Care of Chronic Conditions

The population of people with bladder control problems is growing each year, as the issue concerns mostly seniors and the population is generally living longer. According to data published by U.S. Department of Health and Human Services (HHS) in 2014, the prevalence of incontinence among persons aged 65 and over is significant. The estimates vary depending on the place of residence, with the highest rate among long-term nursing home residents (75.8 percent) and patients of hospice care agencies (62.1 percent). The situation is slightly better among noninstitutionalized persons (50.9 percent), short-term nursing home residents (46.1 percent) and patients of home health care (45.4 percent), with the lowest—but still significant—rate for residents of residential care facilities (39 percent).

The cost of such care is considerable, and involves absorbent pads, skin and wound care and laundry. This does not factor in the cost of nurses and caregivers. Some part of the expense is related to inappropriate product selection that causes skin problems and leakage. In incontinence care, the quality of products is important as it influences further actions. If an absorbent product is made of poor materials it may create skin irritation, for which treatment is expensive. Moreover, if the product does not have some leakage protection, the use will lead to frequent leakage that requires more staff work and higher expenses due to bedding changes and laundry cost. How do you choose the most effective product for your patient?

The variety of available products can seem overwhelming, and if you have never had to use an incontinence product, you may not see a difference at first glance. So, how can you advise what product will best improve the client’s life?

Below are some absorbent product features that can help to ease conditions associated with incontinence; these features are not necessarily common for all such products on the market.

• Breathability. Thanks to having a special, vapor permeable outer layer, such products help the skin breathe easily, thus improving its condition. The vapor permeable cover means the skin does not produce as much sweat, stays drier and is less prone to irritations, which is especially important on hot days. These coverings are also softer and quieter than plastic outer layers, providing discretion and a higher chance of uninterrupted sleep. A larger surface of breathable zones means better protection for the skin. The National Association for Continence (NAFC) requires manufacturers to provide breathability at least on the side “wings” of a product and discourages using products with a plastic outer layer, “because it negatively impacts skin health, contributes to trapped heat and perspiration and thus skin breakdown, contributes to growth in odor-causing bacteria, is noisy and uncomfortable and generally serves no useful benefit over high quality disposable absorbents.” There is common thinking that breathable products do not contain urine odor, but this is simply a myth. Odor control is related to the quality of absorbent materials used and is not related to the type of outer layer. If skin irritation, such as incontinence-associated dermatitis (IAD), is your customer’s problem, recommend to him or her breathable or vapor permeable products instead of cloth-like products.
• Standing gathers. These are also called leakage barriers or leak guards. Surprisingly, there are still some products without this feature, which is one of the best protectors against side leakage. Standing gathers have the biggest importance when leakage is abundant, even if it does not occur often. The lack of gathers is the reason customers experience embarrassing situations or need to change their underpads and bedding often. By recommending products with standing gathers, you let your customer avoid awkward situations and build a rapport, helping them save time and money.
• Softness. Briefs, underwear or pads are touching the body directly because they are replacing regular underwear. They should be soft and gentle so as not to irritate the sensitive skin of intimate areas. The most sensitive perineal areas deserve special care, which is why materials touching them should be extremely gentle. The absorbent product usually has a special distributing layer right beneath the top sheet, which may be made of either a nonwoven material or plastic. As you can imagine, plastic is not pleasant for the skin, especially in more intimate areas, so aim to avoid irritations and choose products with soft, nonwoven distributing materials. Also, skin on elderly people is thinner and more prone to abrasion, so contact with rough materials may break down its structure. By offering soft products, you provide comfort and skin protection.
• Elastic elements. Flexible waistbands, elastic leg cuffs and closing tapes help to adjust the product to the body without compromising the skin. When we drink and pass the liquids, or simply breathe, the body perimeter changes, so even if the brief is well fitted right after donning, it may become too tight and irritate the skin in the short term. Having elastic tapes and waistbands allows the product to work with the body as it changes during wear. Elastic waistbands accompanied by elastic leg cuffs also assure better fit to prevent leakage.

If your customers value comfort of wearing products combined with appropriate skin care, they will be happy to try briefs offering all of these flexible elements.