Catheters etc - any help appreciated....

[LizzyA]

Dear all.

My mum has vascular dementia, it seems to be advancing quite quickly. She is currently in hospital, she's had a rectal prolapse, they apparently cannot operate on this due to her muscle tone/quality. We have also been told that she will have a catheter permanently from now on so will need care 4 x a day to change it etc. She currently has carers at home 2x a day.

We are worried - last time she was discharged from hospital she had a temporary catheter and managed to remove it twice before it was removed permanently as she just didn't recall what it was there for. She fiddled constantly with it as well so it leaked etc too.

Any experience or advice? The hospital have just advised that she'll need to go into a care home if it doesn't work out which seems a bit extreme. Also we are worried about the cost of 4x a day care (she is self funding). It doesn't seem right that if she needs this care for a medical issue that she has to pay!

I would greatly appreciate any advice.

 

[Lilac Blossom]

Dear Lizzy - My OH has a catheter - he also has vascular dementia. The reason for him having catheter is due to prostate problems. He was in hospital when the catheter was introduced and I was told it had to be a permanent arrangement. I am not sure if a "temporary catheter" is different from permanent one but of course male catheter is different from female. OH is unable to take care of anything to do with catheter so that is one of the many things I help him with as I care for him at home.

In the two years that OH has had catheter I have become accustomed to "doing the needful". As your mum had a catheter before you will have some experience but if there is anything you would like to ask me I would be more than happy to respond.

I have no idea how to PM on this site but will check this thread.

 

[Chaucer 1931]

My mum with vascular dementia/Alzheimer's has the same issues as your mum Lizzy,I live with my mum and have been dealing with all the aspects of catheter care and she too has a rectal prolapse-can't be operated on either! It brings it's associated problems too. She does and has attempted to pull hers out,is forever removing the g-strap that anchors the bag to her leg! And of course has opened the tap valve over the floor-I've bought endless carpet-pet stain products and waterproof bed covers/duvet covers.
If you ever want to ask me anything or want a sympathetic ear,please do PM me! I know how challenging the issues are along side dementia and there isn't an awful lot of advice to read up on anywhere,except a few TP'rs like Lilac Blossom and myself on here that actually know what it is about.


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[Lilac Blossom]

I've just popped in to say I have rediscovered how to PM on this site. (Please bear with me as I am an auld wifie and not too well acquainted with all this new technology stuff)

So pleased to see Chaucer's post although sorry that both your mums are in the same situation xx

Keep posting (((hugs)))

 

[Jessbow]

I might be missing something here....
Change it 4 times a day, or empty it?

To change it, I think you'd need the district nurse,
to empty it, prob carers.

I'd certainly play dumb myself/squeam-ish/Cack handed myself- certain DONT undertake to do it except in an emergency.~~I doubt carers are qualified to change it

District nurses are not chargable

 

[Lilac Blossom]

The catheter must be changed every three months (or sooner if there are problems) This is to try to minimise infections. This must be done either by qualified nurse or doctor.

Catheter leg bag needs to be emptied four times a day - this is done by care worker or, in our house, by me.

At bedtime night bag gets attached to leg bag and in the morning night bag is removed from the leg bag - this is done by care worker or, in our house, by me.

 

[LizzyA]

Firstly thank you for your kind responses x

Sorry if I used the wrong term - yes, it is the bag that needs emptying 4 times a day as Lilac has said. Mum will have carers coming in 4x a day - the district nurses don't supply this service where we live. Mum is self-funding so it will be a huge bill which seems wrong for a medical issue.....

Chaucer - your issues sadly sound very similar to ours and to those we experienced last time that mum was discharged from hospital. It must be very challenging for you, I guess I am fortunate that i won't be dealing with this all myself as you and Lilac are. Mum has had carers coming in for 4 months 2x a day. After a week in hospital she has forgotten this completely. She is due home once the care has been set up (probably Monday). I can't imagine that it will go smoothly. I hope I'm wrong.

 

[Lilac Blossom]

Dear Lizzy

I am quite alarmed to read that district nurses do not deal with catheters where you live. Of course DNs do not come in simply to empty leg bag but removing and replacing the actual catheter requires the skill and training of nurse or doctor - no careworker or family carer is qualified to do this.

I would urge you to get all the info you possibly can from hospital staff before your mum comes home. Make sure you have phone numbers you can call if there are any problems with catheter, get them to show you anything you are not too sure about.

Sorry just a really quick post at this time.

 

[Chaucer 1931]

Hi LIzzy

You say the carers will be attending to emptying the catheter bags,that shouldn't incur any additional costs as it would or should be classed under personal care. I would,as I'm sure Lilac Blossom will agree,that the carers must use a fresh pair of disposable gloves each time,even just to empty the bag.

I mention this because,last year when my mum had carers in when coming out of hospital after being in for a a spell and to give me a bit of time for myself and my daughters in the morning,each different carer that came just fished a pair of used gloves that they had obviously been used on previous clients! And I saw them rinse and put the gloves back in their overall pockets!-yes,UTI alert!
Needless to say I cancelled the service as they were part of the old type of 'home help' rather than dealing with anyone with any degree of dementia.
My point is,please make sure that the carers are are aware of catheter care-not to change the actual tube of course,as Lilac says that should be only dealt with by the District Nurse.
I don't want to cause undue worry,but be prepared for the event of UTI,s. Catheters open up a channel for bacteria,and the best way to try and prevent these is for your mums carers to be as sterile as possible when attending to her.
The fact that your mum will probably become obsessed with fiddling with it is a high possibility too and also will add to the risk of UTI,
What will help a lot is to encourage or ensure that she is drinking plenty of fluid-squash,flavoured water and either cranberry juice or cranberry capsules from the health store are helpful in both her urinary and bowel problems,if she can get Fibrogel into her a couple of times a day,either as drink or jellies,it all helps with keeping things easy for your mum.
The night bag may bring other problems too,but please don't hesitate to ask us Lilac and myself and anyone else on here with experience of dealing with this,even if you just need to share a worry.
Hope this helps a little,and sorry for the longish post,try not to worry.X



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[Lilac Blossom]

Hi Lizzie

I totally agree with what Chaucer has written regarding the importance of highest possible standard of hygiene in connection with catheter care. UTIs do happen so easily, even with the best standard of care. Drinking plenty fluids is also of utmost importance.

Try not to worry too much about catheter although it is daunting to begin with at home. Hospital staff are so familiar with the whole thing that they do not think of explaining the process to us "beginners" so I would say just ask them and of course, as Chaucer has said, ask here on TP also.

How is your mum getting on - is she still in hospital?

 

[Skyrim]

More catheter tips.

I've had to deal with catheters and stomas while working as an HCA in both residential and dom care and they really aren't too problematic in themselves. As already mentioned hygiene is really important here but there are two tips I can suggest to help manage this best with someone with dementia. First point is, as with any other aspect of personal care, some people will, shall we say, not be exactly co-operative with the process. So have everything ready, half-opened and close to hand before you start to empty or change the bag. It can be helpful to have something on the go...the TV?..as a bit if a distraction. One of my first experiences was of a client deciding to get up and wander with an open clip....I got rather wet.
Second tip is that you need to prevent the caree from fiddling with either the clip or the tube. Doing the latter can result in urine bypassing the catheter and frequent call outs to the District Nurses to reinsert. Net leg stockings are helpful to cover the bag and drainage clip or you could try a loose pair of leggings under skirts which can prevent tugging or fiddling at the tube. Also vary the bag situation...some people prefer it to be higher up the leg, some like calf or ankle. Its all trial and error i'm afraid.
Best of luck.