What is the future of incontinence products? Let’s start with the past...

The Past
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 in a few cities. Retailers weren’t enthused, and the AARP wouldn’t accept advertising in its magazine because the subject was “negative.”

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. She was instantly recognized by consumers who needed a solution, and her message, which kicked off many television spots, was “Good news from Depend!”

Allyson touted an ongoing stream of product improvements, such as new styles, better fit, more absorbency, new poly packages and leg gathers. Her instant recognition and positive messages, supported by more than $100 million in television and magazine advertising, helped Depend become synonymous with incontinence. Millions of Americans were able to enjoy life outside the home and spend more time with family and friends because of the added confidence provided by Depend.

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 Depends tagline back then. This made her feel like she was truly helping people. Sadly, June Allyson passed away in 2006.

Three Decades of Change
It has been 32 years since Depend was first tested. Here is what progressed during that time.

• 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 packages were easier to tote also.
• 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.
• In the late 1980s, it was discovered that 20 percent of feminine care pads, such as Kotex, Always and Stayfree, were being used for incontinence. This led to the introduction of Poise by Kimberly-Clark, a successful line of pads ranging from 7.5 inches to nearly 16 inches long. 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 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 #1 seller because they were more like regular underwear while offering a high level of protection.

It’s been more than 10 years since protective underwear was introduced, and no notable major innovations have occurred since. 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. For example, undergarments are now called shields, even though there were shields that were a different product form.
• There are no standards for describing absorbency levels. One manufacturer’s most absorbent product is “extra absorbency,” while another’s is “super plus.” How does an individual decide?
• Nomenclature used to describe products is not easily understandable, especially when trying to compare brands. For example, there are ultra-thin pads, ultra-thin with wings, ultra-thin long, moderate and maximum - yet the maximum version is not as absorbent as ultimate. This is how just one manufacturer describes its pads; another uses its own descriptions, such as moderate, heavy and overnight. How does one decide?

The Present
So what is available today?

Pads. From very thin liners for dribbles, to those for “sudden wetness.” Pads are smaller and less expensive than full garments. The larger pad sizes are sometimes referred to as “denial” pads, because the next step is a full disposable garment.

Pull-on underwear. More like regular underwear and good for urinary incontinence. Available in two absorbencies and up to four sizes.

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. Disrobing is not necessary to change this product, which is available in one absorbency and two sizes.

Shields, formeraly "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. Read "Prostate Surgery & Incontinence. The Facts." for more information.

Other products in this category include a “drip collector,” which is worn over the penis and used for occasional dribbles, and a Cunningham clamp. This is a hinged, stainless steel frame supporting two foam rubber pads and a locking device. The wearer places his penis between the two foam pads and the hinged clamp is shut, putting pressure on the urethra. Often used after prostate cancer, these reusable devices help prevent dribbling.

Briefs or adult diapers. A full garment providing maximum protection against urinary or bowel incontinence. Secured with readjustable tapes or Velcro tabs, there are more 100 brands, styles, absorbencies and sizes available, but not in stores where only a limited selection is available.

Boost or booster pads. This product is like the old “diaper doublers.” It provides added protection and longer wear time from your primary absorbent garment, thus helping to stretch your budget. Worn with a full absorbent garment, it fills and then overflow into the primary garment.

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. Often used aggravated skin needs to heal.

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.

Body stocking. This girdle-like product serves two purposes: It provides a slim fit that makes the garment less noticeable, and reduces rustling noise. These can be useful for those with Alzheimer’s and dementia, who may have trouble removing a garment without making a mess.

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. Users can choose from small, personal wipes that are flushable, large ones for fecal and urinary incontinence, dry wipes used with skin cleansers, and even large, flushable wipes that can be disposed of in the toilet. Sold in purse packs, tubs and economical refills, a wipe at each change is essential.

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. When changing an incontinence product, especially a pull-on or refastenable underwear or brief, it is critical to care for the skin, or serious breakdown can occur. 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.

The Future
What baby boomers demand now are products just like their normal underwear, not merely “underwear-like.” A man or woman who has been wearing normal underwear for 60 or 70 or more years simply does not want to wear an adult diaper, which is demoralizing.

The ideal product will:

• Look like normal underwear. Colors and patterns will look more like regular men’s and women’s underwear. No matter her age, a woman might like to match her underwear to her outfit when going out. The days of “any color as long as it’s white” will soon be over.
• 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. While there are products to fit waist sizes from 20 inches to 94 inches, most are unfortunately not available in stores.
  
  The manufacturers will introduce products especially designed for individuals with special needs who lack of muscle tone doesn’t allow current products to fit correctly - either the children’s or adult pull-on products.
• 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.
• Simplify product selection. Manufacturers or the governments will establish comparative nomenclature to help consumers decide which product is right for them.
  
  In the 1980s, tampon manufacturers used different absorbency ranges with different descriptions. None were comparable between the different brands. One manufacturer even used the description “heavy duty” for its most absorbent tampon! Ultimately, the federal government mandated standard absorbencies and descriptions. Perhaps this is what it will take in the incontinence products category.

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.

Don’t rely on help from your pharmacy; today’s pharmacists are filling twice as many prescriptions as they were just 10 years ago and often don’t have time to come out from behind the counter. And the 18-year-old stock person doesn’t have the answers, even if you could find one in a store nowadays. Another common problem is running out of products and finding your store is out of stock and being told “there might be more in tomorrow afternoon.”

Here is a resource you may find helpful: The CareGiver Partnership offers more than 400 incontinence products, ranging from the limited selection found in most stores to the hundreds used by health care professionals. Whatever you need can be delivered to your home on a schedule that you determine and that can be changed at any time.

Experience tools that help you quickly and easily find the right product, such as the Incontinence Product Finder. Browse a library of more than 500 caregiver resources, the largest in the world. And enjoy access to a board-certified Physician Assistant and Mayo Clinic-trained nutritionist.

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. Since this is their only business, they know incontinence products inside and out. Call 1-800-985-1353. Ask about a sample service that allows you to try before you buy; for $3.49, you will receive a two-count sample of your choice from more than 100 products.