How do you help someone you love with the most personal parts of care… without feeling overwhelmed or unsure if you’re doing it “right”?

If you’ve ever stood in a bathroom or beside a bed wondering how in the world you’re supposed to change a pull-up or a brief, you’re not alone. Most Christian family caregivers eventually face this moment — and many tell me it’s the task they dread the most. Not because they’re unwilling, but because they’re afraid of hurting their loved one, doing it incorrectly, or stripping away their dignity.

I hear these stories every week. A daughter trying to help her mom after another urinary tract infection… a husband quietly struggling to get a pull-up on his wife without tears… a caregiver who feels guilty for feeling grossed out or unprepared. If that’s you, friend, you are in familiar company. And you’re not failing. You’re simply learning a new skill during a very hard season.

Today, let’s walk through this together — calmly, clearly, and anchored in the truth that God is not a God of confusion but of peace (1 Corinthians 14:33). You will leave this article knowing the difference between pull-ups and briefs, how to decide which product will help most, and a few practical steps that will immediately make this task easier.

And we’re going to do it using one of my favorite tools from the DigniCare™ Method: Beginning With the End in Mind.

The Caregiver Behind the Question

Picture this: you’re already running on little sleep. You’ve changed the sheets twice this week. Your loved one insists they’re managing their incontinence “just fine,” yet the laundry pile and recurring infections tell another story. You want to help — you need to help — but you also want to preserve their dignity.

You feel the tension between responsibility and overwhelm. You want clarity, structure, and a way to do this well without creating conflict or shame. You want to be faithful in this season, even though this particular task feels like a mountain.

That’s exactly why today’s conversation matters.

Understanding Pull-Ups vs. Briefs: Why the Difference Matters

Before we talk about how to change incontinence products, we need to understand which one best supports your loved one’s needs. Let’s bring some order back into this — because God’s design for caregiving is not chaos, but clarity.

1. Start With Mobility: Who Moves Easily?

Pull-ups function like underwear.
They slide up over the hips, require some ability to stand or lift the hips, and tend to feel more “normal” to the person wearing them.

Use a pull-up when:

• Your loved one can still stand or help with dressing

• You want something more discreet under clothing

• The incontinence is light to moderate

Briefs — often called “tabbed briefs” — open completely and secure at the sides. They don’t need to be pulled over the hips, which means you can put them on while the person is lying down or has very limited mobility.

Use a brief when:

• Your loved one is a heavy wetter

• Overnight leakage is a problem

• Mobility is limited or standing is unsafe

2. Consider Absorbency: How Much Are You Managing?

Pull-ups do a great job with light or moderate urine loss. They do not handle floods.

Briefs are designed for maximum absorbency. This is why many caregivers use a combination: pull-ups during the day, briefs at night. This keeps dignity intact and reduces laundry, frustration, odors, and skin breakdown.

3. Prepare the Environment: Order Brings Calm

One of the simplest ways to reduce stress during incontinence care is to prepare your supplies ahead of time.

Have on hand:

• Clean pull-up or brief

• Wipes

• Barrier cream

• A trash bag

• Optional: scissors (for pull-up removal), disposable pads

When the environment is calm and organized, you feel calmer. And when you’re calm, your loved one mirrors that.

Five Quick Tips for Using Pull-Ups

1. “Warm” the Pull-Up First

A colleague once taught me this trick: crumple the pull-up slightly to soften the fibers. This helps it contour to the body and feel more like underwear.

2. Use Pull-Ups for Outings

Because they are less bulky, they’re perfect for doctor visits, church, or lunch out.

3. Tear Away the Sides

Most pull-ups are designed to tear easily. If the sides don’t tear, keep a small pair of scissors in the bathroom.

4. Learn the No-Shoes Technique

Yes — you can change a pull-up without removing shoes and socks. I teach this technique on YouTube because it often transforms a caregiver’s confidence immediately.

5. Watch for “Reusing”

Many older adults — especially those who lived through the Depression — will reuse a pull-up if it “doesn’t look wet.” This is a top contributor to recurring UTIs. Count products and check the trash if infections keep occurring.

Five Quick Tips for Using Briefs

1. Choose Briefs for Heavy Overnight Wetting

They simply hold more fluid. This prevents skin breakdown and protects bedding.

2. Pre-Fasten the Tabs

When someone is sitting, partially attach the tabs, then pull the brief up like pants. Once standing, adjust the fit.

3. Use in Bed When Mobility Declines

Because briefs open fully, they’re easier to change when rolling the person side-to-side.

4. Fit to the Body

Briefs allow more adjustment for thin, curvy, or hard-to-fit body types.

5. Add an Extra Pad Only When Needed

An internal booster pad can help with high-volume incontinence, but don’t over-pad — it can cause leaks by redirecting fluid.

Maintaining Dignity Is the Real Goal

This is not just about products. This is about image-bearing dignity (Genesis 1:27). Your loved one’s worth does not change because their continence changes. They are still God’s creation, still deeply valuable, still worthy of honor.

Your attitude matters more than your technique.

When you approach this task with calm confidence, clear instructions, and a gentle spirit, you create a safe, peaceful experience. If you show discomfort or disgust, they feel it. But when you show assurance, they relax — and the task becomes easier for both of you.

As you learn these skills, remember: this is not a failure of your loved one; it is part of the progression of dementia. Nothing more. Nothing less.

A Simple Next Step You Can Take Today

If this topic brings up questions — and it usually does — I want to invite you into a space where you can get personal, practical coaching from me in real time.

Join us for the FREE monthly Ask the Dementia Coach Q&A.
It’s a small Zoom room (usually 2–4 caregivers), designed for Christians who want clarity, calm, and biblically grounded direction for their specific situations.

You’ll walk away with:

• A clear plan for your next step

• Peace about what you’re facing

• Confidence to care without chaos

Register here: Message me the word “ASK” on Instagram or Facebook, and I’ll send you the link immediately.

You do not have to figure this out alone.
Let’s walk this season with dignity, order, and truth — together.

May the Lord bless you and keep you.

Ever Wonder How To Know What Is Causing Your Caregiver Stress?

Take Our FREE Caregiver Stress Assessment Today!

https://dignicarebydesign.com/dca

Read More:

Talking About Caregiver Burnout With Michelle Gordon

Email me: lizette@dignicarebydesign.com

Message me at Instagram: https://www.instagram.com/thinkdifferentdementia/

Listen to the Podcast

Listen to the episode on the player above, click here to download the episode and take it with you or listen anywhere you normally listen to podcasts.

[0:01] Well, what’s up, Christian caregiver? Welcome back to Christian Dementia Caregiving, the podcast where we teach Bible-believing Christians how to make dementia caregiving easier for you so that you can continue to create moments of joy and actually have hope during this journey. I trust that you have been finding tremendous value in these quick little episodes that are a little more practical related to taking care of somebody living with dementia. I figured that doing a series of these quick tip episodes might help you in your journey and give you a couple of of ideas on how to do things a little bit differently.

[0:50] Today’s episode, and I know that these episodes are a little different because they’re way more practical than some of the other types of episodes where we work on really our thinking processes about caregiving, but it’s more than just how we think about caregiving. It’s the actual skills to perform care to a person that we help, that we love. So I thought that this mini series of quick tip episodes might be beneficial for you to have in your back pocket. And today’s episode is going to be about how to change a pull-up or a brief.

[1:32] Now, before we can talk about how to change a pull-up or a brief, We need to look at what the difference is between a pull-up and a brief, and when one is more appropriate and when another one is more appropriate. So let us start with that very practical discussion about the differences between a pull-up and a brief. They are the same but different. They both have a purpose of protecting the outer clothing for a person who is having trouble maintaining or controlling their bowel and their bladder. So they are both types of incontinence products. And the purpose behind incontinence products is truly to maintain the dignity of the person who is wearing them and protect the outer clothing from becoming soiled. The reason for that is immediately once the outer clothing becomes soiled, we know that that person has had an accident, that there has been a problem. So let’s start with pull-ups. What are pull-ups? Well, pull-ups.

[2:49] Part of it is in the name, right? It is something that you just pull up over your hips, similar to underwear, and generally they can be more discreet and they feel more like underwear. They are not super comfortable, specifically if you’re not preparing the pull-up before you actually put them on. A lady that I worked with many, many years ago taught me this trick. She would take the pull-up and she would kind of rub it a little bit, kind of warm it up, kind of crumple it a little bit around the middle part so that it would conform to her body more and kind of loosen up the fibers of the pull-up. And pull-ups are generally considered to be a little more discreet, and they are preferred by people who are more mobile or more independent.

[3:50] A brief is a type of a product that looks more like a quote-unquote diaper. They come with tabs that open completely and are secured on the sides. The biggest difference between a pull-up and a brief, other than how they are put on, is how much liquid or how much fluid they are able to absorb and which one is easier for the caregiver to change. And so pull-ups can be changed both in bed and sitting on a toilet. A brief can be changed also in bed and sitting on a toilet. it. It’s just very much a skill set level of care. So let’s start with five quick tips.

[4:43] For using pull-ups. One of the biggest differences related to pull-ups is we need to know how mobile the person is. If the person is very mobile out in the community, wearing a pull-up can be an easier transition because they look like underwear, the person can put them on, more like underpants if they’re still able to get dressed. And if you are able to put them on If you need to put them on laying in bed, the person needs to be able to lift their hips up to pull them up over their hips. You can put a pull-up on both in bed as well as in a toilet or on a bedside commode. The second quick tip for using a pull-up is when we want to be more discreet. Briefs are bulky and pull-ups conform to your body more so they look more like underwear. But part of the problem is that if the person is, if the volume is too much, then discretion goes out the window. So we have to consider that.

[5:57] But if a woman, if somebody is going to a concert or something or out in the community for lunch or a doctor’s office, and we typically may be using a brief at home usually, but when we’re going out into the community, we want it to look a little bit more conforming to the person, then we can try a pull-up for that period of time. Another quick tip for pull-ups is it is.

[6:28] Vastly, and I’ve kind of alluded to this a little bit, it is better used for people who are not having big periods, a lot of urine, very much suited to light or moderate incontinence. It doesn’t hold a flood. Another benefit or quick tip for using a pull-up is most pull-ups tear away way at the side, which means you can either tear it, and if you’re not strong enough to tear it, you can also use a pair of scissors by putting it in the bathroom and make sure that you can take them off easier. If you are helping somebody with a pull-up, there is a technique that you can actually change a pair of pull-ups without taking a person’s pants on and off. However, that can be very challenging if you haven’t seen it. And in order to help you with that, we actually have a video of me showing how

Changing Pull-Ups: Tips and Tricks

[7:29] to change a pair of pull-ups for somebody without taking their shoes and socks off. And you can find that on our YouTube channel, and we will include the link in the show notes below.

[7:51] Are you a Christian dementia caregiver struggling to cope? Does dementia caregiving really need to be this hard? I invite you to join our free monthly Ask the Dementia Coach meetup. Get personalized guidance and support from me, a pastor’s wife, occupational therapist, and Christian dementia coach. By blending evidence-based strategies with Christian principles, you can radically improve your caregiving experience. Register Register now for our next session of Ask the Dementia Coach. We limit registrations, so don’t miss out. Sign up today.

[8:41] So that’ll be fun for you to actually go look at. A certified nursing assistant actually taught me that trick many, many years ago, but it is a great way to change a pull-up without taking people’s shoes and socks off. I promise it is possible. You need to go check it out. Another couple of tricks that I want you to consider, quick trips, quick tips, is to prepare the environment, to make sure that you have all of your supplies in the bathroom or in the bedroom wherever you’re going to change this person’s pull-ups or briefs.

Transitioning to Briefs: Essential Guidelines

[9:19] Those are five quick tips for pull-ups. Now we’re going to go into five quick tips for briefs.

[9:29] And this yet again, and they’re very similar, pull-ups and briefs are very, very similar. They really do, the biggest difference is in how much it absorbs. So the related to making a decision to use a brief is when you absolutely need to have more fluid be able to hold for people who are heavy wetters, especially overnight. So sometimes you can use a pull-up during the day and use a brief at night because briefs are more absorbent at night. So make a decision related to the absorbency. Somebody who is more independent typically does better with a pull-up, especially at the beginning when they may be a little reluctant to start wearing incontinence products. But later on, most people living with dementia will not have a particular awareness that they are wearing a pull-up or a brief. Another quick tip for you using briefs is they are way more adjustable for fitting around the person. But a great initial quick tip strategy is to put the tabs on before you put them on and put them on like a pair of pants or put them away, especially if the person’s sitting. So if the person is sitting…

[10:59] The brief on and fasten it before standing them up so that you can pull them up and then you can adjust the fit. So that is a great technique to be able to do. A quick tip for using a pull-up, a brief in the bed is make sure that, you know, the person can roll because it’s a little easier to change a brief in bed than it is to change a pull-up in bed. So when somebody is a little more limited in their mobility, it is sometimes easier to change and clean them in a laying down position than a sitting up position.

[11:40] Another quick tip for using a brief is it can accommodate different body shapes. Brief is easier to adjust to that person’s unique body shapes. And another trick that you can use with the pull-up, I mean, I’m sorry, with the brief is that, and actually with the pull-up, so we’ll use this one for both, but you can actually put additional pads inside the brief and the pull-up to help with some additional fluid or absorbency. Now, remember the purpose behind incontinence products is to protect the outer clothing so that we can protect the person’s dignity. That is what we’re going for here. We’re going for dignity. But a couple of general guidelines and a couple of general things that I want you to keep in the back of your mind is that you want to maintain dignity and comfort. You want to always have your environment prepared.

[12:41] You want to decide if you can do it in a sitting position or if it needs to be in a laying down position. position, you can try to distract the person as you’re helping them with the task, give them short directions.

[12:56] The more confident and the less grossed out or upset you can be when performing the care, the better the person is going to respond. If you come in with a, I don’t want to do this attitude, or a reluctant in helping with these very personal tasks, the person that you are helping will actually sense that and will make sense, and it will make it harder for you to actually perform this task with them. I know that this is a very hard topic for a lot of people, and if you’re not there yet, just kind of file this episode in the back of your mind.

[13:43] If the person living with dementia lives long enough, at some point or another, they will need help with this particular task because they lose the ability to complete this task with good quality.

[13:59] Which means when they have bad quality, they’re more prone to urinary tract infections, other types of infections,

Understanding Incontinence: Caregiver Insights

[14:10] and all of the negative sequelae that can come from not having done this. Now, something that I want you to keep in the back of your mind, this has come up several times as I work with people, a person might look like they are changing their pull-up or their brief by themselves, but due to not recognizing that it might be wet or soiled, they may be reusing it and become prone to having urinary tract infections. So if you have a loved one who is having multiple urinary tract infections they may not actually be changing their pull-ups like you believe them to be changing their pull-ups so a bonus quick tip is that you can consider you know knowing exactly how many pay attention to how many of the products are actually being used specifically on somebody who is using a pull-up and is more mobile and is doing this themselves because they may not actually be changing the pull-up because they grew up in the depression eras. It doesn’t look like it is soiled, but every time it’s like underwear.

[15:25] They need to be changed every single day. They cannot be used repetitive days in a row or else you will open up a can of worms for yourself that you don’t want related to infections.

[15:39] So these are just five quick tips as well as a description or explanation of

Upcoming Events and Personal Support

[15:45] the difference between a pull-up and a brief. I trust that this episode has been valuable to you even if you’re not at a point where you’re actually needing to do peri-care or private cleaning of somebody. I hope that you will remember this episode when it occurs in the future and come back to it and just get a quick little education related to.

[16:12] Changing a pull-up or a breathe. Now, if you haven’t yet joined me for the Ask the Dementia Coach monthly meetup that I do, our next Dementia Coach monthly meetup is August the 22nd at six o’clock Eastern. This is your opportunity to hop into a Zoom room with me and other people in our community where you can get some one-on-one coaching from me related to any specific question you have related to challenging dementia behaviors or how to take care of a person living with dementia. I limit the signups to 12 because I want to make sure everybody has enough time. Not everybody shows up who signs up, so usually we’re only two to four people in the the Zoom room, but it is a co-creation opportunity for you to be a part of this podcast and actually get your specific individual questions answered to your particular situation.

[17:21] We can maintain your privacy. You do not need to use your own name. We can take your video off. You don’t need to come on camera, whatever we need to do to maintain your privacy. I am open to doing that, but this is my way of giving back and asking you to help formulate this podcast into what it is that would be beneficial and helpful to you. So I invite you to message me the word ask to Instagram or Facebook Messenger, just the word ask, and we will send you the link for you to sign up for.

[18:04] August’s Ask the Dementia Coach. I do hope you take me up on my offer for some free dementia coaching. As I end all of my programs or try to, may the Lord bless you and keep you, and I will see you in our next episode.