Revealed: Why so many adults in Britain are wearing nappies - and are being ... trends now

Revealed: Why so many adults in Britain are wearing nappies - and are being ... trends now
Revealed: Why so many adults in Britain are wearing nappies - and are being ... trends now

Revealed: Why so many adults in Britain are wearing nappies - and are being ... trends now

The silver-haired actor Harry Van Gorkum — who once starred in Friends as Monica’s British ‘soulmate’ Don — stands in a luxury apartment in his underwear and looks confidently at the camera.

‘Now we’re comfortable, let’s talk urine leakage,’ he says, holding up an incontinence pad for men which he promises ‘slips discreetly into my underwear’.

Not so long ago it would have been unthinkable to see this on prime-time TV.

But while it’s undeniable that advertising like this is helping open up conversations around incontinence, critics warn that this kind of marketing also exploits people’s embarrassment — encouraging them to buy products to soak up leaks instead of seeking medical help for an often treatable problem.

Meanwhile, there are concerns that people in hospital or care homes, particularly older patients, are falling victim to a ‘pad culture’, which means that, even if they are not incontinent, they are put in nappies (and then left in them for hours).

Incontinence affects more than one in five people in the UK and demand for products to treat it is soaring. 

Friends actor Harry Van Gorkum in an advert for Tena where he holds up an incontinence pad that he promises 'slips discreetly into my underwear'

Friends actor Harry Van Gorkum in an advert for Tena where he holds up an incontinence pad that he promises 'slips discreetly into my underwear'

Incontinence affects more than one in five people in the UK and demand for products to treat it is soaring

Incontinence affects more than one in five people in the UK and demand for products to treat it is soaring 

From ‘adult nappies’ which, like baby nappies, come as pull-on pants or wraparound pads with sticky tabs; to washable, reusable pants; or stick-on pads and liners worn inside underwear, sales increased by 13.2 per cent in the year to March.

Last year we spent a staggering £234 million on these products, according to market data analyst Kantar, with around 1.16 billion individual items sold — that’s equivalent to 37 incontinence products bought every second.

The UK is far from alone: customers in the U.S. account for about a third of global spending on incontinence products, European countries for another quarter — but sales are growing most rapidly in Asia, particularly in China, India, South Korea, Taiwan and Japan.

Indeed, the Japanese manufacturer Oji Holdings has recently announced that it is switching from making baby to adult nappies because of changing demand.

Arguably, it’s a financially savvy move, too, because manufacturers can charge more for larger adult products.

In Tesco, a packet of 12 medium Tena adult nappy pants costs £8.55 (71p per nappy) — baby nappies were less than a third of the price, with a pack of 64 size five Pampers nappy pants costing £14 (22p per nappy).

What's behind rising demand?

Clever advertising may be driving sales (more on that later) but experts believe that failings in care are also fuelling the rise — with too many people ending up in nappies for treatable problems.

The value of incontinence liners, pads and pants in the UK is rising. It is thought that clever advertising may be driving sales

The value of incontinence liners, pads and pants in the UK is rising. It is thought that clever advertising may be driving sales

Incontinence is not an illness but a symptom of other health problems, such as damage to the bladder and bowel or the pelvic floor muscles that support them.

It can also be caused by neurological disorders such as Parkinson’s disease or multiple sclerosis, and the side-effects of certain medications, including HRT (hormone replacement therapy) and some antidepressants.

Research suggests that around one in three women in the UK experiences some form of leaks (often owing to damage sustained during pregnancy and childbirth); menopause can also trigger or aggravate symptoms, as hormonal changes reduce the elasticity and strength of the pelvic floor.

In men, incontinence becomes more common in later life — around one in ten over 65 experiences leaks, typically as the result of an enlarged prostate or treatment for prostate cancer.

Incontinence is generally more common later in life, with around one in ten over-65s experiencing leaks

Incontinence is generally more common later in life, with around one in ten over-65s experiencing leaks 

Obesity is another risk factor — excess weight and body fat put pressure on the bladder and its supporting muscles; so, too, is getting older.

Although incontinence affects all ages, it’s far more common in older people, and one of the most common reasons for them being admitted into care or nursing homes.

The NHS says approximately a third of care home residents and two-thirds of nursing home residents experience urinary and/or faecal incontinence.

But NHS England is clear — incontinence is usually treatable.

The health service already spends around £80 million a year on incontinence pants and pads (or ‘containment products’, as it calls them) but says their use should be kept to a minimum and ‘treatment [of incontinence] must always be the preferred option’.

Under NHS guidelines, people experiencing incontinence should be assessed by specialist staff to rule out any serious underlying problems and/or have a medication review with a GP.

A month's supply of incontinence pants from the supermarket costs around £87

A month's supply of incontinence pants from the supermarket costs around £87

Once a cause is established, conservative treatments for both men and women include dietary advice (for example, avoiding caffeine, alcohol and artificial sweeteners which can irritate the bladder, and increasing fibre intake for healthy bowels) and pelvic floor muscle exercises and/or bladder retraining, to teach patients how to wait longer between loo visits.

If these don’t work, patients are meant to be referred to a specialist and may be given medication (to improve muscle tone or alter the body’s signals about when to urinate) or offered surgery, such as procedures to support the bladder.

‘Containment products can offer security and comfort, helping people continue with their normal daily activities. However, they are costly [a month’s supply of incontinence pants from the supermarket costs around £87], can affect a person’s dignity and do not offer a long-term solution unless the person has not responded to other treatments,’ the guidance adds.

It is important that men with symptoms seek treatment as soon as possible because incontinence can be a sign of an underlying health problem, such as an enlarged prostate, says Hamid Abboudi, a consultant urological surgeon at Imperial College Healthcare NHS Trust and founder of londonandsurrey urology.com.

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Intimate women's health problems answered by doctors

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‘If you notice any changes to your urine flow, you should see a doctor,’ he adds.

‘If you leave it too long, it can be much harder to treat and can cause lasting damage to the bladder or kidneys.’

With women, most cases of incontinence are related to pelvic floor damage and are usually treatable, says Tina Mason, a specialist pelvic physiotherapist at the private Women’s Health Brighton clinic.

‘The pelvic floor muscles are like any other muscles in the body,’ she says.

‘If you injured your leg, you wouldn’t just drag it around behind you. It should be the same with your pelvic floor.

‘It’s always good to get these things sorted earlier rather than later, but even when you are into your 70s and 80s, a physio can give you tailored exercises to improve or stop incontinence symptoms. It is never too late.’

If symptoms worsen because of changes around menopause, as well as pelvic floor exercises, oestrogen hormone creams and vaginal moisturisers can improve tissue elasticity, she adds.

A 'pad-happy' hospital culture 

The Royal College of Nursing (RCN) says giving more people access to pelvic floor and bladder-training programmes would improve their quality of life and save the NHS money on incontinence products and hospital admissions.

But, instead, older patients in particular are being pushed into using adult nappies.

Older patients in particular are being pushed into adult nappies when in hospital, though access to pelvic floor and bladder-training programmes could help improve their quality of life

Older patients in particular are being pushed into adult nappies when in hospital, though

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