Incontinence products.

Adult incontinence products are gaining new absorbency at greater prices, but these advances allow facilities to provide better resident care with less strain on the staff - in effect, cutting costs. What's more, better product quality is adding value for the people using these products, in terms of more comfort and skin protection. Recently, three leading vendors of incontinence products commented on these trends, in interviews with Nursing Homes/Long Term Care Management.

Janet Firestone, market development leader of Principle Business Enterprises, Inc., says that because her company's products are designed to be more absorbent, facilities have less need for a strict schedule of changes, which tend to "imprison the resident" and cause embarrassment. "The real issue," says Firestone, "is the actual cost of a system versus its price. Incontinence products that are changed frequently often exact a high cost on a facility in product volume, staff hours and staff members' perceptions of their jobs." Additional real costs include the expenses of linen changes and managing skin breakdown, she adds.

An inescapable cost of any incontinence management approach, she says, is the fact that management is not just products, but a program addressing all the factors that contribute to a resident's incontinence. "Facilities should have a restorative care nurse who concentrates on these issues, rather than just ordering a bunch of large diapers to be used by everyone," she says.

Firestone notes that new product lines are evolving all the time in this field. For example, her firm has specialized inserts for use with more traditional products, to add absorbency for incontinence sufferers: enhanced-absorbency inserts, Topliner I and Topliner II, for urinary and fecal incontinence. In addition, an adjustable brief with Velcro straps allows for an easy-fitting product for self-toileting residents who are in restorative care programs.

The adult adjustable product marks an overseas trend that is just arriving in the United States, says Scott Jungles, director of marketing for SCA Hygiene Products (formerly SCA Molnlycke). Jungles says the pull-up product gives adults more dignity while affording ease of use. He notes that residents with dementia often "interpret the product as the underwear they are familiar with and are thus less likely to fidget with it and far more likely to self-toilet."

Europe also is seeing a trend for increased absorbency of incontinence products, necessitating fewer daily changes, says Jungles, having recently completed a two-year stay there. In Holland, for instance, "products need to be changed an average two and a half times a day versus an average five times a day here in the United States." What's more, he adds, "even considering the additional cost of the high-absorbency product, the overall cost of a day's protection is still less than it is for using a less absorbent and less expensive product." Europe faces the same cost pressures that the United States does, he notes.

Meanwhile, a major American trend, says Jungles, is in ensuring resident comfort, such as with better fitting leg closures, and enhancing convenience for staff, as with products with tabs that can be opened and reclosed to check on the need for a change or readjustment.

"Overall," says Jungles, "top-of-the-line products have added a great deal of added comfort and skin protection."

AmeriCare's flushSafe pad addresses yet another concern that facilities have with incontinent residents, according to Gail Barger, vice-president of marketing. Its flushability helps facilities minimize problems with infection control caused by the need to dispose of used incontinence pads. Says Barger, "Pads may contain pathogens that can lead to bacterial or viral contamination, which means that facilities must bag the used products in biohazard bags." Flushability does away with this procedure.

It may also, Barger adds, save costs arising from new environmental regulations. Because the Clean Air Act will make it necessary to include scrubbers on incinerators by the end of this year, she says, more and more facilities will find it necessary to pay for the removal of used pads as a biohazard, at a cost of a third to a half-dollar per pound. In addition, she notes, a flushable product eliminates the problem of plumbing repair when other kinds of pads inadvertently get flushed.