Everything You Need to Know About Incontinence Products: The Past, Present & Future

A look at how these products have evolved, where they are today and what to expect in years to come.  

By Tom Wilson, Co-Founder of The CareGiver Partnership and former Global President of Kimberly-Clark's Depend and Poise brands.

Until about 1978, disposable products for incontinence simply didn’t exist and the subject was taboo. At that time, Kimberly-Clark in Neenah, Wis., began test-marketing Depend. Retailers weren’t enthused, and the AARP wouldn’t accept advertising in its magazine because the subject was “negative.”

June Allyson
Former Depend Brand Spokesperson
Movie Star Drives Awareness of Depend
Kimberly-Clark asked June Allyson, who was the No. 1 female box-office star in the 1950s, if she would become their spokesperson, which she did in 1984. Her instant recognition and positive messages, supported by more than $100 million in television and magazine advertising, helped Depend become synonymous with incontinence.

In my role as President of Kimberly-Clark’s incontinence business, I spent a good deal of time traveling around the United States with Allyson and her husband, attending speaking engagements and producing television spots. People would stop her on the street, thanking her for becoming the spokesperson and getting the word out to “get back into life,” which was Depend’s tagline back then.

Three Decades of Change
It has been 33 years since Depend was first market tested. Here is what progressed during that time.
Watch the video:  How to choose the right incontinence product 
  • The first product was briefs, also known as adult diapers. They were, and are, anything but “brief.” Then came undergarments with button straps.

  • Different sizes of briefs were introduced.

  • The outer shell was changed from plastic to a cloth-like, breathable material, reducing the rustling noise and allowing skin to breathe better.

  • Product packaging changed from bulky cartons to slimmer poly bags.

  • The use of super-absorbent material, which replaced a lot of the “fluff,” made the products better fitting while improving absorbency.

  • Guards for Men were introduced, targeted to men experiencing incontinence following prostate surgery.

  • It was discovered that 20 percent of feminine care pads were being used for incontinence. This led to the introduction of Poise by Kimberly-Clark. Unlike pads for feminine care, incontinence pads like Poise were super-absorbent and protected three times better.

  • The last major innovation was pull-on underwear, first introduced in the United States by Kimberly-Clark. One day, I was sitting in my office wearing a “brief” over my suit pants, thinking about how we could do better than that and that I wouldn't want to have to wear one of those. Within two years, Depend protective underwear were introduced and they became the No. 1 seller.

  • It’s been more than 10 years since protective underwear were introduced, and no notable major innovations have occurred since.

  • There has been a recent shift to deal with dignity issues by providing pull on underwear specifically designed for men and women.  They are also available in colors and prints.  In the next year or so, 'white' will be replaced by colors and or prints.  This is what consumers prefer because they provide added normalcy and dignity.  In short... they are more underwear like. 

  • Unfortunately, the leading manufacturers have made it challenging for consumers to determine the right product for them because there are no naming standards for styles and the descriptions are changed frequently; there are no standards for describing absorbency levels; and nomenclature used to describe products is not easily understandable, especially when trying to compare brands.  Here is a quick guide that sorts it all out.

    Product Usage
  • The average wearer uses 2-3 products daily and wears them for 5 to 8 hours on average.  More briefs (adult diapers) are worn daily than other styles like pull on underwear or pads.
  • 10% to 15% of all products leak. Briefs (adult diapers) leak more than underwear while male guards leak the least.
  • Briefs and refastenable underwear are changed by a caregiver more than half the time.
  • Those who wear pull on underwear and more than one product style... wear a pad.
  • Only half of all product changes include a skin caring product such as a wipe, cream, etc.
  • Those who wear incontinence products most often have high blood pressure, arthritis, urinary tract infections, diabetes, heart conditions or prostate cancer.

So, what is available today?  Here is an easy to understand chart of the various types.

Pads — From very thin liners for dribbles, to those for 'sudden wetness.' Pads are smaller and less expensive than full garments.  The largest pads are sometimes referred to as 'denial' pads - a person denies they are incontinent and wishes to continue to use a 'pad' as long as possible, so they don't have to buy 'adult diapers'. 

Pull-on underwear — More like regular underwear and good for urinary incontinence.

Adjustable underwear — Same as the above, but with tear-away panels, making them easier to change for either a caregiver or while away from home for the wearer.

Shields, formerly Undergarments — A body undergarment held up with elastic straps that button into the undergarment or shield. Shields are open on the sides to help skin breathe and are used for urinary incontinence.

Products for men — Sometimes referred to as male guards or guards for men, these are designed for urinary incontinence following prostate surgery and other issues.  Today's 'guards for men"' or 'male guards' leave a lot to be desired.  They don't fit well and are uncomfortable and hence, they don't work all that well. We expect to see significant changes in this area and are working to develop and test a new to the world design that will better meet the needs of men.

There is also the penis clamp which looks a little like a shop of horrors.  One 'clamp' brand is called 'dripplestop'.  Another product for men is referred to as a drip collector.  The penis is inserted into a sleeve that absorbs small amounts of urine.

Briefs, or adult diapers — A full garment providing maximum protection against urinary or bowel incontinence.

Booster pads — This product is like the old “diaper doublers", providing extra protection (+40% versus a primary garment alone) and economy.  It fills up and you throw it away and continue using the primary absorbent product (i.e. pull on underwear or brief).  Booster type pads were created by Kimberly-Clark in the late 1990's, but didn't do well so they discontinued them in 2011.  Other competitors stepped up with even better designs.

Underpads — Absorbent pads with plastic backing to protect mattresses and chairs. Available in a range of sizes, some offer super-heavy absorbency to allow a person to lie in bed without wearing an absorbent garment.

Reusable products — Similar to cloth diapers, these are better for the environment in some ways, yet require washing and use of energy. They will not keep a wearer’s skin as dry as a super-absorbent product will, which has been proven in numerous scientific studies.  There are some systems which use disposable pads that are fitted into washable underwear.  The specially designed underwear are made to fit the pad. Abena from Denmark is one such brand.  Another newer brand for ultra light urine loss for women is branded Fanny Pants.

Other Important Incontinence-Related Products

Wipes and washcloths — Unfortunately, only about half of incontinence product changes in the United States include a wipe, which is effective at improving skin condition and general well-being.

Gloves — Using low-cost gloves is important, especially if you're a caregiver.

Odor control — There is a range of products used by professionals in long-term care facilities. These are much improved over the types found in stores.

Skin care — The routine should include a skin cleanser to remove matter, a moisturizer for comfort, and a skin protectant to provide a barrier against urine and feces.

Disposal - wheather a person is at home, a friends home or traveling, discreet disposal and the control of odor can be a concern.  While many simply throw them in the trash, others may use a produce bag they got from the store.  Today, there are specially designed disposal bags for incontinence products that help disguise and control odor. 

What baby boomers demand now are products just like their normal underwear, not merely “underwear-like.” The ideal product will: 
  • Look like normal underwear. Colors and patterns will look more like regular men’s and women’s underwear.

  • Fit like normal underwear. Wearers also want a close-to-the-body fit for better containment. Manufacturers may replace fluff with thinner fabric-like materials that contain a new class of super-absorbency. This will make the product much thinner, more flexible and less noisy.

  • Be sized to protect better. Since the ability to absorb and protect is directly linked to the fit of the product, more sizes will be available. Manufacturers also will introduce products designed for individuals with special needs whose lack of muscle tone doesn’t allow current products to fit correctly.

  • Cost less and offer better value. Future incontinence product designs will use less materials to provide the same or better protection, and will be manufactured on equipment that is more efficient than today’s.  We are working on a replacement for pull on underwear for men what will reduce  materials by over 50% and may save consumers millions of dollars each year.  Plus they offer greater dignity, discretion and comfort.

  • Better manage fecal incontinence.  10% to 15% of the senior population has fecal or bowel incontinence (Source: National Institute of Health 2007).  The incidence grows to 45%+ in nursing homes.  Yet no manufacturer has invested the time or money to develop a product specifically designed to contain stool.  We are working with our manufacturer/partners to generate interest in this area.  There is one product from Abena (imported from Denmark) that is designed for fecal incontinence... but it is a pad like structure, not a full containment garment.

  • Simplify product selection. Manufacturers or the governments will establish comparative nomenclature to help consumers decide which product is right for them.  Even some of the senior officers at major corporations who manufacture incontinence products couldn't tell you the difference between a male guard, pull-on underwear, adjustable underwear (used to be called refastenable underwear) brief, adult diaper, shield, an undergarment with a hook and loop fastening system versus one with button straps, a drip collector, a pad, a liner, a guard or a body stocking.

    On top of this, the manufacturers change the nomenclature frequently, add new products, discontinue others and on top of this change the absorbency descriptors on a regular basis. Who can tell the difference between an extra plus and a super plus; what's more absorbent... maximum or ultimate?  Even two leading manufacturers in the U.S. use different nomenclature for the same product type.  The market leader refers to their least absorbent pull-on underwear as "extra" while #2 refers to theirs as "plus"; the market leader refers to their less absorbent underwear as "super" while #2 has named theirs "extra".  So which would you buy standing at the shelf - extra or plus or super?  No wonder everyone is totally confused.

    It is impossible to compare absorbencies because there are no standards.  Some brands just use names (i.e. super plus, ultimate, maximum), others use a picture of cups while others use an image of droplets.  The consumer is at a loss.  Frustrated, they take a chance and purchase what they think or hope will work, only to find out that a product doesn't fit or worse, leaks.  In most stores, the pharmacist is not trained nor do they have time to come out from behind the counter.

Difficulty Shopping for Incontinence Products
With all the styles, sizes, absorbencies and brands, what will work best? Many people buy what they think they need, and find out at home the fit is wrong or the absorbency isn’t sufficient, which leads to wasted money and time.  They can't be returned once opened.

Try Before You Buy - Samples to Your Home
The answer is being able to 'try before you buy'.  Here is a resource where you can try over 100 different incontinence products - different styles, sizes, absorbencies and brands.  The only cost is $3.49 to cover shipping and handling.

The CareGiver Partnership offers nearly 500 incontinence products that can be delivered to your home on a schedule you determine. Take advantage of the Incontinence Product Finder that helps you find the right product, browse a library of more than 1000 caregiver resources, and enjoy access to a board-certified Physician Assistant and Mayo Clinic-trained nutritionist.

They even offer a Never Run Out service so you can have products delivered to your home on a schedule to fit your needs.  There is no commitment, but you can save $8.00 on your first order and 5% thereafter.

But what many customers say they really appreciate is the personal help by an all-female team of knowledgeable Product Specialists who have each been a caregiver to a loved one. Call 1-800-985-1353.

Below are several helpful videos that provide additional information about incontinence.  These are presented by the makers of Prevail. 

The CareGiver Partnership is a national direct-to-consumer retailer of a broad range of home healthcare products for incontinence, diabetes, nutrition support, skin care and more, providing home care products that help maintain personal dignity. The company is celebrating its fifth year providing products, services, and advice to caregivers and their loved ones coast to coast. http://www.caregiverpartnership.com/


Lisa said...

Thank you, Mr. Wilson, for this helpful information and somewhat perplexing description of a perplexing problem. What will it take to get all you guys on the same page with the standardization? How is the absorbency of a tampon determined? I'm sure you have been all through this in your mind and the marketing guys will have reasons against solving the standardization problem. Anyway, it's been very interesting to get the insider scoop on something that just seems to make sense as a much-needed solution. Looking forward to the next phase.

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