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She is a very young, end stage patient with little to zero cognition. this is a recent happening. she has worn depends and is completely incontinent for several years. her under garments have not changed in size are comfortable and dry when she gets undressed. by morning she is drenched, bed linens etc.

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Use rainmom's suggestion. Look up adaptive clothing. They sell one-piece adult jumpsuits that fasten up the back, for exactly this problem. You know you are not alone when you can find the garments you need online!
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My son is autistic. When he was younger he would take off his pjs and diaper at night / then eventually pee somewhere in his room. I solve the problem by buying one piece footed pjs, cutting of the feet and then putting them on him backwards - making it impossible for him to undo the buttons. He's 23 now and still wears them - don't know if he'd still undress at night but I don't want to chance it.
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