Incontinence Care in LTC: Product Selection by Care Level

Walk any LTC unit and you will see the same mistake: one brief for everyone. Incontinence care in long-term care works better when products are matched to care level, because a resident who walks to the bathroom has different needs than one who is turned in bed every two hours. This guide splits your population into three levels and maps each to a product form, an absorbency, and the workload math.

The three levels below are a starting point, not a diagnosis. Run them past your director of care and skin-care lead, adjust the boundaries to your population, and you have a selection table that survives contact with the floor.

Which Product Suits Which Care Level?

The table maps each care level to an absorbency and a product form; the sections below explain the reasoning, the sizing and the workload behind each row.

What Does a Level 1 Resident Need?

These residents manage most trips themselves and only need backup. A lighter brief around 3,000 ml is usually enough. The Day Comfort 3,000 ml brief fits this group: absorbent enough for the gap between trips, easy to change, and quiet under clothing, so residents do not fight it.

Form matters as much as absorbency. Residents who transfer independently often do better with a pull-up style that fits the bathroom routine; those who need help standing are easier to manage with a tape brief with refastenable sides. Keep sizing honest — too small leaks, too large bunches and rubs.

Caregiver workload stays low here. Changes are mostly self-managed; staff step in only when mobility drops or output picks up. If staff are changing Level 1 residents more than twice a day, the care plan — not the product — has drifted.

What Does a Level 2 Resident Need?

This is your biggest group in most homes. Residents need staff help with transfers and changes, and output can be heavy. A 4,000 ml brief with a wetness indicator is the practical pick: the indicator lets staff change on need instead of on the clock, which trims both workload and skin exposure. The Day Pro 4,000 ml brief is built for exactly this segment, and the stripe pays for itself in fewer checks.

Plan for four to five changes per day here. Every change involves a transfer, so product choice directly shapes staff backs and shift time. A brief that holds reliably for four hours means fewer mid-shift surprises.

Watch sizing in this group: assisted populations drift toward Large as mobility drops, and the drift is not linear. A surplus of Medium with a shortage of Large means the census changed before the order did.

What Does a Level 3 Resident Need?

Residents who are turned and changed in bed need maximum absorbency and containment. A 5,000 ml overnight brief, paired with a barrier underpad, is the standard setup. The Night Plus 5,000 ml overnight brief holds through eight hours, which matters when staffing is thinnest. A leak here is not just laundry; it is skin breakdown, extra linen changes, and a longer care task at 2 a.m.

Change at every turn cycle; do not stretch intervals to save a brief. The savings show up later as pressure injuries and treatment costs that dwarf it.

Positioning matters too: with the resident on their side, the brief fits flatter and the leg cuffs seal better. Log change times — the pattern tells you whether the product is holding or the schedule is guessing.

How Does Skin Care Pair With Product Selection?

No brief fixes skin that stays wet. Clean, dry, and protected is the sequence: cleanse at each change, pat dry, apply barrier where the care plan calls for it, then fit the correct absorbency. The Canadian Continence Foundation (CCI) publishes practical guidance on continence care aligned with what most provincial inspection frameworks expect. The right product shortens moisture contact time; the right routine prevents the damage in the first place.

Tie product choice to your skin-care rounds: if redness shows up on the same shift consistently, check fit and change interval before blaming the cream. Incontinence-associated dermatitis is largely preventable, and prevention is cheaper than treatment.

When Should You Revisit the Product Mix?

Reassess every quarter and whenever a unit's acuity changes. If Level 2 grows, your Day Pro allocation should grow with it. Adult briefs by care level are not a one-time decision; they are a living ratio. Keep the three tiers stocked, keep indicators visible to staff, and let care level drive the order rather than habit.

Build the review into a meeting you already hold. Fifteen minutes at the monthly care conference, with the storeroom log on the table, catches drift early. When a resident's level changes, update the product assignment the same week, not at the next order.

Related reading: explore our long-term care and home care resources.

start with our underpad buying guide for absorbency, sizing and cost.

Frequently Asked Questions

Which brief absorbency suits a Level 2 assisted resident?

Level 2 residents are typically mobile with assistance and need a product changed four to six times a day. A daytime brief rated around 3,000 mL handles scheduled changes, while a 5,000 mL overnight brief covers a single change through the night. Sizing matters as much as absorbency: a brief that gaps at the leg cuff leaks regardless of capacity, so keep two sizes in the formulary and fit to hip measurement rather than to weight.

How many changes per day should a care home plan for?

Planning figures in Canadian homes usually run four to eight absorbent products per resident per day, and most operators budget on six changes. The number moves with care level: an independent resident may need two daytime products, while a bedridden resident can need eight to ten changes across a 24-hour period once bed protection is counted. Build the par level on the change count, then convert it to case quantity.

Do Level 3 bedridden residents need underpads as well as briefs?

Yes. A bedridden resident is turned on a schedule, and each repositioning can disturb the brief, so a 60 x 90 cm underpad with a five-layer SAP core is used as bed protection beneath it. Two or three pads a day is a common planning figure for heavy-output residents. Underpads are replaced when soiled rather than on a fixed clock, so count them as a separate line.

How often should the product mix be reviewed?

Review the mix whenever the census changes by roughly ten per cent, or when the care-level split shifts by more than two residents. A home that moves from mostly Level 1 to mostly Level 2 will under-order 3,000 mL briefs and over-order lightweight products within one ordering cycle. A quarterly review against actual usage is the practical cadence, with an interim check after any admission wave.

Does skin care change with care level?

It does. Level 2 and Level 3 residents need a barrier cream or film at each change where skin is exposed to urine or stool, and the brief material matters too: a breathable back sheet reduces moisture build-up. Where skin is already broken, the mix should move to a softer, less occlusive option while the skin recovers, even if that means a lower absorbency rating for a short period.

CliniEco Medical is a licensed medical device establishment (MDEL #35334).

Related reading

• long-term care supplies
• open a wholesale account for institutional pricing