pants are recommended for the initial layette.
A multi-sensory experience for the bed-wetter is desirable and best served by wearing cloth diapers. Four of the five senses are acutely engaged in the process. They are:
1. Touch (bulk against the skin and a sense of wetness).
2. Sound (the crinkling of plastic or rubber pants when walking).
3. Sight (bulkiness, whether or not clothing is worn over the waterproof pants).
4. Smell (of plastic or rubber, baby powder, and a slight scent of urine eventually acquired by hand washed diapers).
Breaking the News
By the time the bed-wetting adult is informed of the decision to return him to diapers (we will refer to the male gender, as most bed-wetters are male), diapering supplies should already be on hand. They should include as a minimum, diapers, diaper pins, diaper bag, waterproof pants and baby powder. The bed-wetter"s bed should always be protected by a plastic sheet or rubber sheet. Allowing him to examine the products beforehand will reinforce the fact that the decision is firm and final; and while reasons can be discussed, it should be emphasized to the bed-wetter that the decision is final and not negotiable. Allowing the bed-wetter a few hours to contemplate the inevitable return to diapers may ease the transition, but that should be of no concern to the caregiver. If necessary, he should be informed that any resistance on his part will result in immediate punishment.
Reasons to wear diapers include:
1. To prevent wet beds and odor;
2. To improve sleep by eliminating the necessity to change sheets during the night;
3. To lessen disruption to the household;
4. To reduce the volume of laundry;
5. To emphasize practical consequences of bedwetting;
6. To supply incentive to attain dryness.
7. To remind the bed-wetter that he is acting like a big baby
The bed-wetter should be informed that he will be expected to cooperate in the following regime: At a specific time each evening, (7:00 pm recommended) he will make himself available in his room (or other designated area) for diapering. It will be emphasized that there are absolutely no exceptions to this regimen; not even when visitors are present. Consistency is crucial.
It will be explained that others will be in control of the adult bed-wetter until he is ready to control urination by himself. This may include wives, girlfriends, adult babysitters, co-workers or any other designees.
Management and Punishment
It will be explained to the bed-wetter that being returned to diapers is an enuresis management strategy, and that management options may include punishment at the discretion and convenience of the caregiver.
While basic supplies will consist of the items mentioned above, other useful additions will include a changing pad, a diaper pail, diaper rash ointment, and baby wipes. Ideally, the bed-wetter's equipment will include a changing table. A six-foot long folding worktable is ideal for this purpose, and can be fitted with a blanket and changing pad. A shelf can easily be added between the table legs, and can be used to hold diapers and other supplies. If discretion is desired, a blanket can conceal the diapering supplies; however, it is recommended that they remain in plain sight.
The bed-wetter's diapers should be straightforwardly referred to as such, and other equipment should be referred to by name, i.e. changing table, diaper pail, diaper pins etc. It is permissible to refer to his plastic or rubber pants as 'baby pants or baby panties' because of the wide use of the term in the vernacular.
At the appointed time, the bed-wetter will position himself upon the changing table. At this point he will be wearing just a Tee-shirt. A diaper will have been prepared by combining an adult diaper and one or more folded cloth baby diapers as inserts. The diaper will be powdered, and slipped under the adult's backside. Powder will be applied to his frontal diaper area, and then the diaper will be raised between his legs and tightly secured back to front with diaper pins. His plastic pants will then be slid down his legs with one hand, while holding both his ankles with the other hand. He will then be free to remove himself from the changing table and rejoin the others in the household. If pajamas or track pants are permitted he can then put them on, although it is recommended that his diapers and baby pants remain uncovered.
Disciplinary authority can be accorded to each caregiver, or they can report to a central figure.
The diapered adult will be expected to carry on as normally as possible prior to bedtime. He will not be allowed to 'hide', but might be asked to do chores such as hand-laundering diapers, hanging diapers and plastic pants on a clothesline, rinsing his diaper pail, etc. He will be expected to answer any questions posed by visitors in a truthful and straightforward manner. For example, "I'm wearing diapers because I wet the bed".
There is bound to be some teasing on the part of visitors or their friends. This is inevitable and minor teasing will serve as motivation to become dry.
Once diapered, the bed-wetter needs to be supervised by the caregiver or another adult. It is permissible, in some instances, to ask friends to undertake this task, or even someone unknown to the diapered adult, as long as professionalism is involved. Disciplinary authority is to be in accordance with the guidelines listed above under 'Discipline'.
Even before being returned to diapers, the bed-wetter must understand that his cooperation is required and expected, and that failure on his part to submit to the process will bring severe punishment followed by forced compliance. Punishments may consist of anything from loss of privileges, to spankings. Most caregivers who have had to resort to spankings for non-compliance have not had to repeat the punishment. The adult bed-wetter quickly learns that he is in a no-win situation. He will be spanked and diapered regardless who is present. Severe sanctions should be reserved for only the most serious infractions, i.e, non-cooperation in the diapering process, and unauthorized removal of diapers.
Frequency of Wetting
While each case is different, studies have shown that once returned to diapers, the average bed-wetter will initially wet more often. Usually twice weekly wet beds might translate to five or even seven nights of wet diapers. The phenomenon is not completely understood (perhaps shame, perhaps security), but it is known that after approximately three months, the dryness achievement rate approaches that of untreated bed-wetters, then quickly overtakes it. About 80% of adults in the B.D. (Bed-Wetter Discipline) program achieve dryness within six months. The program may suspended when an adult has been dry for thirty consecutive nights, however, some caregivers prefer to extend the program depending on the situation. It must be remembered that this program is a zero tolerance program. Any recurrence of bedwetting will require that the adult bed-wetter re-enter the program. Some adult bed-wetters never achieve dryness. If bed-wetting continues beyond six months, then the bed-wetter is to be removed from the B.D. program (Bed-wetter Discipline) and entered into the more advanced B.H. program (Bed-wetter Humiliation). Among other things, this will result in the bed-wetter being diapered 24/7.