Caring for the caregivers

One of the things that doesn't get enough attention when it comes to living with incontinence is caregiving. Those who assist their loved ones managing their symptoms - the emotional ones as well as the physical ones - often don't get the support they need, and that can take a tremendous toll on their own wellbeing. Today's guest is Lori Mika, a certified dementia practitioner and a passionate caregiver herself as well as an account executive for Tranquility Incontinence Products, who shares with us about the things you can do to flourish in the caregiving role. 

More information about Tranquility Incontinence Products can be found at 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/

CARER offers stylish, reusable underwear that feels just like your favorite regular briefs. Experience all-day comfort, superior protection, and live confidently. Claim your FREE sample and feel the difference! Visit CARER online today.

If you look at the numbers behind incontinence in women, it’s hard to believe just how big an issue it is. Incontinence affects more women than diabetes, breast cancer and heart disease, but it doesn’t get the attention it deserves. That’s why NAFC has created the We Count campaign, to help you realize that you are not alone, and there are treatments available right now that can make a real difference in your life. Visit NAFC.org/we-count to learn more. 

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: Thanks, Bruce. I'm so excited for this discussion.

Bruce Kassover: Yeah. I'm excited today also because what we're going to be talking about is not symptoms and treatments and things that we often cover in this podcast. Instead, we're going to be talking about caregiving, which is something that really deserves to have a much brighter light shined on it. And today's guest is Lori Mika. She's a certified dementia practitioner, a passionate caregiver, and she's an account executive for Tranquility Incontinence Products. She's really, really, feels deeply about educating customers on senior care and products and how to use them and really improve their health outcomes. So I'd like to welcome you, Lori. Thank you for joining us today.

Lori Mika: Well, thank you so much for having me. I'm very happy to be here and talk about my situation and hopefully help others.

Bruce Kassover: Well, we look forward to it. And you know, this is an interesting job that you have. Maybe you want to tell us a little bit about how you got to be where you are today.

Lori Mika: Oh my goodness, it's been a winding road. Let me just tell you. My parents are older and I always had older parents, I guess, growing up. And so I found myself in a caregiving situation many years ago, probably about 13 years ago. My dad was diagnosed with Alzheimer's disease and we at the time I was working for the Alzheimer's Association, so what a blessing, I learned so much and I got, you know, quite a bit of information there. I actually ended up leaving that job and coming and taking a position at Tranquility. Tranquility was a supporter of the Alzheimer's Association, and so I decided I didn't want all that information and knowledge that I gained to go to waste, so I decided to become a certified dementia practitioner.

And so now through this whole time, I'm still caring for my dad and he's, unfortunately, passed away. But now my mom has incontinence issues. So not only do I get to work for Tranquility and, and share our products with people, but I actually get to, you know, have my parents wear our products. And I've learned so much from, you know, what they've been through and how well the products work, and it's just been a real blessing to be, you know, a dedicated caregiver.

I'm a mom, I'm a daughter. You know, it just, there's a lot to juggle. Let's just say that.

Bruce Kassover: I'm sure there is. And you know, it's an interesting perspective, you know, coming to the practice as somebody who's done it herself.

Lori Mika: Mm-hmm.

Bruce Kassover: And, you know, one of the things I'm wondering about is about the nature of caregiving to begin with, because I would imagine that a lot of people don't even think of themselves necessarily as caregivers. You know, they're just, you know, mom needs help, dad needs help, and I'm just doing stuff.

And the idea that you have this sort of role that you're filling might sound a little strange to people. Maybe you could talk a little bit about that.

Lori Mika: Oh, for sure. You know, there are so many different ways to be a caregiver. You don't have to have, be a full-time caregiver to be considered a caregiver.

There's a lot that is needed when you know someone is having, you know, an illness or they've been diagnosed with something and they need extra care. As we age, of course we know that things can get more difficult. Then you can compound that with some sort of a diagnosis such as, you know, I speak of dementia a lot because I do have a lot of experience in that area, but there's so many other, you know, mental and physical cognitive abilities that change as we age. Right? And so we rely, you know, older folks have to rely on family members and friends to help them, you know, navigate whatever journey they're going on. So you can be the neighbor of somebody and be checking in on your neighbor, and you can consider yourself a caregiver.

You can be giving full-time care, having your loved one live in your home and being cared for them in your home, your parent, or your loved one. Your grandparent can be in an assisted living facility, but you're going there in, you're helping them with some daily tasks, and you're considered a caregiver. So there's so many different ways to give of yourself and care for your loved ones.

Bruce Kassover: That really has me thinking also that this is such a personal issue when it comes to dealing with incontinence that I would imagine that, you know, if you're a caregiver for somebody who has some sort of an ailment, that you know, they, they may or may not be receptive to the help that you're trying to provide.

But when it comes to something like incontinence care, I would imagine that there's a lot more pushback and a lot more resistance to allowing themselves to be treated. Is this something that you find as well?

Lori Mika: For sure. I mean, incontinence management is just one part of caregiving. You know, watching my own parents' health decline, it's been very emotional for me.

Many caregivers would agree, I mean, they would do anything to help their loved ones, but it's a delicate conversation, right? I mean, it's not just about products or medical care or do this or don't do this. It's about having those delicate, intimate conversations about coordinating care, getting the right products.

It can be awkward, it can be uncomfortable. It is, I can't say it can be, it is awkward and uncomfortable. It was for me. But I knew I had to do it. And luckily, you know, I have a little bit of background in both disease management as well as, you know, knowing so much about incontinence products, it was a little bit easier for me, but for others, I mean, it's a very intimate, awkward, kind of personal conversation that you don't necessarily want to have with a parent or a grandparent or someone that, you know, it's a different role. Like I now have become the parent and the caregiver and the roles have reversed. So it's a dynamic shift of that relationship.

Bruce Kassover: You know, people who are listening to this may find themselves sort of at the beginning of their caregiving journey also, and because we agree that it definitely is, can be an awkward conversation, do you have any advice or strategies for somebody who's not yet had that talk but really wants to?

Lori Mika: Sure. I think you just need to approach it with compassion and go in knowing that it might be an awkward conversation. It might not be something that really someone wants to talk about, but there are signs when someone is having incontinence issues.

You know, there may be odors in the home or even there may be signs of leakage in a chair or you know, extra laundry that's being done for some reason. We probably know that those things are associated with some kind of an incontinence issue that's not being managed properly. So, you know, you don't of course want to lead with negativity or anything like that. You want to be positive. You know, they're probably already embarrassed. It's not something that people talk about. There's a certain stigma that comes along with incontinence and you know, you just want to be compassionate, gentle. You know, as someone come in, as someone who really wants to help to make that change and, you know, ask good questions.

"Mom, I've, I've noticed," or, "Dad, I've noticed that, you know, you might be having some issues." It's a tough conversation to talk about, but maybe I can help you. "What are some ideas that you have? What are you doing now? What can we change where, you know, where are there some opportunities to make your life better?" And focusing on making life better and bringing back dignity and just really coming through, coming from a place of love, I think is the most important thing.

Bruce Kassover: I think that makes a lot of sense. Now, if you're somebody who's gonna be stepping into a caregiving role, and you know, this may be or probably is new ground for you as well, you sort of have to prepare yourself to be doing certain activities, doing certain things with the person you're caring for.

What is the range of sorts of things that a caregiver might be expected to do?

Lori Mika: The challenges with incontinence, first of all, you know, sort of go far beyond the inconvenience of it. I mean, it can negatively affect quality of life, which is what we talked about. You don't want to be constantly, your loved one to be constantly worried about leaks or odors. That can lead to isolation, lead to depression.

Maybe they've stopped going out, right? Maybe they're staying home because they're so embarrassed. So, you know, those things you're probably noticing, maybe your loved one is withdrawing a little bit. I think, as a matter of habit, I guess, you know, you don't certainly talk about these things in general with a loved one, but you know, coming to it with a position of positivity and, "I want to help you, let me help you, how can I help you?" And just offering that assistance in that conversation and making it not seem like the end of the world. You just want to make sure that, you know, when the burden becomes too big or too great for families to handle alone, you know, that's where you have to step in, or for a loved one to handle alone. That's when you have to step in and be a helper, like, you know, they always say like, when you, when something bad happens, right? You look for the helpers. You need to be that helper. That's really what you need to do is be that helper for the person and start the conversation.

Maybe purchase, you know, some products that they might try and just kind of have them in the house, put them in the bathroom, let them go at their own pace. I think that's very important too, is having the person kind of adjust to this new lifestyle at their own pace, and they'll tell you.

Bruce Kassover: I think that makes a lot of sense. Now, it also gets me wondering: absorbent products of course are an important element, but I'm sure that they're not the only thing. If you are taking on a caregiver role, what sort of things go into the toolkit; that is, what sort of issues might you be expected to deal with and what sort of items would you have to help you deal with them?

Lori Mika: Sure, sure. There are a lot of extra issues that come with incontinence, right? Some people, older people will suffer with incontinence alone for years before even trying, you know, they're trying to manage it on their own. And, you know, we've heard some, you know, stories of people using anything other than an incontinence product to help manage their incontinence.

I think the first thing you want to do is encourage your loved one, you know, to visit their physician and talk to their doctor about it. Maybe offer to go with them and help facilitate that conversation. There may be some medical interventions that can help, you know, alleviate the issue and there may not be, but just knowing that there's no physical, or cognitive reason, I guess, that they're having incontinence is sometimes good. Or if there is an intervention that can happen through, you know, a medical procedure, then that's also good to know. And then you can have an make an educated choice on what route you want to go and if you are, if the decision is to wear incontinence products, there are a lot of, you know, issues like you talked about in the beginning a little bit about skin issues. You know, there's always the leaks, the odors, the skin irritations. They can be disruptive to somebody's life. The challenge, you know, if they're wearing the improper product, a poor fitting product or a low quality product, the skin breakdown can happen within, you know, 15 minutes of that skin's exposure to urine.

So we want to make sure that they're choosing, you know, the right products, like a high quality product that absorbs and locks in that fluid so they don't have to worry about the excessive leaks. They can get a good night's sleep overnight and not have to worry about, you know, leaking onto the sheets or anything like that.

So there's a lot of complications from mismanagement, you know, incontinence and there they're a real concern.

Sarah Jenkins: I just was wondering, do you have any tips for people, when they're just starting their search on how they can find the right product?

I know, you know, it's hard enough for someone who's actually experiencing incontinence to figure out what to use.

Lori Mika: Oh, yes.

Sarah Jenkins: I can only imagine a caregiver who is kind of coming out this, as you know, no idea of what to pick, what style, what all of the different terminology means. Do you have any advice for them?

Lori Mika: Yes, I do. It is very confusing to go out to a store. I mean, the first place that most people go is to a big box store, right? They'll go to their local grocery store or a big box store and look at the shelves, right? And how many choices do they have? So many, and it's hard to decipher, you know, what's true information and what's not.

There may be 17 products that say 'super premium absorption' on them, and which one is the one that's right for me, it's really daunting, but choosing the right product can be, you know, it can reduce complications, and the average person we found tries seven products before they find one that actually works for them.

So it is daunting and you know, it can sometimes be wasteful, to be trying all these products all the time and not finding one that really works for you. So, some of the things that you want to. For is a really high quality absorbent product with a super absorbent wicking core, and it's designed to lock that moisture in.

We talked about, you know, skin breakdown a little bit, so we want to lock that moisture into the product and so it doesn't travel back up to the top and be touching the skin. That really reduces, you know, the risk of skin breakdown and which can lead to many other things as we know: uTIs, sores, bedsores, those kinds of things.

We want to have that top layer dry, you know, to prevent that irritation, you want to look for a really soft feeling product against the skin, because that can create friction if it's not soft. So we want to make sure that is as soft as possible. And also you want to look for something that's breathable. You want to have some sort of air flow coming in there.

We always talk, when we're talking about incontinence products, we talk about the microclimate that can be created down in the area where the product is being used, and that microclimate can get full of bacteria; it can be very hot and lead to more problems if that microclimate is not ni nice and cool and air is flowing in there and it's keeping dry.

So finding that ideal product that is soft, absorbs, locks in the fluid and creates that ideal microclimate down there that can continue to allow your skin to have airflow to it and keeping it dry is important.

Sarah Jenkins: Thanks. That's super helpful.

Lori Mika: Good.

Bruce Kassover: Now you were talking earlier about how, you know, a lot of the patients that, that you've interacted with are dementia patients or, or patients with, with some sort of a cognitive impairment.

What are the particular challenges of dealing with these sorts of patients when you have to get them to wear absorbent products?

Lori Mika: Right, sure. There can be a lot of confusion if there are some cognitive difficulties. You know, "Why do I have to wear this? What is this? I'm not used to this." There are some times even when the wearer or the loved one can get a little bit combative even when they're being changed. So I think anytime you're dealing with any kind of a cognitive issue, you want to find a product that is similar to just regular underwear, and that would be like a pull on type garment, right? It would be, they look more like underwear, they feel more like underwear. You just pull 'em on just like you would be putting on your underwear.

You can also, you know, kind of just create habits, right? You want to make sure that just as you're helping them change in the day, or maybe they're doing it themselves, you know, you're handing them an incontinence product that's a pull on and say, "Okay, here are your underwear," right? And those become, we actually call them disposable adult underwear.

So in, you want to start a routine with them, like, for certain, when you're getting them ready in the morning or maybe they're getting themselves ready, you're laying out their clothes and you know, you'll lay out the clothes and you'll lay out the disposable adult underwear next to them so that, that it becomes part of the routine and they're getting used to wearing that particular product.

A lot of products are made with very soft material, so they feel a little bit like underwear. Certainly they're thicker and they're definitely a different feel than underwear would be when you're holding it in your hand or when you're wearing it, but you want to make sure that that kind of becomes just part of the regular day as we're going to put on our disposable adult underwear now. And that seems to work.

We talked a little bit about when maybe you have to do the changing yourself and there is some combativeness because the person doesn't want to be changed. You know, you just want to create a very calm, safe environment, and certainly explain what you're about to do. People with dementia or cognitive disabilities certainly don't want to be surprised by anything.

You know, explain what you're doing. Ask for permission. "Hi, I'm here to change you now, you know, let's, is that okay with you?" And, you know, just get that buy-in from them. Clear communication is important.

Coming to them from the front rather than from the side to startle them is also really important. Sometimes people with dementia, they lose their side vision or peripheral vision, I guess it is, and so you, they don't see you coming at them, so you want to come to them, right, you know, face to face and talk with them and, you know, nod your head, be positive, "I'm here to change you. Are you ready for that?"

And that kind of helps ease some of that anxiety because we know combative behaviors and different things result from a lot of things. Them being uncomfortable, them being startled, you know, them, you know, just not understanding what's going on. The calmer you can make this, you know, situation and the more you can explain, the better off it is.

Bruce Kassover: That makes sense. Now, in addition to the challenge of changing and getting into a routine with absorbent products, maybe you could talk a little bit about skincare.

Lori Mika: For sure, for sure. Skincare is of utmost importance because we know it can lead to a whole host of other problems if it's not managed properly.

We definitely recommend, I talked a little bit about before, about using a super absorbent product that can hold more fluid and pull it down into the product and hold it in. You just do not want that fluid to travel, urine, to travel back up to the top. I mean, when you're sitting, you know, in a wet, sloppy mess down there, just the bacteria can start developing and, and the, you know, that's when the skin starts breaking down, when that bacteria gets in there. It also causes odors and it can lead to skin breakdown within 15 minutes of exposure to the skin. If that's mismanaged over long term, if it's not managed properly over long term, then we know that it's, you know, can cause UTIs, it can cause sores, bedsores, and, you know, maceration of the skin leading to wounds.

And then, you know, when it comes to wound care, certainly that sometimes leads to hospitalizations, which creates, you know, a whole nother situation that unfortunately, the person has to go through and the family or the caregiver goes right along with them and you know, and they hope that, you know, the hospitalization, the wound can be healed and we can get back into their home or their assisted living or whatever at some point.

But sometimes those hospitalizations can be very long and disorienting, especially for someone with dementia or Alzheimer's.

Bruce Kassover: That really makes it very clear just how important it is. That's really significant. So I, I appreciate that. Now, here's another thing that I'm wondering about.

How do you deal with patients after they've had an accident? Because it's, you know, it can be potentially embarrassing and uncomfortable and all those things. How do you deal with somebody, especially somebody or in particular somebody who might not have all of their faculties about them?

Lori Mika: Right.

Bruce Kassover: You know, how do, how do you handle that?

Lori Mika: Well, first of all, just be kind. Be kind to yourself. Be kind to them. You know, you're all, you're both doing the best that you can and that really is enough. The fact that there was an accident, they're probably embarrassed and you may be embarrassed too, but approaching with compassion and just making sure you're both are at ease.

And, I mean, I can remember times where I would kind of joke with my parents. I'm like, "Oh, well it happened again. That's all right. Let's see what we can do. Let's figure it out." You know, and, and just kind of with a smile on your face, you know, this is just part of life. This is how our life is now, and accepting that, right, it's not changing.

"We had an accident, eh? It's okay." And, and I, I don't mean to bring up, like if you had a child, if it was your own child, you probably wouldn't get angry and mad and frustrated. You'd be like, "Okay, we had an accident. Let's just go fix that." It is the same kind of calm, reassuring kind of temperament. You don't want to show frustration either, because if you look frustrated, that person may mirror your frustration, right?

So then you're both frustrated. So just trying to keep it light, just and explain what you're doing, understand that the person understands why you're doing it, and just to kind of talk your way through it. It doesn't have to be a bad experience. It doesn't, can't always be fun, but you know, if you can kind of keep it light and say, "Well, okay, here's what we're gonna do now, we'll deal with this. It's not a problem. Let's just, you know, try and, you know, handle it and be discreet about it and, you know, make sure that we do a nice job cleaning you up. We'll be fine and then we can go on with our day. "

Another thing that sometimes helps to avoid accidents is actually setting up a toileting schedule with your loved one. You might want to set up something or set an alarm or your own alarm on your watch or something every two hours. Let's, let's go and try and use the restroom. And that is a great way to manage it because then we're not waiting three or four hours in between toileting, we're going every two hours. Less chance that there might be accidents. And you can help reduce, you know, the pressure on both of you if you're doing a toileting schedule. Of course, it's not going to work a hundred percent of the time, but I think it's going to alleviate quite a bit of the accidents that people have, you know, in between changes. So it makes a big difference if you can get someone on a schedule.

Bruce Kassover: So you're dealing with somebody who has incontinence issues and I'm wondering if you see any other behaviors or anything else that they might be doing that's contributing to the condition.

Lori Mika: Sure. Right. You know, incontinence is certainly a common issue, but it needs to be managed correctly. Many people assume it's just a normal part of aging, but that's not always the case. I mean, undiagnosed medical conditions and physical changes can, you know, cause or worsen incontinence.

And one thing that people do, very common misconception is they think that drinking less water will prevent accidents when in fact it can actually dehydrate them and irritate the bladder, worsen incontinence and, and cause other issues. So that said, some healthcare professionals do recommend limiting fluid intake a few hours before bedtime, which may reduce overnight accidents, but you certainly don't want to stop drinking water with the intention of thinking that that is gonna stop you from urinating and leaking.

You'd rather be in the right product and continue to drink your water and stay hydrated. 'cause you don't want to have any of the other conditions arise from dehydration because that can cause a whole nother set of medical issues for you. So make sure you're drinking plenty of water.

Bruce Kassover: Well, that makes perfect sense, and it sounds like it's a nice rational approach. However, you did talk about frustration and that does bring up another question because there's a second person who needs caregiving in this equation, and that's the caregiver themselves. And I'm wondering if you could talk a little bit about self-care and how you can help manage that as well.

Lori Mika: Of course, of course. You always need to carve out time for yourself, even if it's five minutes to sit and just have peace and quiet in a quiet room. Just take that time. It's hard to find it, and you feel like you're under so much pressure to caregive and do all the things that you need to do, but you also need to step back and take a look at yourself and see how you're doing. Do a mental check-in. "How am I today? Oh, ooh, this has been a rough day. I better try and do something nice for myself." You know, both of you, the caregiver and the person being cared for can live, you know, a full life and you certainly don't have a lot of time for yourself. But you can take five minutes to meditate or you know, there's a lot of time you could get a respite and have a friend come over and sit with your loved one if they need to be, you know, have someone with them all the time and go out and go for a walk.

You know, spend some time in nature, do some of the things that are simple, don't take a lot of time, but give you a little bit of peace of mind. I always recommend joining a support group too. There are so many wonderful support groups through Area Office on Aging around the country, senior centers, online support groups, and I know you have support groups too, so there's a lot of people that you can talk to that are going through the same thing.

And I think it always helps when you're able to just have a conversation with someone that's going through the same thing and you're sharing stories and you're like, "I'm not alone. Wow. I thought I was, I thought I was on on an island and I was the only one doing this." But you find out that there are others and you get to swap stories and learn how they handled things, and you learn so much and, and you know what? You become friends and then you have this whole other network of people that you can lean on. So lean on others. You don't have to do it alone. Some people think they do. In fact, I fall into that trap all the time. "I'm the only one that can do this. I know I'm the only one that can do this. My, my mom needs only me." And I go, "No. No, that's not right. I need to step back and I need to let others step in and help too."

Bruce Kassover: I think that's a very nice sentiment. I'm really glad to hear that. Now I'm wondering if you could tell us, because we've been spending a lot of time talking about products and selection and getting patients comfortable using them. Well that's really sort of Tranquility's specialty also, and I'm wondering maybe you could tell us a little bit about Tranquility and what makes you guys distinct.

Lori Mika: I would love to. It's one of my very favorite things to do because Tranquility products can help people so much. I, you know, I think definitely, people need to know that they don't have to settle for an inferior product. There are a lot of products out on the market, and if you have a severe incontinence issue, probably the store brands that you see, you know, on the shelves are not gonna work for you. They may, they may, you may have to change them a lot, and you know, if you're very stringent on changing every, you know, hour or two, they may work. They're not bad products. They're just designed for kind of the dribbles and drips that, you know, you get as you get older in, you know, general incontinence management, you might have a dribble and drip when you cough or sneeze or something like that.

And those products work fine for that. But if you have a serious incontinence issue where maybe you don't have the sensation that you have to urinate, maybe you can't make it to the bathroom on time, or maybe, you know, it's just like, it's always a gush coming out because you don't notice until the last minute that you have to go, you need something that is going to be, you know, high quality, and it's gonna have some distinct functions about it. And I always talk about, you know, three vital functions and three vital protections that Tranquility offers. And one is preventing the leaks. We offer a lot of bells and whistles like cuff guards and our super absorbent core to prevent leaks from coming back up to the top and seeping out the sides.

Our products, you know, the other protection that we have is controlling odors, right? We don't want to have that embarrassment odor. We don't want people to stay in their homes. We don't want people's homes to smell, right? We don't want to have that embarrassment for them. So controlling odors, looking for something that will absorb, retain, and lock that bacteria that causes the odors in so it can't travel back out from the product. And then also, of course, protecting the fragile skin, which we've talked about a lot. You know, life without incontinence is challenging. We make products from, you know, various sizes all the way from youth sizes up to a 5XL.

So it's a very large size range and in several different absorbencies. We have our premium products that are designed for maximum absorption and super absorption. And we have a second line of products called Tranquility Essential that is a heavy and moderate type absorption. Within those lines we have, I talked about the briefs with the tape tabs on the sides, which are very good for someone that may be in bed a lot and needs to be changed, and the tape tabs are a little bit easier for the caregivers to be able to change that person with.

You could also get a little bit more customized fit with the tape tabs because maybe, you know, the legs are smaller, so you need it a little tighter around the legs and a little bigger around the waist. So it gives a very customized fit. One of our most popular products is our overnight disposable underwear, which absorb 34 ounces of fluid, which is quite a lot. An average void, I think we say it's around eight or nine ounces. You can imagine how many voids that would be.

Our overnight products in our, in our disposable underwear. We also have overnight products called All Through The Night in the briefs, but on the underwear it's called our Overnight Underwear.

And like I said, they, they hold 34 ounces and they're very soft on the outside, very soft on the inside. We have, you know, the core of the product has an acquisition layer that flows throughout the entire length of the core of the product. So, you know, no matter where that person is urinating that fluid is gonna be locked in, trapped in there and absorbed right down into the product very quickly. Some other manufacturers kind of do a spot dispersing of that polymer that's in there that absorbs the fluids. But our products are evenly distributed with that. So wherever that urine hits the product, it's gonna pull it down in and distribute it across the entire core of that product.

So our underwear and our briefs we've talked about, we also have under pads and various sizes, from, you know, some people call them 'chucks,' and that's just your basic kind of plastic-backed pad. And we have some that will absorb several ounces of urine that are quilted and can be used in the beds and can also absorb up to 34 ounces that are very nice, high quality and, and often, people use them for repositioning their loved ones as well because they're strong enough that you can, you know, turn someone from one side to the next using our underpads. So a wide variety of underpads as well. We offer personal care pads for someone that may not have graduated into the pull on underwear and brief styles yet.

We also do wipes and some Swimmates. That are designed for adults who are one of the only manufacturers of swim products for adults. And those actually don't contain the urine, but they will contain fecal matter. You know, so that there are no accidents in the pool and people can enjoy their lives.

We're dedicated to providing real life protection. And when we talk about Tranquility products, we do talk about our real life protection. We guarantee that our products are gonna hold exactly what we state on the outside of our bag , and I don't have one to show you right here, I wish I did, but we have cups that show it looks like a little measuring cup on the outside of our bags.

And so you look at the outside of the bag and, and it says this will hold, it has four cups, right, full of fluid and it, and then a little bit in the fifth cup, 34 ounces. So we guarantee that under pressure when someone is sitting, wearing our products or laying down or moving around. 'Because you're not wearing products in floating in space, right? There's pressure on those products. So we guarantee that our products are gonna hold exactly. Is stated on the outside of our bags, whether it's 34 ounces, 25 ounces, or 13 and a half ounces, which are some of the varying absorbencies that we have. Those products, when there is pressure applied to, to 'em, they will not leak. Right? So we guarantee that real life protection and we want to give everyone the opportunity to try them. We have people waiting to talk to you about care consultations. We'll, we'll have this conversation with you. What are your challenges? What's happening? Well, someone might say, "I'm leaking at night."

Well, we have a great product for you. Why don't you try our overnight products? Let's send you some samples. That's one thing that our product stands behind is sending you a sample before. You have to choose the product, right? We'll send you out several samples, a couple different sizes, maybe a brief style and a pull-on style, and lets you decide what works for you.

We don't want to tell you, we want you to decide what's working for you. So we'll work with you to come up with a care plan that, you know, takes all those considerations into mind, and comes up with a solution that's right for you. And we'll keep working with you until we find it.

Bruce Kassover: That's really encouraging to hear. So one of the other challenges of caregiving is affordability also, because you know, there are expenses involved and, you know, especially in a challenging economy, it could be considerable. So maybe you could talk a little bit about affordability of some of the products as well.

Lori Mika: Sure. Of course. There are, you know, it's an expense and it's something you have to kind of build into your budget, you know, every month or every week.

And incontinence products, you generally need a lot of them. So that expense, you know, can get rather high. You know, if there is a situation where you're having some trouble affording the products, there are some resources out there. 

A couple different ways to look at that is going through your area, office on aging or possibly senior centers. Some of them have programs that offer, you know, products to bridge the gap between what you can afford and, and maybe the next month until you could purchase them again. There are also some Medicaid programs out there, if that's an option, and there are, many, most states have programs that actually cover, Medicaid programs that actually cover incontinence products and you get a certain allotment every month. So I would recommend reaching out to either your provider or a DME that works in the Medicaid space that can help you make sure that you're getting the products, you know that you are due under your Medicaid coverage.

A lot of people don't know that Medicaid will cover incontinence products, and we talk to so many people that once we tell them, yes, reach out to your provider and ask about incontinence products and they actually do and they call us back and they're just almost in tears because they're so happy. They don't have this added expense every month and their products can be covered.

So it's, you know, it's a tough thing financially and it's also very emotionally releasing when you find out that yeah, there is, there are aids out there for me to help pay for these products and the Medicaid coverage is, if it's not covered under Medicaid, sometimes there are waivers in the state, like, senior care waivers that can cover these products.

You can also look at, in Ohio we have a program called Passport that helps seniors afford these types of things. And if it's not Medicaid and you have regular insurance or you have Medicare, there is no coverage for incontinence products, unfortunately. But there are some, we'll call them 'waivers' or we might say that it's like an FSA or a health savings account that they offer, and you can use those funds for that.

So there are ways to, you know, to get some assistance in those areas. And I think asking a lot of questions, doing your research, calling the area office on aging in your local community and finding out what those programs are is really, really important.

Bruce Kassover: Well, that's gotta be a relief to a lot of people to hear. So that's great to share.

Lori Mika: Yes it is. And, and we can help too, if you call our customer service number, too, we have preferred dealers that we work with that can help guide you along in this too. This is what they do every day, especially with the Medicaid space. They can help guide you to proper providers that carry Tranquility products that we know work. And so you're not alone, you know, and having to figure all this out. We do know people that can help you no matter what state you're in. We do know people that can help you find the right products and make sure you're getting them on your Medicaid coverage.

Bruce Kassover: That is excellent to hear. So how can somebody who's interested in learning more about Tranquility and what you guys offer, how can they find you?

Lori Mika: Well, we definitely want you to look for us either online at Tranquilityproducts.com and learn about us that way, or if you'd like to talk to a live person, which I know many people do, you can call our customer care team at (866) 865-6101.

Bruce Kassover: So, Lori, as you know, this is Life Without Leaks, and one of the things we always like to do before we wrap things up is ask our guests if they have one little hint, tip, strategy, bit of advice to help people who are listening live a life without leaks. So maybe you have one you can share with us.

Lori Mika: I do. I, I want to just say that life with incontinence is challenging, but finding the right solutions shouldn't be. Please call us. We can help you. We want to help you find the right solutions for you.

Bruce Kassover: That is outstanding to hear and I appreciate it. I thank you for sharing your thoughts and your insight with us today and, certainly I'm confident that there are thousands and thousands of caregivers out there right now who will be listening to this, who can really benefit from everything you've had to say, so want to thank you for, for sharing with us today.

Lori Mika: It's absolutely my pleasure and I do hope that this will help some people out there and, and, you know, certainly it's hard, but you're not alone. And that's, I think, the most important thing to remember is you are not alone. Ask questions. There are others in the same position as you, and you can find the help.

Bruce Kassover: Life Without Leaks has been brought to you by the National Association for Continence. Our music is Rainbows by Kevin McLeod. More information about NAFC is available online at nafc.org.