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Problems with pulling out urinary catheter connection at night

NicW

New member
Jun 19, 2020
8
My elderly father collapsed at home in March this year and spent nearly 4 months in hospital and a rehabilitation unit. During this time he had to deal with Sepsis, UTIs and COVID-19 and a Grade 4 pressure sore. He has now been diagnosed with Dementia and has a urinary catheter attached 24/7 due to an open sacral wound.

We are in a trial period of personally caring for him at home, however, more or less every morning, we are woken to him calling out or us coming down to find him laying on the floor stark naked with the sheets, duvet and his PJs soaked with urine. He constantly plays with the connection, straps, bags etc and we know for a fact that he pulls at the connector. He is insistent that it has become disconnected on its own, despite us telling him constantly that we can see what he is doing when we are asleep. He also has a habit of removing his bottoms and then getting them caught up in the pipework/bag.

The constant wetting of the bed is significantly increasing the risk of his wound becoming reinfected and, allied to other concerns over risk of falls, we are needing to consider how his care needs are going to be best maintained going forward, i.e. specialist care at home vs nursing home.

Can any other forum members provide their thoughts or experiences on how they get their loved ones to stop playing with their catheters?
 

Jessbow

Registered User
Mar 1, 2013
3,074
West Hertfordshire
In short, I dont think you will . If he has dementia, not ammount of telling/bribing/trying to get him to understand will work.

He doesnt understand why its there irrespective of how many times you tell him.

You might like to wonder about other options- pads etc
 

MartinWL

Registered User
Jun 12, 2020
227
I sympathise with this as I have a much milder similar issue. My father manages ok most nights but accidents do happen occasionally and in particular there is a problem of accidentally discarding the connecting tube between day bag and night bag which means he cannot connect up at night. Your case is far worse and I agree with @Jessbow that you probably cannot teach him to manage better.
 

canary

Registered User
Feb 25, 2014
13,418
South coast
Ive had similar problems with OH - waking up in the morning to find 2 litres of urine in the bed as the night bag has been disconnected from the leg bag:eek:

There is no choice for OH as he has urine retention, so its got to be a catheter. That means that I have had to mitigate everything as far as possible.
  • I got a good waterproof mattress cover (you can get mattresses that have an overall cover which can just be wiped down) and waterproof duvet and pillow covers.
  • 2 or 3 kylie sheets will soak up the worst of it and can be quickly washed and dried ready for next time
  • the disrict nurse orded some leg and night bags that have a cylinder valve rather than a lever one. There is also a little plastic clip that has fits on the cylinder and has to be removed before the valve can be opened or shut. Nothing is really tamper-proof, but this makes idle fiddling harder
  • these bags are also much harder to take apart than the ordinary ones (sometimes I have trouble doing it myself) so although it wont stop a determined remover it does make it harder
  • you can also put tape round the join which, again makes it harder to take apart
I have found that using all these tactics has made it all manageable. I also wondered whether a bed guard might work to stop him falling out of bed, but I know you have to be careful about using them.
 

Weasell

Registered User
Oct 21, 2019
551
@canary offers some excellent ideas!

Here are a few more!

Install Video recording equipment! When does the problem occur ? Play back footage. Build up picture of activity. If he sleeps soundly until 5am get a one to one from 5am Onwards.

Buy pressure mats that alarm the minute he is out of bed.

Ask GP for medication to promote sleep.

This suggestion is not for this hot weather as it would be unkind.
Get him to wear lycra cycle leggings, covering all pipes connections. Over that put a body suit with a zip down the back. This way he will only have access to the night bag.

Does he suffer from itching? Would an antihistamine help?
 

NicW

New member
Jun 19, 2020
8
In short, I dont think you will . If he has dementia, not ammount of telling/bribing/trying to get him to understand will work.

He doesnt understand why its there irrespective of how many times you tell him.

You might like to wonder about other options- pads etc
Thanks Jessbow,

He did used to wear pads when he was first hospital, so that might be an option.
 

NicW

New member
Jun 19, 2020
8
I sympathise with this as I have a much milder similar issue. My father manages ok most nights but accidents do happen occasionally and in particular there is a problem of accidentally discarding the connecting tube between day bag and night bag which means he cannot connect up at night. Your case is far worse and I agree with @Jessbow that you probably cannot teach him to manage better.
Thanks for your thoughts on this tricky subject. I appreciate you taking the time to respond.
 

NicW

New member
Jun 19, 2020
8
Thanks Izzy, That's very interesting and something to consider for us going forward.
 

NicW

New member
Jun 19, 2020
8
Ive had similar problems with OH - waking up in the morning to find 2 litres of urine in the bed as the night bag has been disconnected from the leg bag:eek:

There is no choice for OH as he has urine retention, so its got to be a catheter. That means that I have had to mitigate everything as far as possible.
  • I got a good waterproof mattress cover (you can get mattresses that have an overall cover which can just be wiped down) and waterproof duvet and pillow covers.
  • 2 or 3 kylie sheets will soak up the worst of it and can be quickly washed and dried ready for next time
  • the disrict nurse orded some leg and night bags that have a cylinder valve rather than a lever one. There is also a little plastic clip that has fits on the cylinder and has to be removed before the valve can be opened or shut. Nothing is really tamper-proof, but this makes idle fiddling harder
  • these bags are also much harder to take apart than the ordinary ones (sometimes I have trouble doing it myself) so although it wont stop a determined remover it does make it harder
  • you can also put tape round the join which, again makes it harder to take apart
I have found that using all these tactics has made it all manageable. I also wondered whether a bed guard might work to stop him falling out of bed, but I know you have to be careful about using them.
Hi Canary,

These ideas in your bullet points are definitely food for thought. We do have a waterproof hospital bed type mattress on his bed, but the idea of having the same for waterproof duvets and pillow covers is a very good idea.

The different bag types is also interesting. He actually pulls the connection out and putting the tape over the join might be an additonal deterrent.

We are fortunate to have a bed where we can adjust the height. We normally lower this right to the ground and with a crash mat alonsgide, it mitigates most of the risk if he works his way out of bed during his restless nights.
 

NicW

New member
Jun 19, 2020
8
@canary offers some excellent ideas!

Here are a few more!

Install Video recording equipment! When does the problem occur ? Play back footage. Build up picture of activity. If he sleeps soundly until 5am get a one to one from 5am Onwards.

Buy pressure mats that alarm the minute he is out of bed.

Ask GP for medication to promote sleep.

This suggestion is not for this hot weather as it would be unkind.
Get him to wear lycra cycle leggings, covering all pipes connections. Over that put a body suit with a zip down the back. This way he will only have access to the night bag.

Does he suffer from itching? Would an antihistamine help?
Thank you Weasell for some very excellent ideas. The video recording option is definitely something that can be put in fairly easily.