A way to let go of fear

Accepting the use of adult diapers is a journey with various stages-denial, concealment, rejection and reluctance

- Puja Awasthi

When the idea of using an adult diaper was first suggested to Narendra Mishra, now 75, his instant reaction was outright rejection. "Do you want to shame me? Am I so helpless? Is my life a burden?" he remembers asking his son.

Seven years ago, when the suggestion was first made, Mishra had no alarming health concerns. But a persistently low blood pressure made him dizzy if he got up suddenly, and chronic knee pain made walking to the toilet onerous. Nights were particularly challenging.

In a country where social conditioning has led us to believe that a marker of being a grownup is the ability to control bowel urges, and to clean up after oneself, Mishra's concern was not misplaced.

Dr Abhishek Shukla, senior geriatric physician who established Uttar Pradesh's first and only dedicated elderly care facility, Aastha Geriatric Hospital and Hospice in Lucknow, said a number of psychosocial reasons stood in the way of diaper acceptance. "As we age, there is natural functional decline in our five essential organs-heart, lung, liver, kidney and brain. This becomes difficult to accept as our conversations around healthy and graceful ageing are still nascent. There is an urgent need for seminars, awareness building and the like," Shukla said.

While incontinence, he said, could be age-related (for instance, the outcome of a natural weakening of the bladder and pelvic floor muscles), it could also result from a completely different cause such as hypocalcemia (too little calcium in blood), which when corrected would reverse the incontinence.