Catheter Help

ripscott

My 101 year old dad just got home from a 3 week hospital/rehab stay. He now has a catheter that he never had before. He does not understand what it is or why he has it. (Explained it to him 1000 times) Ever since he has got home he is shouting that he has to pee, says it is itching, and is pulling at it. I'm afraid of the damage he will do if he pulls it out. They put it in and took it out twice while at the hospital( retaining his urine) and he screamed and fought both times- took 4 nurses to hold him back. A nurse is coming to our home to check it and change it every 30 days. Dad is going to go nuts because he doesn't understand. How do we get him to leave it alone and how do we keep him from fighting the nurse?

mommyandme (m&m)

If he has a catheter maybe hospice could be involved. If they admit him, a nurse would come weekly, also a CNA, along with other support staff. Would his doctor be on board with that idea? 

He may need an anti anxiety med given prior to the nurse’s visit. Maybe he needs meds to help him relax in general?  When the hospice nurse knew she was coming to do something uncomfortable for mom, she requested I give her the Ativan 30 minutes prior to her visit.  

So sorry for this situation. I hope your dad finds some relief soon. 

M1

Oh Ripscott--such a dilemma.  I have seen many, many demented older men get into bad trouble this way.  The catheters are uncomfortable--they are held in place in the bladder by a small ballon near the tip that is inflated with air.  But:  it is all too common for demented older men to pull them out, even with the ballon inflated, and can do terrible damage to their penis and urethra that way.  Unfortunately, if he really can't urinate, the alternative treatment is to put in a catheter through the abdominal wall (suprapubic).  Much more invasive to put in, obviously, but frankly, he might tolerate it more easily.   The abdominal wall is not nearly as sensitive as the urethra. bladder sphincters, and glans of the penis that are currenlty being irritated by the Foley.  Otherwise he will be at risk of rupturing his bladder when he can't empty it (also extremely uncomfortable), and/or going into complete kidney shutdown.    

A call to the urologist may well be warranted to discuss the possibility/need for a suprapubic catheter, or to see if they have any other ideas.  Let us know---

SunnyMae

Agree with M1's post. 

A smaller bore tube might help with the irritation of the catheter, or if there is a latex sensitivity other tube materials might decrease irritation.

With a prescription (I think it would be needed) lidocaine gel at the exit site might help (tip of the penis). 

If he is pulling on it try threading it down though the pant leg. 

Iris L.

What is the reason for the catheters?  Is it for a medical reason or for the convenience of the staff to avoid toileting him if he was not ambulatory?  Indwelling catheters are to be changed every 24 hours in the hospital.  This was the standard of care, unless it has changed.  

Iris

loveskitties

In the last month of my Dad's life he had to have a cath, as he could not urinate otherwise.

He was constantly pulling at it and in fact did get it out once.

We were never able to tell if it was hurting, uncomfortable or just having the tubing attached to his leg which of course was not usual.

Speaking with the urologist is first choice, to see if other options are possible.  Second, would speak with doc who prescribes his meds...maybe an adjustment to anxiety meds would help.

Hope there is a solution for you and him.