Just when the shopping trip is going so well, when the food finally arrives at the fancy restaurant, or just when the movie gets good-oops-incontinence strikes. Appropriate planning can make the difference between the lousy timing and a ruined outing.

Tip 1: Let’s start with clothing. Loose, big clothes are usually easier to manage. A mini or maxi-pad can offer some extra insurance. For long trips, boys can use a condom catheter (non-invasive) and a leg bag. Chucks or waterproof padding can be placed in car seats, wheelchairs, strollers, etc. for an extra moisture barrier.

One thing we ALWAYS have with us is a change of clothes (disposable underpants, pants, shirts,socks), wet wipes and plastic bags. We’ve thrown lots of under garments away just because it is not worth trying to rinse them out. Toss them in the plastic bag and throw it away! We try to always be prepared, but it doesn’t always happen at the most opportune time. Jared weighs about 80 pounds and I have had to carry him many times to race to the bathroom. He is 100% urine trained (took 8 years to get there, but we made it!). We are still working on BM and he is trying. We are certain that he does not feel it until it is already starting to come and by the time he tells us, it’s too late. He struggles with constipation, so he only goes about every three days. We do what we have to do and in the time we have to do it.
–W. A. Goss, New Jersey

Tip 2: Teach your child (even if he or she is an adult) to stand while their disposable underpants are being changed. This makes the whole process much easier and cleaner.

As far as changing or cleaning him up when we’re out is concerned, I usually just go into a handicap accessible stall. Jacob can stand fairly well but can’t balance. We do what we can from his chair then stand him up for the rest. I carry diaper wipes to clean him off. They work better than toilet paper. Last time, I made the mistake of buying scented wipes (and of course bought the jumbo pack). My poor ten-year-old Jacob smelled like baby powder after a clean up.
Even though Jacob urinates in the toilet fairly consistently, when we’re out, I still put pull-ups (GoodNites) on him. Even if he were to tell us, we cannot be guaranteed that there are facilities close enough for him to make it in time for me to get him out of his chair and get his pants down.
We’ve gotten pretty complacent about bringing extra clothing when we are out with Jacob. He rarely has accidents anymore, but with his skinny legs, occasionally something will leak out of his diapers. Just recently, we were in the park, when I noticed a dark stain on Jacob’s tan pants. Luckily, my daughters had been to a sleepover and their clothes were still in the van. I threw a pair of jeans on Jacob. When he’s sitting in his chair, you couldn’t notice the ‘feminine’ cut, to the jeans. I have no idea what we would have done if we didn’t have these jeans in the car. I will now, always pack a bag of spare clothing to keep in the van.
Julie, mom to 4 children, Chicago, IL

Tip 3: Animal products and products like supplemental shakes can increase the strong odor of bowel movements. A high fiber diet will decrease constipation and increase ease of elimination and even decrease odors. If your child’s urine is dark in color or smells strongly, talk to your physician and consider increasing your child’s water intake. Many medications are hard on the kidneys and therefore, make adequate hydration even more important.

We recently packed up the kids and went to the malls for some after-holiday shopping (the nearest mall is 45 minutes from us as we live in the ‘country’). We shopped one mall, then drove to the other. When we arrived at the second mall, poor Justin’s pants were soaked down to his feet. We aren’t used to carrying extra clothes for Justin anymore, but luckily I had his disposable underpants in the baby’s diaper bag. We quickly ran into a store, grabbed him some new clothes and changed him in the large accessible (with a full bench) dressing room. He got a quick baby-wipe body clean up, a new set of duds and off we went. I clipped the tags off the new clothes, brought them to the register and explained what happened. The sales person was very nice about it.
–Patti, mom to Justin, athetoid CP, dystonia & Sydney Nicole, Albany, NY

Tip 4: Overall, potty training is always a good place to revisit every few years. Just because your child was unsuccessful at age four or six, doesn’t mean he or she can’t learn when older (12, 18, even 30!). Try making a communication system like a photo of your potty that your child can wear on a key ring or a pull ring. By wearing this symbol on his or her belt, even a person who is non-verbal can communicate the need to use the potty. Have your child sit on the potty every hour for 1-3 minutes.

IDEAS FOR TRAVELING SMART
1. Get the most use out of your equipment: buy a stroller/wheelchair that reclines to the flat (horizontal) position to allow for diaper changes in the chair.
2. Use aids for standing: Knee immobilizers, used to keep the knees straight, are relatively lightweight and inexpensive (approximately $30) and can help your child stand in order to transfer to the toilet and clean off afterward.
3. Make clothing accessible: Sweat pants that snap up the side make changing easier for bigger kids and adults.
4. Get good coverage: A seat cushion with a removable and washable cover allows for full, sanitary cleanups.
5. Don’t overtax the system: Avoid bladder and bowel irritants like caffeine.

MUST-HAVES for Avoiding “accident”-al Detours When Traveling:
Spare Underwear;
Spare pants and shirt (baggy and loose);
Chucks;
Wipes;
Air freshener;
A large colorful scarf to cover your child while you find a place to change or to use as a “tent” while he or she is changed underneath;
Four large zip-lock baggies.

If we are traveling in my small car, I tilt the passenger seat all the way back so it’s almost lying down and change my son while I stand outside leaning over the car. I also carry a complete change of clothes (shoes too) for him and at times, for myself as well. I carry empty baggies of various sizes to store soiled clothes; plastic, grocery-store bags work well. Just tie them at the top until you can get home.
–J.M., Irvine, CA

Dealing with incontinence is challenging but doesn’t have to consume all your resources. Medicaid, state health insurance programs (such as Title V Children with Special Healthcare Needs Programs) or your private health insurance carrier may cover the cost of disposable underpants or diapers after the age of three. Check with your state’s Medicaid system, state program or private health insurance provider. Anyone caring for a child or youth with special needs can contact the national non-profit group Family Voices [phone: (888) 835-5669 or on the Web at http://www.familyvoices.org ] to get further information and assistance on coverage for incontinence products.

A few simple modifications such as those mentioned here can make a big difference in your travel plans. Don’t let incontinence be a speed bump in life!

by Ginny Paleg, PT and Elaine Meadows, PT
at http://www.goodnites.com/sn