The March 2013 issue of Advances in Skin & Wound Care contains an article, "Construct Validity of the Moisture Subscale of the Braden Scale for Predicting Pressure Sore Risk" by Omolayo, T et al. One of the factors contributing to moisture in the Braden Scale is incontinence.
"The authors were surprised to find incontinence briefs in use among participants who are reported to be continent. It appears briefs are used when residents cannot reach the commode in a timely manner or when nursing assistants are unable to respond promptly to resident calls. Briefs become a toileting alternative. This economy of effort is not consistent with the goals of mobilizing residents to prevent muscle weakness, decrease incontinence, and prevent PrU's. Toileting deserves more attention. If residents receiving rehabilitation services are encouraged to use briefs instead of walking or being assisted to the commode, it is possible that mobilization and bladder training controls are not being met. This may delay rehabilitation or result in longer nursing facility care. There is evidence that bladder training and mobilization can be improved with regular toileting, and this should be a goal of care. One study of culture of care in two nursing facilities demonstrated that, even in a setting with a strong culture of care, a commitment to continence care and incontinence prevention was not fully embraced."
Evidently many facilities are using diapers to replace nursing assistants, thereby saving money and increasing profits. This is exactly what happened to our mother in the hospital, leading to her pressure ulcers and her death. This despicable practice must stop. An investigation is needed to see how widespread this practice is.