Nancy Muller, Executive Director of the National Association for Continence (NAFC) pointed out that the US wastes $750bn/year in health care spending, including $210bn on unnecessary services, $190bn on unnecessary administration, and $130bn on inefficiency. Fraud accounts for a loss of $75bn. Savings are sought and one of these relates to the Medicaid Nursing Home Waiver whereby the State saves on Nursing Homes by covering the cost of community-based long term care. This means helping the family to look after elderly relatives. Often the home-based carers themselves are elderly, physically impaired and in need of education about inco management and the available products.
Skin gets increasingly vulnerable with age and skin-care for incontinence sufferers is a key problem. Even with skilled nurses in excellent long-term care homes, incontinence-related skin erosion and ulceration is a serious problem. So, as care moves into the community, State authorities are concerned that they could be overwhelmed by such problems and admit to having no idea what type of products they should be recommending to minimise the issue.
NAFC has therefore pulled together a group of suppliers (K-C, SCA, Attends, First Quality, Medline, PBA) and State Authorities ( CA, MA, MN, SC, and TX) who have teleconferenced monthly for the last 2 years. They have rejected the ISO “absorbent capacity is key” philosophy and are incorporating threshold performance standards and recommendations for strikethrough time, rewet weight and retention under load. The numbers vary according to whether the briefs are “Standard” or “Premium” priced, and whether the wearer suffers from Light/Moderate or Moderate/Severe incontinence. Recommended values for a medium size – presumably measured on the whole pad - range from 35-60 seconds for strikethrough, 0.5 to 2 gms for rewet and 250-400gms retention.
6 sizes are recommended; all components must be FDA/OSHA/EPA approved; closure systems must allow multiple use; and the garments must be breathable without leaking. Test results are to be shared between States and there will be regular audits to reduce product variability and prevent inferior products being used.