Adult Incontinence Products - An unfinished business

Adult incontinence products (AI for short) and baby diapers are like grapes and wines. Even when they seem to share the same common origins, they are in fact two very different kinds of animals.

The goal for a baby diaper is simple, to please the parents. Baby diaper manufacturers have two simple objectives, to make sure there are no leakages, while at the same time to be perceived by parents as being drier and comfortable.  With A.I. it is not that simple.  Maybe this is why it is much easier to find parents willing to use cloth diapers on their babies, than what it is to convince adults to us cloth on themselves.  It is also interesting to see how even those hard-core ecologists quickly change their minds, when they are the ones in need of the product instead of their babies.   In one case the end consumer (the baby) has basically no final saying, while in the second case, they all have their own ideas and opinions about their needs and personal preferences.   In addition, while all babies share the exact same kind of incontinence, with adults we have a full spectrum of special circumstances, going all the way from very light incontinence (like that associated with stress), those with full incontinence, and those that have both urinary incontinence plus fecal. 

In my opinion, more Institutions should take advantage of this fact, rather than forcing a particular brand of briefs on their patients just because they passed a minimal set of tests, which by the way are not always the best for each kind of incontinence. The patient should be allowed to have a saying on what they use on themselves within the economic limitations of the Institution. Maybe even having the possibility to choose what they want, and then adding the difference in cost from their own pocket, as they currently do in Brazil. 

While the baby diaper market has been experiencing a small contraction in the U.S. during the last 3 years, it is expected to have a small growth in the next 5 years; the adult business is experiencing the opposite. Just a week ago, Bloomberg published an article claiming that the adult diaper market is about to take off. It stated that according to Euromonitor, a 48% growth was expected for the category by 2020, which is an equivalent to a 9.6% growth every year for the next 5 years.  The same report also mentioned that one in every 3 adults (80% of them women) have bladder control issues.  The same report was replicated by dozens of news agencies all over the world, making most diaper manufacturers and raw material suppliers very happy.   Euromonitor quickly clarified that this expected growth is for the whole category, and not just for adult briefs.  This category covers much more than just diapers, it includes all types of absorbent products, and also it includes some new non-absorbent disposable products designed to control the incontinence by physically closing the bladder.

According to the latest World Health Organization, published last October, 34.2% of the population is over 60 in Japan, while 25% of the population in Western Europe, 22.4% in Canada and 20.4% in the U.S. are over 60. It may be true that half of the incontinent people are under 50, as the KC commercial claims, but it is the older people who are experiencing most of the full incontinence.

Kimberly-Clark, the market leader for A.I. products in the U.S., has done a superb job at educating people (and in fact the whole society), about incontinence.  Procter & Gamble has done its part too, by helping remove some of the stigma associated with incontinence among women.  The results so far have been phenomenal. Based on my own little research after reading many blogs, I have to say that just in a couple of years they are succeeding at making people feel more open about incontinence.   It is hard to believe the dramatic increase of people that are willing to talk about their own incontinence. It is like a trending topic (smile).  On the other hand, even if they tripled the budget for underwear awareness,  I believe that most people will prefer a discrete super thin solution that works, if it is priced competitively, instead of a thick garment that everyone can see. 

We know that it is generally accepted that one in every 10 boys wet the bed at night, at least once per week. This is about twice the frequency experienced by girls of the same age.  Even today, we still do not have a clear understanding of the mechanism why most of these kids stop being incontinent once they reach adolescence.  As you probably know, we have special products for young kids. These products today account for close to 5% of the baby diaper market, if you care to include them in this category.   On the other hand, I am not sure if I can believe that 1 in 3 adults, as claimed above, or in a more general statistic shared by the newest KC commercial, that 1 in every 4 Americans, have bladder control issues.   I guess it all depends how you define the issues.  If incontinence can be defined as having a small leakage once per year, then maybe almost everyone qualifies.  But what is the right way to define incontinence? 

When does someone really have bladder control issues? I believe there is an incontinence problem when the individual feels the need to use something to protect against potential “accidents”.  The frequency of the accidents correlates with the need for protection.   In many cases, it is not the lack of control of the bladder but the lack of mobility that makes it difficult for the person to go to the bathroom.   In this sense, it is not the bladder that failed, but instead the legs to move around to get to the toilet in time.  While it may be true that some people may not be concerned with a few drops of leakage, for others it could be a disaster. Education and the removal of stigmas can make more people feel comfortable about wearing some extra protection to avoid any potential accidents, even if these accidents are not frequent at all. This is what can make the market grow in double digits.

Why do I call the AI products an unfinished business?  First, because I believe there are so many special circumstances that still need to be fully understood, in order to optimize products for each kind of market need, that I feel we still have a long way to go.  Each market segment can be further subdivided; basically a new subcategory is still being created every year.  Second, because there are so many needs that have not been properly addressed, that are still waiting for a clever solution.  What kind of solutions?

For example, people that are bedridden, in wheelchairs, or with limited mobility, all need products that can keep them dry, even drier than active people as their skin is more sensitive to damage; at the same time they need a solution that can control the smell. New products with a better management of the breathability, maybe adjusting the water vapor transmission rate automatically based on the temperature of the room or the temperature of the skin.  Today many products that claim to have odor control, only delay urine’s biodegradation, but in reality they do not remove the smell of urine. In case of fecal incontinence, the problem is much more critical as you can imagine.  Wetness indicators that change color may be fine for babies, but it is not the same when you want to check if a diaper is wet with an adult with the diaper under the clothing and you want to respect their dignity.  They need a way to be able to show the level of wetness in a more discreet way, and also in real time not until the diaper is full.  Managing urine incontinence in males, can take advantage of the anatomical differences of the sexes, providing a full line of new options made just for them, maybe in a way that could avoid the need to have to remove the whole brief, making it easier to pee at public bathrooms, or to carry discreet inserts replacements that could be high in capacity but low in storage space requirements.  What if these inserts can be made smaller than the size of a wallet, but just as effective as the largest brief?

We can all help to find new solutions to everyday incontinence problems; sometimes the simplest solutions can be surprisingly effective.  As an example, my partner Giulio D’Inca and I just launched our diuresis indicator for diapers in Beta testing, we are going to launch it commercially as soon as its approval as a medical device class 1 in Europe.  The Diuresis Indicator consists of an elastic strip with graduated printed marks that can be attached to a diaper with an adhesive tape and you use it to measure the amount of urine inside a diaper.  After the diaper is soiled, you lift the diaper in the air (hanging) using the provided elastic, and you can read the volume of urine directly from the strip. This simple invention helps to avoid the need of catheters that are a known cause for infections, and during this short testing it has already detected acute dehydration cases that have saved the lives of bedridden patients.   I am aware there are many solutions to be implemented; this is why I always try to motivate raw material suppliers, manufacturers, and OEMs, to think out of the box.  To read blogs, pay attention to comments, and look for problems that require a solution. AI, for sure is an unfinished business.

Note: Also published at the Nonwovens Industry maggazine, March 2016