Urinary incontinence affects an estimated 25–33 million Americans and is the second most common reason for nursing home admission. For long-term care facilities, home health agencies, and DME suppliers, incontinence care products represent one of the highest-volume supply categories — and one with significant impact on resident skin integrity, dignity, and quality of life.
Types of Incontinence Products
The incontinence product market has expanded dramatically beyond basic adult briefs. Today's formulary options include:
- Tab-style adult briefs (protective underwear): Full brief design with side tabs for repositioning. Best for immobile or bed-confined patients. Available in light, moderate, heavy, and overnight absorbency levels.
- Pull-up underwear: Underwear-style design for ambulatory patients. More dignified appearance; preferred by patients who retain some continence control. Major brands: Prevail Per-Fit, TENA Pants, Depend Silhouette.
- Bladder control pads and liners: Thin, adhesive-backed pads for mild to moderate stress urinary incontinence. Worn inside regular underwear. Available in multiple absorbency levels.
- Underpads (Chux): Absorbent disposable pads placed under patients in bed or on chairs. Provide secondary protection and protect bedding and furniture. Available in standard (17x24") and large (23x36") sizes.
- Male guards: Boat-shaped pads designed for male anatomy with moderate urinary loss.
- Reusable underpads: Washable fabric underpads for facilities with laundry capability. Lower per-unit cost but require laundering infrastructure.
Absorbency Levels and Product Selection
Matching absorbency level to actual voiding volume is essential for both skin health and cost management. Over-absorbent products are costlier; under-absorbent products lead to leakage, skin breakdown, and increased linen changes. NAFC (National Association For Continence) recommends a continence assessment including:
- 24-hour voiding diary to quantify volume and frequency
- Assessment of patient mobility, dexterity, and cognitive status
- Evaluation of peristomal/perineal skin integrity
Incontinence-Associated Dermatitis (IAD)
Incontinence-associated dermatitis (IAD) affects 20–33% of incontinent patients in long-term care. It is caused by prolonged skin contact with urine and feces, which disrupts the skin's acid mantle and promotes breakdown. IAD is a precursor to pressure injuries and significantly increases wound care costs. Prevention requires:
- Barrier creams and protectants: Zinc oxide-based (Desitin, Medline Remedy) or petrolatum-based products create a moisture barrier on intact skin.
- Cleansers: pH-balanced, no-rinse foam cleansers (Coloplast Bedside-Care, Medline Perineal Wash) are gentler than soap and water for routine incontinence care.
- Frequency of changes: Prompt removal of soiled products reduces exposure time. Hourly or two-hourly toileting programs (scheduled voiding) reduce incontinence episodes in cognitively intact patients.
- 3-in-1 products: Products combining cleanse, moisturize, and protect functions (Coloplast Bedside-Care, 3M Cavilon) streamline care without compromising protection.
Procurement Strategy: Standardizing the Incontinence Formulary
For a 100-bed skilled nursing facility, incontinence supply costs can reach $150,000–$250,000 annually. Standardization and bulk purchasing provide significant savings:
- Standardize on one or two adult brief brands (e.g., Prevail and a house brand backup)
- Purchase by the case (typically 48–96 units) for volume discounts of 20–35%
- Evaluate total cost of care — not just product price — including linen changes, nursing time, and skin care supply usage
Healix stocks incontinence products from Prevail, TENA, Depend, Medline, and more. Browse our incontinence catalog for case pricing.