Caring for your skin when living with incontinence

Anyone who lives with incontinence knows that leakage isn't just embarrassing or uncomfortable - it can create skin issues that range from simply irritating to genuinely endangering. Today's guest is Kolo Wilkinson, Clinical Nurse Lead with Tranquility Incontinence Products, and she shares with us advice and insight on how to best care for your skin, how to choose the most effective products and much, much more. 

To learn more about incontinence-related skin care, download Tranquility’s FREE eBook, “Save Your Skin: Superabsorbent Solutions for Managing & Preventing Incontinence-Related Skin Issues.” https://tranquilityproducts.com/incontinence-basics-ebook/

To learn about Tranquility Incontinence Products and their range of incontinence products, visit them at https://tranquilityproducts.com/.

For more information about the National Association for Continence, click here, and be sure to follow us on Facebook, Instagram, Twitter and Pinterest.

Music:
Rainbows Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0 License
http://creativecommons.org/licenses/by/3.0/

For over 35 years, Tranquility Products has provided real-life protection for people with incontinence. Choose from disposable briefs, pull-on underwear, booster pads and more, in a wide range of sizes from youth to 5XL.  Go to TranquilityProducts.com and click “Free Samples” or call us at 1-866-865-6101... We’re here to help! 

Transcript

The following transcript was generated electronically. Please let us know if you see any transcribing errors and we'll get them corrected immediately. 

Bruce Kassover: Welcome to Life Without Leaks, a podcast by the National Association for Continence. NAFC is America's leading advocate for people with bladder and bowel conditions, with resources, connections to doctors, and a welcoming community of patients, physicians, and caregivers, all available at NAFC.org. 

Welcome back to another episode of Life Without Leaks. I'm your host, Bruce Kassover, and joining us as always is Sarah Jenkins, the Executive Director for the National Association for Continence. Welcome, Sarah. 

Sarah Jenkins: Hi, Bruce. It's great to be here. 

Bruce Kassover: Thanks, Sarah. Yeah, today is going to be a good one because joining us today is Kolo Wilkinson. She is a clinical nurse lead with Tranquility Incontinence products and a board-certified nurse in medical surgical nursing. She's been in healthcare for more than 15 years, she has a bachelor's degree in respiratory therapy in nursing, a master's degree in healthcare leadership, and today she's going to be talking with us about something that's really particularly important and doesn't get enough coverage, and that's about skincare issues associated with incontinence. So, thank you for joining us and welcome to the podcast. 

Kolo Wilkinson: Hey Bruce. Thank you so much for inviting me to be here, Sarah as well. And I'm really, it's an honor to be here today and I am, I'm excited about this conversation we're going to have. It's something I'm very passionate about. 

Bruce Kassover: So tell me, it sounds like you have a really significant background in a lot of aspects of healthcare, nursing care. How did you get to be here where you are today? 

Kolo Wilkinson: Yeah, well, that's a great question. So I, you know, I've, it's been such a blessing to be able to have found my niche, as you mentioned in my introduction.

I've had, so, a longstanding history. I, you know, I almost forget that I was a respiratory therapist as well, but combined, if I combine both professions, I've been in healthcare for over, a little over 25 years, about, 20, 23, maybe between 20 and 25, somewhere in there. But you know, it's just, it's been an incredible journey.

I am a board-certified nurse, as you mentioned, and I've helped to manage incontinence actually throughout the healthcare spectrum. So. I was a mom-baby nurse and a transition labor nurse, and so I actually managed mommy baby diapers and helped moms post birth with their management of incontinence that some mothers would face.

And then all the way through more acute care through your med-surg floors, your ICUs, your PICU, and had touchpoint with managing incontinence, helping patients to manage incontinence and skin care management throughout my career. So I've really had contact with a lot of different products, been able to help develop best practices and even as a, I was a nurse educator within a hospital and helped to develop some policies and protocols around how to properly manage any skin issues that arise from the lack of proper skincare and moisture management.

Bruce Kassover: This is a really important topic because when we talk about incontinence, we're always talking about things like leaking and the emotional and the self-esteem issues that are associated with it. And we talk about things like, you know, pelvic floor and the, the muscles and the organs that are involved, we talk about absorbent products, we talk about an enormous number of things. One of the things that doesn't get enough coverage is skincare related issues. And so, so what do you see, what sort of skincare issues do arise from incontinence that are typically presented when you're dealing with a patient?

Kolo Wilkinson: Yeah, that's a really great point. It's kind of like the unspoken issue that we don't touch upon, but it's probably the most common issues that people have when they have incontinence-related issues. It's the skin that really is probably the most impactful for anyone dealing with moisture management related to incontinence. Or we sometimes refer to it as IAD, which is Incontinence-Associated Dermatitis. 

And so when we talk about it in that fashion, what we are, what we see are redness and irritation to the skin. That eventually leads to the breakdown of skin, and, Bruce, this can happen actually pretty quickly. When moisture comes in contact with the skin and is allowed to stay up against that skin, we know urine can be highly acidic. We can start to see breakdown of that skin pretty quickly, and this can result in wounds that go from stage one all the way up to stage four where we're having real, real, real issues helping these patients to heal. 

And one other theme that people might not even think of is UTIs. Although that's not necessarily a skin issue, Bruce, we see a lot of increase when there is mismanagement of incontinence. We see that because the skin has a lot of moisture, this could actually lead to an increase of UTIs. And so, people may not think, “Oh, UTI is moisture related, skin moisture related,” but it actually is. So we see just how important the management of incontinence can be for a lot of individuals.

Bruce Kassover: That's really fascinating. The UTI aspect of it is something that I hadn't expected, especially because we know if, if you, you know, on our website we have a number of blog posts, articles and things like that. And consistently some of the very most popular areas of interest are things related to UTIs.

We know that there are an enormous number of people out there who have issues with this. And hearing that, you know, skincare is related, can be related to that, is really important. So, so that's a fascinating insight. Now for the non-UTI for, for skin irritation, are we talking about something that sort of looks like, starts like diaper rash or something that people, you know, might be familiar with, or is it something different than that? 

Kolo Wilkinson: Yeah, so when we, when it first starts, it is kind of like diaper rash, bringing back in my mom-baby history. But what we, what we often see first is kind of like this redness to the skin, but one thing that sets moisture-associated skin dermatitis apart from other skin breakdown is that the skin is still blanchable. And what I mean by that is if you press up against the skin and you see that kind of redness come back to the skin with skin moisture- associated issues, you still are able to blanch the skin in its beginning stages, even when that redness is there. So that's one indicator that, “Hey, we may have a little bit of a problem.”

It's red, it's still blanching, but this can quickly deteriorate very, very fast and become a bigger issue. And again, I talked a little bit about, you know, if you have that moisture up against the skin, the urine is very highly acidic. Only 15 minutes of exposure can actually lead to very drastic, even urgent situations for patients.

I'll just share a little bit on a personal note. I had, my mom suffered a horrible wound from the mismanagement of skin moisture management. She was left wet in a bed. She was in a hospital bed and that ended up being a hospital acquired wound. And this, over 24 hours, it went from that blanchable redness to a full gaping wound that you could put an entire fist in. And it eventually led to her having to have an amputation, and that greatly impacted her quality of life and it actually eventually led to her passing. So it's extremely potentially harmful if these issues are not identified in the early stages and remedied. 

Bruce Kassover: Wow. I'm so sorry to hear that. What a terrible story. That's just awful to hear. And I'm sure that, look, if you're talking about one person's experience, it's got to be pretty common. I would imagine that this is something that is regularly seen by people with incontinence. Is that fair to say?

Kolo Wilkinson: Yeah, it is. It is fair to say. And you know, one of the things, like I said on the onset, this is why I'm so passionate about this, Bruce, is because it impacted a family member. And a lot of it just goes into advocacy, and so I'm so excited to be a part of this conversation because I want to help empower, to be able to say, “Hey, you know, I'm seeing some signs and symptoms that maybe my loved one is having that skin wetness that's leading to some issues, some redness, some irritation around their skin, and I really think that this needs to be addressed.” Once you have that knowledge, knowledge is power, as people say.

And so once you have that knowledge, you can help to speak up for your loved one, for your relatives, to help prevent them from something very drastic and maybe even tragic because of the mismanagement of moisture up against the skin. 

Sarah Jenkins: Yeah, no, I mean, again, I will echo Bruce, I'm so sorry to hear about your story. That's really heartbreaking. I guess I, you know, we would just want to know what patients can do to prevent that from happening? What are the things that they need to be checking, you know, how long is too long to sit in a, a diaper – probably anytime, but you know, what can they do to prevent this from happening?

Kolo Wilkinson: Well, one of the things that they can prevent this from happening is, first of all, insisting that a high quality brief is being used to wick away moisture from their skin. So a common saying that we hear in healthcare and I've heard all along is, “A brief is a brief is a brief,” and that's simply not true.

You want a brief that's going to wick away moisture and lock that in. You want a brief that has a high absorbency capability and capacity as well. And then you also want a product, not just a brief, but even an adult diaper, something more like a pull up. You want something that comes in a variety of sizes.

And why that's important is if you have a product that is too big, you're going to have leaking out the bottom of the product. Leaking causes more moisture around the sacral area. So we're talking the thighs and behind, under the buttocks where skin folds may exist. And that actually increases that potential for skin breakdown, especially with friction, turning and moving in the bed.

So you want to make sure that the product is not too big. You also want to make sure that the product is not too small. If it's too small, you're going to have that friction and rubbing up against the groin area. That can lead to further irritation once you combine that friction and that moisture. So you want to have a product that fits right.

It's not a one-size-fits-all situation. So those are some things that I would say that patients and family members can insist upon when their loved one is in need of making sure that they are highly protected when it comes to their incontinence management. 

Bruce Kassover: So I would imagine though that even if you have a perfect fitting product and one that really does all the moisture wicking that you want it to, that you still can't have it on for too long, because otherwise, eventually you're going to start to get wet. So what are your thoughts on how long people should be using these products for before they change them?

Kolo Wilkinson: Well, you know, that is, a lot of that, Bruce, is dependent on the product. Again, if you're, you have a product that has high absorbency and high capacity, I happen to work for Tranquility. Our products are tested for something we call ‘capacity under pressure.’ So they have the ability to hold a rather substantial amount of urine, and we measure this by cups.

Sometimes on packages you'll see drips and it's kind of hard to tell what the capacity is for a drip, but not so much a cup. But in general, our products will hold anywhere from 24 to 34 ounces, depending on the size and depending on the level of product that you're using within Tranquility.

And we go from essential to a premium product, but you want to make sure as best practice that you are checking and changing your patients as needed. And for most, within the hospital facility, that's going to be every two hours that you're checking and changing as needed. It's important to remember, too, that incontinence products will not absorb stool. They'll only absorb urine. So all the more reason to make sure that you are checking and changing. But as a healthcare professional, my recommendation would be that about every couple of hours you're changing and making sure that your product is not at capacity. 

Bruce Kassover: Yeah. You know, that's a good point. We've been talking a lot about urinary incontinence, but bowel incontinence is a whole other issue, and I'm sure that has a similar ability to create skin issues, yes?

Kolo Wilkinson: Yes, absolutely It does. It does. 

Bruce Kassover: So tell me this, so how should a patient go about choosing a product that's right for them?

Kolo Wilkinson: Yeah, so when you are looking for a, a product, one of the things that you want to make sure is that it is a super-absorbent product versus a regular absorbent product. So, people may think, well, what does that mean, Kolo? How can I, how can I tell? Well, kind of going back to my mom-baby years, when you rip open that diaper, there's like these little beads that may fall out, little polymers that, that is what you want to also see in, in an adult diaper and what a regular diaper would have if you were to kind of rip that core apart. You're going to see a lot of ‘fluff’ is what we call in the, in the incontinence industry, and that fluff is made of cotton.

And what fluff does is it clumps together when it gets wet, and that clumping can actually cause pressure areas within the groin that, within the sacral and groin area. That is a problem because if you have pressure and moisture mixing together, that can lead to an increase of pressure injuries from related to moisture.

And that's where we see an increase of skin breakdown. And so you don't want a product where you're ripping it open and it has, it's full of that cotton fluff in it. What you want is a product when you rip it open, it has something called super-absorbent polymers. That's actually what makes baby diapers so highly effective.

It's the same ingredient. What that super-absorbent polymer will do is it will suck away fluid and lock in that moisture so that it cannot be squeezed out. So again, I talked about capacity under pressure. You want a product where it has that super-absorbent polymer and you're still able to continue with your activities of daily living.

Like maybe you like to go and play bingo, or you like to play cards with your friends, or maybe you want to go out for a movie or for lunch with the family. You want to be able to be sitting in a super-absorbent product that is not going to leak out and cause you to have an accident, which can have an impact on your quality of life if you're having to change. And it can actually be kind of embarrassing if you, if you have a product that is leaking out and you're having to interrupt what you're doing to go and address that. 

Bruce Kassover: Kind of embarrassing is sort of is, is selling it short. I think that that's, you know, one of the biggest issues that we find is, you know, people are, are terrified about having accidents. And, you know, I love your, your comment about, you know, paying attention to capacity because I don't think people have any real idea of actually how much they produce. I mean, the only time you actually measure any urine is when you go to the doctor's office and you have to give, you know, fill the little cup, right? People don't really have any idea of how much urine the body actually produces, do they?

Kolo Wilkinson: No. No. And it, and it differs for everyone, and it's dependent on a lot of different factors. So if you are dehydrated or maybe you're on a medication like a Hydrochlorothiazide or Lasix that helps, makes you urinate more, you know, you might have different issues.

So we can't really say that everybody goes the same because it's different from for everyone. But you want to make sure that you're in a product no matter whether you're a heavy wetter or maybe more of a dripper that is going to, no matter what, absorb that moisture waste so that you're not having any issues with that moisture being up against, with the urine being up against the skin.

Bruce Kassover: And you know, one of the other things we often hear about are people who are not even using absorbent products, are not, I shouldn't say that, I'm sorry, are people who are not using products that are made for urinary incontinence. They're using you know, feminine hygiene pads and things like that. Those are not recommended either. Right? 

Kolo Wilkinson: Well, it all depends, Bruce. So again, if you maybe are an individual who is more of just like a dripper, maybe that personal care pad is appropriate for you. But even with that, I would say if you would prefer to just use that personal care pad, so you still want to make sure that it is a super-absorbent personal care pad, meaning you want to ensure that this, this what we call ‘PCP’ is made specifically to help address issues with incontinence as well. 

Whether it's just a few drips or a little bit more, you are going to pay attention to the capacity as well. If you're noticing that you're filling up that personal care pad, then that probably is not the right product for you. Remember, it's not a one-size-fits-all, so, and it's not, a brief is not a brief is not a brief. So you got to make sure that you know, if this is not providing the results that you need it to provide to continue with your activities of daily living, that may be a personal care pad is not sufficient, and you might want to consider a brief or an adult diaper to be able to truly manage your incontinence.

Bruce Kassover: What about people who are concerned that they're going to be noticeable? 

Kolo Wilkinson: What I typically say to those folks is make sure you are in the right fit. So, one of the things about that is when I hear my patients say, “Oh, people are going to see it,” and I say, “Well, it's probably because you're not wearing the right size.”

So you want to ensure that you are looking at the product packaging. With Tranquility products, what we have is a weight reference on the bag in pounds and kilograms, and you can match up that weight reference to the size that you should be in. And typically, that will help you to make sure that you're in the right size and it will, if you are in the right size, it will be more discreet.

Another way is, not all people are shaped the same. So you can have somebody who is 175 pounds, who's five foot, three inches tall versus somebody who's 175 pounds and six foot tall, right? So another way to ensure that you're making, you have an accurate measurement, is to take a tape measure and measure from the widest point of the hip to the widest point of the hip. Take that measurement and multiply it by two. And if you're using the Tranquility brand, you'll actually get a more honed-in specific on what size that you should be wearing. So again, proper size does matter when you have concerns about discretion and making sure that it's not going to show underneath your clothing.

Bruce Kassover: Now on the other side of that though, are the people who probably don't care so much about discretion but who are super concerned about leaks, especially leaks that might be noticeable, and maybe they're going to double up. What are your thoughts on doubling up, wearing, or, you know, sticking a pad inside of a pull-up or something like that?

Kolo Wilkinson: Oh yes, yes. We call it ‘double diapering’ in the industry. And here's kind of the way that I like to illustrate this, Bruce and Sarah, is, let's say you have a diaper that held eight ounces, and then you took another diaper that held eight ounces, and you put those two diapers together. How much will they hold together? What do you think the answer is? 

Bruce Kassover: I guess it'll just be eight ounces. 

Kolo Wilkinson: Yeah. Ding, ding, ding. You are right. It is just eight ounces, Bruce. But a lot of people don't think that. They think, “Okay, well if I have this diaper and this diaper together, both eight ounces, it'll double the amount that it can hold,” and that's simply not true. It still will only hold eight ounces due to that waterproof outer layer of each diaper. So once that first diaper gets to the capacity, or that eight ounces, if it's an eight-ounce diaper, it will not leak through. Meaning you're not going to get higher capacity by having two of those together. Instead of double diapering, what I typically recommend is using a higher capacity product so that you don't have to worry about… I think, I think a lot of people do this is to prevent leaks, right? But if you're using a product that is, has higher capacity, is the right fit, is the right product, then you're not going to need have that need for that double diapering. However, if you are a heavy wetter, somebody who has heavy incontinence, there are some other things that you can do to increase the capacity of a diaper, but maybe, and, but doing this without that waterproof outer layer so that you are really allowing for that urine to soak through and be caught by the diaper. 

Bruce Kassover: Now I've heard of something else called the booster pad. What is that? 

Kolo Wilkinson: Yeah, so a booster pad is a little bit different from a that PCP that we talked about earlier.

So the personal care pad, what a booster pad is designed to do is to allow urine to leak through. So remember how I said don't double diaper, but if you want to increase the capacity of your super-absorbent polymer, this is going to be the best solution because the booster pad does not have that waterproof outer layer.

It's going to allow your urine to leak through so that the overflow is caught by that bottom diaper. So again, not two diapers with a waterproof leak, but a diaper and a booster pad will help to increase the capacity. So let's say you had a diaper that held 30 ounces and your booster pad holds eight ounces. How much do those hold together? 

Bruce Kassover: I, you're going to have to tell me because I do not want to do the absorbency math. 

Kolo Wilkinson: I understand. Yes. I love that absorbency math – we should, we should hashtag that. But what it's going to carry is 38 ounces. Remember, if you had an eight-ounce diaper and an eight-ounce diaper, and you put those together, it was only eight ounces.

Well, if you use a booster pad with a diaper, it's going to increase that capacity, and now you're going to have a 38-ounce capacity. So they are completely different from a personal care pad because that personal care pad also has that outer waterproof layer that does not allow urine to leak through. So instead of using a personal care pad in a diaper, you want to use a booster pad in a diaper and preferably a booster pad that also has that ability to help wick away moisture as well. 

Bruce Kassover: That makes perfect sense. Now, I'm wondering, because we're talking about sizing and you were talking briefly earlier about how different, you know, different people of different sizes certainly will have different needs. And I'm wondering in particular about people who are on the larger side of things, are there any different sorts of either products or approaches that they should be considering? Or is it pretty consistent, the advice no matter how large or small you happen to be. 

Kolo Wilkinson: Yeah, so we refer to maybe a larger size, like as our, like bariatric patients. And so with our bariatric patients, there are a lot of concerns and we are actually seeing a need to make sure that patients who require a larger incontinence product have those needs met. 

At Tranquility, we have products that run range all the way from small all the way to 5XL. We have a 3XL breathable, 100% breathable product. And why that's important is because we know that air helps to allow for dryness and also helps to allow for healing for the skin. And so that 100% breathable bariatric product is incredible and it helps to address fit needs for patients that maybe need a larger product. And it's stretchy and it's soft, and it's also discreet when wearing it.

But one of the things considerations for bariatric patient is just the same. You want to make sure that you are in a product that fits, so you don't want the product to be too big. Again, too big means leaks around the legs. Too small could lead to excoriation around the groin area. So, even with our bariatric patients, there are size options for you. You do not have to be in something that is too small or will not work for you. Ask to be placed in a product that was meant for your size. 

Bruce Kassover: You know, that gets me thinking about other specific populations that also may have needs for these sorts of products, like, for example, children with complex healthcare needs, or maybe not even children, but other people who have you know, complex healthcare needs. What about this group? Is there anything in particular that they should be thinking about or that makes it particularly challenging for them? 

Kolo Wilkinson: Yeah, so going back to my years as a mom baby nurse, one of the things about babies, Bruce, and or young or pediatric patients is, a lot of times they can't tell you when they're wet, right?

If they, either they're too young, they don't have the words, or they have some sort of condition that doesn't allow them to have the ability to maybe verbalize in the way that they need to, to let their caretakers know that it's time to be changed. And so with this particular group of patients, it is highly important that you are in a high-capacity product, a high-absorbing product that's going to wick away moisture and help keep these individuals dry, because they may not be able to speak and advocate for themselves. 

And I know for a lot of parents, they really appreciate this, Bruce, because it helps them feel that they are really protecting their loved ones, their young ones, and that they are able to do this kind of guilt-free because they know that their child is in a product that is doing is doing what it's supposed to do, so it's high absorbing. It has a high capacity, it's wicking away that moisture, and so they feel confident that they're providing the best possible incontinence care to their younger patients or even adult patient with needs. It really matters when it comes to this particular group of patients that you're using a high-absorbing, high-capacity product.

Bruce Kassover: So we've been talking a lot about things that are related to the pelvic area, of course, you know, that makes sense. It's an incontinence podcast. But I'm going to guess that skincare issues can happen in other areas as well. Is that right? 

Kolo Wilkinson: Absolutely, absolutely it can. And you know, we talked a little bit about our bariatric market, bariatric patients, they come to mind when we talk about skin moisture. That can happen in other areas because if you have heavy skin folds, you can have moisture that works into those areas and can also lead to skin breakdown, skin irritation, and that can eventually lead to a very urgent issue that needs to be addressed.

And so one of the things that we have at Tranquility is a product called a Thinliner. And these are sheets, if you will, that wick away moisture. They come in a couple of sizes, so 6” by 14” and a 6” by 10”. And they have those super-absorbent polymers woven into the fabric just like our briefs and our adult diapers do.

And what they do is, they wick away moisture in those high-risk, susceptible areas so you can put them under the breast, under a skin fold in the armpits. We have patients that have, maybe, heavy rolls around the neck. These Thinliners just lay on that neck and they can… on the nape of the neck, and they can wick away moisture.

But one of the other things that I didn't talk about and I meant to is that, you know, when you have a product with a super-absorbent polymer, it's going to do a couple things, Bruce. So – and this is why it's so important – is not only is that super-absorbent polymer going to wick that moisture away, but it's also going to neutralize the acidity within urine.

And we know that the pH within urine is what causes that irritation. The acidic urine can cause that breakdown of the skin, so that super-absorbent polymer is, one, going to neutralize that acidity within the urine, and, two, it's going to help reduce the odor of urine. So when we talk about a dignity standpoint, quality of life, not feeling embarrassed, you want to use a product that has that super-absorbent polymers, because it's going to address those two really important issues with not only making sure that your skin is not irritated, but also making sure that it cuts down on the odor. And same with these Thinliners, they're going to do the same thing.

So if you have that sweat that goes around the neck, around the armpits, breast, stomach area, it's going to do that same work and making sure that that moisture is wicked away. And it's reducing the acidity that may come from your sweat as well, depending… Medications impact that and just different body composition impacts sweat, the consistency of your sweat as well. And it's going to help reduce the odor as well. 

Sarah Jenkins: If someone does develop a rash, are there creams that they should be using to treat it? And I guess if they're prone to getting a rash, are there things that they can use as a barrier to kind of prevent that from happening?

Kolo Wilkinson: Sure, yes. And I love the word that you used, ‘barrier,’ because that's exactly what they're called, Sarah. We call them barrier creams. And there's a variety of barrier creams that are on the market that can be ordered through your primary care physician, and there are even products that are available over the counter that work as a barrier cream that you can use to protect the skin.

And what I typically tell all of my clinicians that I educate and also caregivers is that whatever product that you're using as a skin ointment, ancillary product to help keep that moisture away from the skin, just make sure that you're not using it too much. So I like to say “Don't frost the cake!” You don't want to be able to write your name in the barrier cream.

Once you put it on that, on your patient's skin, you want to use a, the best practice is to use a half dollar, quarter sized to about a half dollar sized amount, and then you want to be able to rub that barrier cream almost into the skin or just have a nice thin layer on that skin where you can still visualize the skin and do an assessment as to whether there's any irritation like we talked about on the onset. Is there any redness there? Is there pain when you're pressing up against the skin? Is, does your patient wince as you are applying pressure? Too much barrier cream can hinder that skin assessment. So again, barrier creams are great, they work, but if you use too much of it, especially if you're using a super-absorbent product, that can actually cause a barrier on that super absorbent product.

And so, once you have that cream on that super absorbed product, it's not going to be able to wick away moisture because barrier creams are wonderful. They work, they create a barrier, but we don't want them to create a barrier in the super-absorbent incontinence product. So nice thin layer and allow that combination of that thin layer of barrier cream and your super-absorbent polymers to wick away moisture and keeping your skin dry.

Sarah Jenkins: That's a really great tip. Thank you. 

Bruce Kassover: Now we've been talking about a lot of different things. We've been talking about skincare issues and absorbent products and how to, you know, what to look for in sizing and different populations. I understand that Tranquility has recently put together a book on skincare that sort of brings together a lot of these thoughts into one place so that people can, you know, don't have to remember everything and can sort of refer to it. Can you tell us a little bit about that also and how people can get it? 

Kolo Wilkinson: Yeah, sure. So we have what we call a one-stop shop for all things incontinence, and that's our clinical portal that can be accessed at Tranquilityproducts.com. And what I love about this site is that we have made it easy and have broken it down by audience.

So whether you are a clinician, a physician or a caregiver, we have information that is all throughout the site. We have printable materials, we have sizing information, we even have videos. We talked about proper sizing; we have videos that help you, to help you to learn how to make sure that you are, have the right size for the right patient.

We even have videos on how to know when a product, a super-absorbent product like a Tranquility product is at capacity. Our products have a wetness indicator, and so we teach about how to use that wetness indicator to know when it's time to change your patient. And so, I love this site. It, again, it can be found at www.Tranquilityproducts.com, and it's a wonderful resource for clinicians and caregivers alike.

Bruce Kassover: And now, when it comes to that skincare book, if anybody wants to get it directly, I believe that the URL, the web address, is a little too long for us to say right here on the podcast because nobody's going to be able to write everything down really quickly. So what we're going to do is we're going to put a link in the show notes that anybody can just click on to go to it directly. (https://tranquilityproducts.com/incontinence-basics-ebook/)

So with that being said, as you know, this podcast is Life Without Leaks. And one of the things we like to do before we go is to leave our listeners with one little hint, tip, bit of advice, strategy, a suggestion, so that they can help live a life without leaks. So I'm wondering if you might have one that you can share with us.

Kolo Wilkinson: Oh, this is, this is so good. Yes. Okay. So if I had one tip to leave with you today, it would be, make sure that you are using a high-quality product when it comes to incontinence management. Don't short yourself on this because not only will it help you just to be able to live a full life without leaks, but it also could help you to avoid skin and moisture issues that you just don't have to deal with. So I always say, you know, the quality of the product matter matters. Use a high-quality product. 

Bruce Kassover: That is a great bit of advice indeed. So thank you so much. Thank you for sharing with us all of this information about better skincare for people with incontinence and we really appreciate it and we hope that people don't just take up your advice, but also go and check out Tranquilityproducts.com and take a look at your book and see the range of products that are available. So thank you. 

Kolo Wilkinson: Thank you so much. It was great to be here with you. This was a great discussion. I really appreciated it.

Bruce Kassover: Life Without Leaks has been brought to you by the National Association for Continence. Our music is Rainbows by Kevin MacLeod and can be found online at incompetech.com. More information about NAFC is available online at NAFC.org.