The prevalence of incontinence among people aged 65 and over is significant. Prevalence varies by living arrangement with the highest rates in long-term nursing home residents (75.8%) and hospice patients (62.1%). The situation is slightly better for noninstitutionalized persons (50.9%), short-term nursing home residents (46.1%) and home healthcare patients (45.4%) with the lowest — but still significant — rate in residential care facilities (39%). In the United States, the overall cost of bladder incontinence among adults was estimated at $19.5 billion in 2000, and by now this cost must be higher.

Incontinence costs

The cost of incontinence care is considerable and includes not only absorbent products, skin and wound care but also laundry, as well as the time spent by nurses and caregivers. Much of this expense is driven by skin problems and leakages caused by low-quality absorbent products or inappropriate size selection. Incontinence is also a predictor of functional limitations and is associated with an increase in falls that may result in injuries and often happen on the way to the toilet.

The illusion of savings

One popular way to attempt cost savings is to use cheaper products. This rarely works, as cheaper products typically have a lower quality that triggers further costs. If absorbent products are made of low-quality materials they cause skin irritation, which is expensive to treat. Low absorbency means frequent changes, requiring more products per day and increasing total cost. The feeling of wetness wakes people up and causes sleep deprivation that negatively influences overall well-being. Additionally, using products without anti-leakage features causes frequent leakages that lead to more staff work and higher expenses from bedding changes and laundry costs.

Quality pays back

“Buying cheap means buying more.” This rule of thumb applies to fast-moving goods such as incontinence supplies. Quality incontinence products perform better due to higher absorbency and improved construction using softer materials. They allow a full night’s sleep without changes that benefit both the user and the caregiver. With no leakages, there is no need to change bedding or buy extra underpads. Soft, breathable materials reduce the incidence of wounds and irritations, preventing some costs from ointments and skin treatment. This is especially useful when facing staff shortages, but also allows caregivers to care more for the psychological needs – not only the body – of their patients or loved ones, an outcome of inestimable value.

How to choose quality cost-effective products?

Here are some absorbent product features that can help ease conditions associated with incontinence and are not universally found in such products. These features are typical of premium quality products and the benefits they provide may reduce other costs, making the quality option the cost-effective and efficient option as well.

• High absorbency and retention capacity. The rule “the more, the better” does not necessarily apply here, but high absorbency allows a product to protect for more than two hours which is especially important at night. This not only gives more dignity to the wearer, but also prevents sleep deprivation, improving overall well-being. Staying dry keeps incontinent people away from the toilet at night so the risk of falls, injuries and their complications is reduced.
• Breathability. Incontinence products with a vapor-permeable outer layer help the skin breathe easily, improving its health. If the product has a vapor-permeable shell the skin sweats less, stays drier and is less prone to irritations, which is especially important on hot days. A breathable shell is also softer and quieter, providing discretion and a better chance of uninterrupted sleep. The bigger the surface of the breathable zones, the better for the skin. The NAFC (National Association for Continence) requires manufacturers to provide breathability at least on the side “wings” and discourages using products with a plastic outer layer “because it negatively impacts the skin health, contributes to trapped heat and perspiration and thus skin breakdown, contributes to the growth in odor-causing bacteria, is noisy and uncomfortable, and generally serves no useful benefit over high-quality disposable absorbents.” Note that cloth-like or textile-like products are not always breathable or vapor permeable: a majority of cloth-like products only have breathable wings which do not ensure the same microclimate as fully breathable products.
• Side gathers, leakage barriers or leak guards. Surprisingly, there are still some products without this feature, which is one of the best protectors against side leakages. Side gathers are most important when leakages are abundant, even if infrequent. Their absence is a key reason for embarrassing leaks or frequent changes of clothes, underpads or bedding. Using briefs or underwear with barriers – even if they are more expensive – saves time and money spent on changing bedding and laundry.
• Softness. Briefs, underwear or pads are in direct contact with the body. In fact, they are replacing regular underwear, so they should be soft and gentle to avoid irritating sensitive skin in intimate areas. The most sensitive perineal areas deserve special care, which is why materials touching them should be extremely delicate. Absorbent products typically have a special distributing layer right beneath the topsheet, which may be made either of non-woven or of plastic. As you can imagine, plastic is unpleasant for the skin, especially in intimate areas, so to avoid irritations or chafing it is better to choose products with a soft non-woven distributing layer. Skin in the elderly is thinner and more prone to abrasion, so contact with rough materials may break its structure – there is no need to add that wound treatment may be long and expensive.
• Elastic elements. A flexible waistband, elastic leg cuffs and elastic closing tapes help adjust the product closely to the body without compromising the skin. When we consume or excrete liquids – or even simply breathe – our body size changes, so even if a product fits well right after application, it may become too tight and press the skin during use. Elastic tapes and waistband allow the product to “work” together with the changing body. An elastic waistband accompanied by elastic leg cuffs also ensures a perfect fit in order to prevent leakages. Fewer leakages = lower cost.

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Marta Maleszewska, Ph.D, is a Seni Brand Expert and consultant on incontinence products focused on designing individualized solutions for optimized continence care and making issues associated with incontinence accessible to a lay audience. If you would like to find out more visit www.seni-usa.com or contact us at marketing@tzmousa.com