Warning: long post.
I don't know about the NHS funding situation in detail although I know it's poor. I'm severely incontinent (urinary only) due to nerve damage caused by spinal stenosis and episodes of cauda equina syndrome, and have been for six years so I’ve trialled a lot of products. This is my experience: Boots' incontinence products are poor quality and need to be changed much more often than other brands of equivalent rating. Boots also sell another brand, I think it’s Attends, and when I’ve tried their own I’ve thought that it’s an Attends product that’s failed quality control because Attends perform much better than Boots’ for me, although there are better products for me on the market. There's a huge range of these things out there, but the choice from online suppliers in UK is very limited in comparison with what's available from continental European suppliers. Generally you can buy ‘by the pack’ or ‘by the case’, a case being four to eight packs depending on the brand, and there’s a definite cost saving.
If family are going to have to pay for what she needs, it’s worthwhile consulting your aunt on what she prefers. The UK supplier I buy from, Incontinence Choice, supplies individual samples (paid for) so she could try the different types and brands. I also buy online from a Dutch firm ABDL Factory, but I tend to hit my credit card for it, because the delivery is so expensive I try to buy only four times a year. They also supply samples, in packs according to type and size. From Incontinence Choice I buy the Lille Supreme pants (pull ups) I wear during the day, and from ABDL the Absorin brand slips (also called briefs) I wear at night. For some reason ABDL don’t sell the pants I wear in my size but if they did I’d buy both products from them. For both Tena would probably be my second choice but they’re definitely at the high end of the price range.
There are basically three options and the choice for your aunt depends on whether she’s bedbound or not, and obviously what she’s comfortable in. What the home gave you may not actually be the best for her and if you can buy her some samples of the different types to try, you’d be giving her a lot of help. The pads like the old sanitary pads need to be worn with net fixation pants otherwise they aren’t held close enough to the body and are more suitable for someone who is fairly active. There are pants (often called pull-ups) that are like underwear. These are also meant for ambulant people but they’re the easiest to change, especially if someone travels a lot as I do and have to do it in a public accessible toilet. The care home probably buys them because they're likely the easiest to change on a bedbound patient. They’re also not the most absorbent because they can get very heavy if the absorbency is too great, lose their security and sometimes show if the wearer is wearing pants with a top that doesn’t go to about mid-thigh. This also applies to the pads. With me they don’t protect me through the night either, due to the relatively low level of absorbency (1950ml).
The recommended best option for someone bedbound, and for other users at night, are the slips, also called briefs or diapers. These are the ones like a nappy, they have tabs at the back which stick to the front of the slip, some can only be sealed once, most now can be resealed but it’s something to look out for in the product description. Avoid the ones which have sticky tabs front and back, the wearer needs to fit the product with those and the plastic tabs can be very uncomfortable if in the wrong place. The ones with tabs only at the back and a large ‘landing area’ at the front are much easier to fit. This type of protection is the best fitting so most secure, and also has the highest absorbencies. It also needs help from another person to fit properly unless your aunt is still quite agile; you have to lay it out on a chair or the bed, sit on it, pull the back up, pull the front up while holding the back wings tucked under your elbows, spread the front wings across tummy, pull the back wings around to where they’re wanted to give the closest fit at the front, open the sticky tabs on the back, then press the tabs down on the front landing area.
Some of these slips (briefs) have an absorbent layer nearly all the way across, others are simply large pads stitched to the different style backing. The extra absorbent layer adds to the protection but it also adds a lot to the comfort as it keeps a bigger area dry and comfortable.
All these products come with special backing sheets that can be PE (polyethylene – plastic), completely waterproof but possibly not the best for a sensitive skin as it’s not breathable and also noisy; PUL (don’t know what it stands for but it’s a non-rustling breathable material), and there’s also something else the name I don’t know, that’s also a breathable fabric-like material. This breathable backing is a big factor in choice for me otherwise I get nappy rash. You can’t use petroleum-based products like Vaseline with incontinence wear, it ruins the product’s absorbency.
Don’t be taken too much by absorbency ratings, they’re only useful for comparisons between products. These things are tested in a laboratory and the rating figures given are the maximum amount of liquid they’ll absorb which is always beyond the tolerable wearable level.
There’s no getting away from the fact that these things are expensive but there’s also no getting away from the fact that the right product, comfortable as well as making the wearer feel secure, makes the difference between allowing them to take part in their chosen activities and enjoy their social life, and feeling too insecure to go out. The right product, changed at the right intervals, will also give greater protection from the normal hazards of being incontinent like sores and nappy rash.
HTH.