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From taboo to TV, from millions to megabucks.

incontinence in adults has gained the spotlight in the U.S. in the past decade; as the population ages, awareness and support has grown tremendously

Only 13 years ago, adult diapers were test marketed on grocery store and drugstore shelves in Boise, ID and they hardly moved. Today, one retail outlet devotes 12-16' of shelf space to adult incontinence products.

Then, network TV would not permit the advertisement of incontinence products during prime time. Now, such advertisements are commonplace.

As recently as a decade age, Modern Maturity, the magazine of the Association for the Advancement of Retired People (AARP), would not accept an ad for disposable absorbent products and the U.S. was dependent on Scandinavian and European estimates of the size of the incontinence market.

In a March 1982 article in NONWOVENS INDUSTRY, Donald George used figures from Sweden to project a potential market of $500 million to $1 billion annually based on an estimate that 4% of the U.S. population was incontinent. In the same magazine 10 years later, Scott Sigler of Medical Disposables in Marietta, GA, projected that the $1 billion sales mark would be reached by the year 2000.

It was first assumed that the incontinence market would be primarily an institutional bonanza. The self-care and acute-care market was poorly appreciated and understood. Interestingly, in his 1982 article, Mr. George surmised that a 400-bed hospital should have only four or five seriously incontinent patients. In fact, in 1993 in acute-care facilities with a high percentage of Medicare patients, 30%-60% of patients are likely to be incontinent of urine, with at least 10% of that group being incontinent of stool also.

Surveys in the 1980's of people at home who were incontinent revealed a picture of an embarrassed, isolated, underserved population harboring a "secret" too personal to divulge even to their family doctor. Most were using makeshift remedies with a heavy reliance on feminine hygiene products and paper towels.

What a difference a decade makes! In 1992, Help for Incontinent People (HIP) undertook another extensive survey of community-dwelling incontinent adults. Some attitudes and behaviors had changed markedly. People with incontinence listed embarrassment ind odor as their primary concern. Isolation from friends and family was the least of their worries. The vast majority have now seen a doctor about their incontinence; unfortunately, few have been made better by the treatment they received.

The huge advertising budgets of companies like Procter & Gamble, Kimberly-Clark, Johnson & Johnson's Personal Products Company and the private label companies have seen to it that the word incontinence has been brought from the closet into the common vernacular. Their educational campaigns have been assisted and amplified by the relentless advocacy activities of the non-profit organizations Help For Incontinent People and the Simon Foundation. During the past year the Agency for Health Care Policy and Research, the Alliance for Aging Research and the National Institutes of Health have mounted important public and professional education programs.

A review of HIP's 1984 10-point National Agenda to Promote Urinary Continence reveals an impressive 100% rate of success in less than a decade:

1. That a national information and resource center be created for consumers and medical professionals concerned with urinary incontinence.

2. That an awareness of the prevalence and implications of urinary incontinence be promoted through health care organizations and agencies.

3. That incontinent people be educated to become their own agents of change and advocates for care and cure of their condition.

4. That educational materials be developed for consumer's and that they be distributed through consumer and professional organizations.

5. That programs, articles and educational materials be developed for medical professionals to help expand their knowledge and understanding of incontinence.

6. That medical and nursing school curricula and continuing education courses related to incontinence and voiding dysfunction be expanded and updated to include timely, accurate information.

7. That standards of care for people who are incontinent be developed.

8. That funding sources be encouraged to target money to resolve the problems of incontinence through research and education.

9. That manufacturers of incontinence products be encouraged to work with health care professionals and consumers to provide better products and improved product-use information.

10. That the media be persuaded to provide unrestricted coverage of all aspects of incontinence to destigmatize the condition and to promote care and cure.

In slightly more than a decade, the adult incontinence market has reshaped itself from an institutional market to a market that encompasses all American citizens. Ten years ago, 10 companies were mentioned as having disposable absorbent products for adults who are incontinent. A decade later, HIP's Resource Guide of Continence Products and Services[1] listed 36 companies.

One of the most striking and welcome changes in this market occurred recently when Kimberly-Clark became the first to depart from euphemistic names like "Tran-quility," "Serenity" and "At Ease" in favor of a more matter-of-fact brand name, "Poise." Hopefully, those in product and business development will soon see the desperate need for incontinence products specifically designed for males.

A |Mirror' Image - The Users

Of The Future

Meanwhile, on the other side of the capitalist coin, as most of us have been watching with fascination and assessing our collective roles in the development of increased public awareness, professional education, new products and annual double-digit sales increases, we discover that we are becoming "end users."

How will this impact the future of the adult disposable incontinence market?

Can oar health care system afford to buy all these diapers, absorbent liners, pouches and underpads?

Can our environment continue to accept all the incontinence products we discard bulging with superabsorbents saturated by urine and feces?

Can we bear to see our beloved parents and stricken spouses or siblings swaddled in underpads or adult briefs by nursing personnel who do not have the time or skill to promote continence?

Was it only a little more than a decade ago that institutions were resisting purchasing disposable absorbent products because putting "diapers on our adult patients would be degrading"?

Today, cases of disposable and reusable adult briefs are delivered weekly to every unit in hospitals and nursing homes.

Incontinence can hardly be a taboo subject anymore because it happens to too many people we know - the company CEO after prostate surgery, our father after a stroke, our daughter after a baby.

It is now our family and our friends who are making the adult incontinence market the megabucks category it was touted to be when there were only wing-fold adult diapers made from modified underpad machines. The competition for market share is fierce. The war for retail space and position is brutal. And as strategic plans are drawn for line extensions and record sales gains, how will these "end users," who we now recognize as people we love, live and work with, learn that most of the time their condition can be cured or improved? And who will help them find a health provider to properly diagnose and treat their condition to help them avoid or minimize the need for disposable absorbent products?

Now that I am one of the typical 54-year-old healthy American females living in the home who may currently need or will soon need an incontinence product, will I be looking for a better, cheaper, more discreet absorbent liner or a cure for my leakage? Now that my mother is a frail, elderly, 80 year-old stroke victim, do I want her to have a more absorbent, skin-friendly adult brief or would I prefer that she have care-givers who take her to the toilet every two hours so she needs no incontinence products at all?

The adult incontinence market may be as much a sociological case study as it is a business school study. How will it look in 2002?

Reference Resource Guide of Continence Products and Services, 1992 ed., a 70-page catalog is available for $10 from Help For Incontinent People (HIP), RO. Box 544, Union, SC 29379.

About the author: Katherine Jeter is the founder and executive director of Help For Incontinent People, a non-profit advocacy organization. HIP is a leading source of education, advocacy and support to the public and to the health professions about the causes, prevention, diagnosis, treatments and management alternatives for incontinence.

HIP has just completed its 1992 survey, Consumer Focus |93, of community-dwelling people with incontinence; the survey describes the typical purchaser or potential purchaser of incontinence products. Twenty-two charts and graphs complement the narrative text edited by Jeter and HIP associate director Lisa Verdell. The cost of the survey is $1000. Proceeds from the sale of the survey help support HIP'S various educational and outreach programs.
COPYRIGHT 1993 Rodman Publications, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1993 Gale, Cengage Learning. All rights reserved.

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Title Annotation:advertising adult incontinence products
Author:Jeter, Katherine
Publication:Nonwovens Industry
Date:Apr 1, 1993
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