Catheter unsuitable

[chard]

Hi all

Just back from visiting my 84 y/o FIL. He's in a right mess completely chair ridden and being nursed by my 80 y/o MIL.

Nurses have been going in twice a week to help dress wounds and have requested carers to help with hygine/chair sores etc.

He can just about move to a commode by the side of his chair, and to pass water uses a bottle. Due to the size of his hernia he cannot use his bottle properly and ends up with urine over himself and furniture etc.

The mess is really getting them both down. MIL has requested a catheter to help but apparantly it's unsuitable for him any ideas why?

[mrsxllifts]

Any ideas who said he was unsuitable? Had a similar issue a few years back and turned out that the nurses said it wasn't possible as it meant they might have to do something when they visited, said nurse moved, new one came in and catheter was in within 48hrs making life easier for everyone and much more dignified for the patient. Might be worth talking to GP/practise nurse/hospital dept (if under any).

[BlackVanDyke]

They're right, invasive catheter is a terrible option for someone like that, it would increase his infection risk a lot and can be uncomfortable/painful. Would have a high risk of starting off a cascade of infection and deterioration - unless he is unable to fully empty his bladder (pee getting left behind even after he 'goes') then it's not worth the risk. Much better option: a 'condom catheter'. It's also called a sheath or a Texas catheter, imagine a condom with a tube coming from the end - it stays on all the time and he pees as normal, and it goes into a bag he can have strapped on his leg, or on a stand on the floor.

Here is one such product.

Some kind of urinal bottle with a flexible tube so that he doesn't have to get the whole bottle in the right place might also help - I don't know about such things but suspect they probably exist.

The district nurses can refer your FIL to a specialist Continence Nurse who has the most INCREDIBLE bag of tricks for solving issues like this - ask for a referral, they'll sort out some samples of things for your FIL to try out.

In the meantime, get some bedpads (bed protector squares) and use them under/around the urine bottle while he's trying to use it, should catch most of the spillage and can then just be binned, makes cleanup easier. Another thing that might be helpful is a sort of magic bag made of alginate stuff that dissolves in hot water, so you put your soiled clothes in it and then put the entire bag in the washing machine as is, without having to handle the dirty clothes any further - incredibly handy for dealing with body fluid related messes.

I'm happy to sort out some more links to possibly useful products if you need/want, just shout.

(as you may have gathered I have some personal experience of this stuff but at least I can occasionally share useful info with someone else!)

[chard]

Thanks for your help. My Wife has spent the day talking some sense into MIL and organising things. MIL now accepts they need some help.

Everyone has whipped into action.

We now have Hospital Admission Prevention Team going in twice a day (lovley lovley people). Proper bed on order with pressure mattress, hoist, the doctor has been in and prescibed some stronger pain killers for his arthritus.

I'm amazed at how quickly everyone has reacted and how well cordinated it has been.
Thanks to all the Solihull; carers, medics, social services. Prompt and proper care.

[mph1977]

becca (black van dyke) has hit it on the head , there are really only 2 indications for long term catheters these days

1. retention due to structural difficulty
2. neurogenic bladder - and then we'll often be looking towards either suprapubic catheter or intermittants depending on the individual

some urologists will try to keep catheters in people who have become incontinent follwing urology procedures

as for Becca mentions for chaps with incontinence there are sheaths / conveens/ texas catheters which are pretty effective if sized properly ...

[BlackVanDyke]

chard said:

Thanks for your help. My Wife has spent the day talking some sense into MIL and organising things. MIL now accepts they need some help.

Everyone has whipped into action.

We now have Hospital Admission Prevention Team going in twice a day (lovley lovley people). Proper bed on order with pressure mattress, hoist, the doctor has been in and prescibed some stronger pain killers for his arthritus.

I'm amazed at how quickly everyone has reacted and how well cordinated it has been.
Thanks to all the Solihull; carers, medics, social services. Prompt and proper care.

That sounds like a really really brilliant bit of progress. I'm pleased for you - having the right kit makes ALL the difference, back it up with good human support and life begins to be livable again, if drastically different from previously.

If the hoist is likely to be long-term, then one thing that may not be suggested by the Occupational Therapist, but should be, is to look at whether the hoist they've got is the best one for the circumstances - in particular, the mobile ones like little cranes are a) almost impossible for one person to use and b) absolute murder to use on carpet or in a tight space. There are other sorts - namely overhead ones with long thing legs, that straddle the whole room - that are vastly easier and quicker to use, and which (crucially) do not require any strength on the part of the helping person.

I'm happy to talk equipment and disability/care issues till the cows come home (am doing a BSc in Health and Social Care and am also living it, as a person with severe physical impairments living on my own with 24 hour care) - if you've got specific questions or need something troubleshooting please drop me an email.

[mph1977]

i'd agree with what becca has said about hoists -

depending on circumstances either a standing hoist or a gantry might be better than an 'engine crane' jobbie

[chard]

BlackVanDyke said:

chard said:

Thanks for your help. My Wife has spent the day talking some sense into MIL and organising things. MIL now accepts they need some help.

Everyone has whipped into action.

We now have Hospital Admission Prevention Team going in twice a day (lovley lovley people). Proper bed on order with pressure mattress, hoist, the doctor has been in and prescibed some stronger pain killers for his arthritus.

I'm amazed at how quickly everyone has reacted and how well cordinated it has been.
Thanks to all the Solihull; carers, medics, social services. Prompt and proper care.

That sounds like a really really brilliant bit of progress. I'm pleased for you - having the right kit makes ALL the difference, back it up with good human support and life begins to be livable again, if drastically different from previously.

If the hoist is likely to be long-term, then one thing that may not be suggested by the Occupational Therapist, but should be, is to look at whether the hoist they've got is the best one for the circumstances - in particular, the mobile ones like little cranes are a) almost impossible for one person to use and b) absolute murder to use on carpet or in a tight space. There are other sorts - namely overhead ones with long thing legs, that straddle the whole room - that are vastly easier and quicker to use, and which (crucially) do not require any strength on the part of the helping person.

I'm happy to talk equipment and disability/care issues till the cows come home (am doing a BSc in Health and Social Care and am also living it, as a person with severe physical impairments living on my own with 24 hour care) - if you've got specific questions or need something troubleshooting please drop me an email.

Actually the hoist may not be necessary. He's now on his feet!! The old codger can walk with help, just lacking in confidence. I reckon with the right help this 84 yr old still has some quality time left.