Catheter problems

[Janey_S]

Hi - I was wondering if anyone can offer any advice on catheters. I've had a quick search of the forum for previous posts, but not found anything.

My 83 year old father was hospitalised last month after a fall. Dagnosed with probable UTI, treated with antibiotics, one failed discharge after 48 hours in ACU and then re-admitted next day, went into urinary retention and catheterized. He was discharged 3 weeks ago. I spent 2 weeks chasing up an appointment for TWOC which was finally carried on Tuesday. Unfortunately it wasn't successful. He was re-catherised which she described as 'hopefully a short-term measure' but then indicated we would probably be looking at 6 months!

He's having massive problems with discomfort and pain - particularly at night. It doesn't seem to remain strapped securely in place, he gets tangled up in the tubes, he knocks the night stand over. He completely fills the night then the weight is intolerable. I'm going in the night to empty the bag, but this isn't sustainable for another 6 months. Whenever a District nurse has come out no issue has been found. He isn't able to sleep properly due to the discomfort, which means he is getting more befuddled during the day, and just wants to sit on the sofa and doze with the blinds closed. He is on codeine and paracetamol, and has sleeping tablets, but this doesn't seem to be sufficient. He's been given something by doctor for bladder spasms, and I've tried him with a leg sleeve for the bag rather than straps, which seemed to be more comfortable at first. But twice this week I've been called over urgently because he's in too much pain. He's asking now to go back into hospital. Last night he managed to get off the leg sleeve, disconnecting the night bag in the process and soak the bedroom carpet with urine. He's currently in sheltered accommodation with a 24 hour alarm, but no 'in house' care package available. He's currently receiving a care package from integrated discharge /social services of 4 care visits a day but this is due to come to an end in another 2 weeks. We've already had one discussion where he was adamant he wanted to stay where he was, although willing to accept a permanent carer coming in. It's a one bedroom flat, so no room for an overnight sleep-in carer. I've got private care set up, but I'm not sure this is going to be enough for him. Any advice?

[Bridget Leech]

Are there any good Nursing Homes nearby where you could persuade him to go for a rest and management of his catheter.Then if they could get their GP to assess his problems generally and see what he needs. he might even like it so much that he would stay.It is always the unknown which causes anxiety.
He sounds as though he has some memory problems and really shouldn't be left on his own at night.Have you got a settee like a Futon which can be changed into a bed at night. It is expensive to have a night time Care Assistant but it might help temporarily. He should also have an occupational therapy assessment which can be arranged by his GP. I looked after my husband with an indwelling catheter for 8 yrs. He had a hospital bed and nighttime sedation as well as painkillers.Luckily I have a health background, but I found he was no trouble at night once there was a routine and his agitation settled. keep a detailed diary for a week of what he does,the times he is in pain and what it is like for him, if you can. Also a local hospice visit might help. They deal with all long term conditions,not just cancer, and usually have a pain consultant visit.
I feel for you. It is difficult. I presume he has Attendance Allowance and had a Care Assessment yearly by Social Services and a Carer assessment for you and that you are his Registered carer with his GP and any Hospital consultants.
All the best,
Bridget Leech

[Janey_S]

Hi Bridget - thanks for your response. We did discuss perhaps looking at care homes where 24 hour support was available, but he wants to stay where he is and see if it gets easier with visitng care at better times. His current GP is very good, so staying with them would be a positive thing I think. He lives on his own, so there isn't really another option for him other than being on his own at night. He doesn't really want someone staying there overnight.

I'll look into pain consulant, hospice, thanks.

He's been having a lot of input from OT through the SID team. No Attendance Allowance / Care Assessment (other than reablement package) as of yet - I've filled out the AA form and will send soon, but prior to being admitted to hospital there were no care needs other than helping him get his shopping and going to the odd doctor's appt. I'm not his registered carer, although we've wrtitten a letter to his GP in the past to say I can discuss any issue fully with them due to his issues with hearing.

GP last week prescribed something for baldder spasms which might be having a positive effect, also dscussed reducing fluid intake from late afternoon and having a lie-down during day in case there is fluid buidling up. I've stopped going round during night, although night bag is still full to max when carers empty it in morning. GP today has prescribed treatment for enlarged prostate and upped dose to 5mg Nitrezapam, so fingers crossed this will make a difference.

[Melly1]

Locked for usual reasons.