Adults who are disabled and wear diapers and are accompanied in public by attendants or caregivers may require changing when they are out and about. Some are not able to change their own diaper or pull-up ("briefs"). This could be due to lack of control over their own hands, legs, etc., paralysis, or lack of the awareness that may be pre-requisite.
They might have cerebral palsy, retardation, quadriplegia, etc. Anything that might prevent them from self-care in this situation.
Fold-down changing tables that are occasionally provided in public restroom are sized for babies and small children. Even if you tried to partiallly lay someone larger across one, they are usually too high and too much in public view, not inside a private stall.
On rare occasions, one comes across a fold-down L-shaped seat inside a wheelchair stall.
These are a little better to aid in changing an adult, but they still do not provide support for the whole torso, which is needed for people who can't stand up or sit up on their own without assistance.
There is also the problem for people who use a wheelchair and who are unable to get out of it without help, or without a proper surface to transfer to, or perhaps without the use of an overhead hoist.
Adults who wish to access the public sphere who cannot use a toilet for whatever reason and are not cathetered because there is not a medical reason for that, wear diapers but are then restricted to a few hours out after which they must repair to a place where changing is possible, if they cannot change themselves. There are very few such places outside the home.
Those who can stand up can be changed by themselves or by an attendant, while standing.
There are a few other ways which are in practice:
People who are not too big or heavy --including older children-- are changed:
--while sitting in a wheelchair. they may be able to lean forward, and/or lift their rear up a bit out of the seat while pushing up against the arm and foot rests, allowing their assistant to reach around under and behind.
they may be reclined as far back as their chair will go, and have their legs extended beyond the foot rest, as much like lying down in the chair as possible.
--after being lifted from their chair by the attendant and draped over at least leaned against the attendant's shoulder.
they may still be resting some of their weight on the footrests at the same time.
--on a couch, chair or bench. these are less likely to be in a completely private location, so attendants have to work very quickly to avoid embarrassment or public reprimands.
--on the floor. private wheelchair stalls that are extra roomy with some floor area that gets almost no traffic, esp with doors that shut all the way to the floor, so that no one can see, can allow the assistant to place a protective sheet down and then a chuck so that a pillow can be provided and that and the clothing are not touching the actual floor.
this can make it much easier on the client but it does require the attendant to transfer the person down to the floor and back up again, so back safety techniques must be closely observed.
All of this is of course way more trouble than it ought to be. Changing areas for everyone of every ability and age should be common public amenities. There are many reasons beside a diaper to need a change of underthings or entire outfits while away from the comfort of home. providing such ability to the general population would be a boon for all. often ordinary toilet areas cannot be used for this as they are too unsanitary.
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