Organising outings from care home for wheelchair user with catheter

[Stephen_1512]

Hallo everyone,

A long-standing elderly friend (aged 88) has recently gone into a residential care home for the rest of his life. He has hardly got the use of his legs, so is wheelchair-bound, and has a permanent urinary catheter. Otherwise, he is more or less OK. Mentally he is alert, and "dying" of boredom.

I have suggested to various friends that we should take him out for short local trips (using a taxi adapted for wheelchairs which will be expensive), and have received a surprisingly negative reaction. Their attitude seems to be "Oh well, he's in a care home, he's in a wheelchair, and he has a catheter, taking him out is pointless. It has been explained to him that he is in a care home for the rest of his life, so there's nothing more we can do..."

I can't see why having a catheter would stop him going out of the care home? Certainly, being in a wheelchair is no obstacle to mobility, and wheelchairs can have discrete bags attached for "drainage". I have yet to speak to medical staff there regarding outings (he has only very recently gone into the home). They may well approve. Hopefully they will. I think it would be incredibly good for my friend's morale.

Has anyone else been told (by friends and/or medical staff) they can't take someone out for an afternoon simply because they are in a wheelchair and have a catheter? It sounds like control-freak bunkum to me! (sorry, just letting off a bit of steam...). But maybe I am wrong? Maybe there are complicated legal issues of responsibility and duty of care? Any thoughts would be welcome.

[Irene_1509]

That is very strange! My husband has a permanent catheter and has walking difficulties since his stroke two years ago. When he goes for hospital appointments we always use a wheelchair. Having a catheter is not a problem when going out. It is attached to his leg by straps and cannot be seen under his trousers. If it is emptied before you take him out, he shoukd be ok for a few hours. If the trip is going to be longer, then you can ask the home for a urine bottle, and empty the catheter in a disabled toilet. I am sure he would enjoy a little trip. His carers seem very insensitive.

[jenny lucas]

I agree. My friend's father has a permanent catheter and is totally mobile for his age. He can go in cars, and go for walks etc, it's just not a problem. When he gets up he has to change the overnight catheter set up for the day one, but that is just routine now.

I'm afraid I think the negative attitude is one of 'file and forget' that can all too easily apply when someone is 'out of sight' in a care home. My MIL (with advanced dementia) is in a care home now, but when I visit I always take her out for a drive and a picnic cream tea in the car (she's mobile still, but slowly, and it's an effort, and her dementia now makes it tricky to get her in and out of the car and in and out of cafes etc when I'm on my own). I can't understand when relatives just 'visit'. I mean, yes, I'm sure the resident is pleased to see them, but they'd be even more pleased to get out and about and remember what 'real life' is like.......

If your caree is mentally sound then I would have thought that if he gives you 'permission' to take him out, then there can't really be any issue of safeguarding, surely? he knows what he's doing, and what the risks might be (eg, you losing grip of the wheelchair??). So I would definitely take him out and about if that's what he'd enjoy and it's actually possible to do so! (Yes, speak to the home staff of course first.) (My MIL is now sadly incontinent so staff check she's 'good to go' before I take her out for a couple of hours)

On another tack, would it be possible for your friend to have a lap top with Internet access that he could use to keep in touch with the wider world? If he can cope with it (a silver surfer!) he would find it mentally stimulating and a way of staving off boredom. I do feel for him, and hope that the home is one that has a strong activity programme - my MIL's former one had a lot 'going on' and that was important to them. Also, again, just a thought, is it a 'mixed mentality' home, as if there are LOT of residents with dementia, rather than only physical ailments, he would find that far more constricting socially alas.....hopefully, though, he will find other like-minded residents to himself with whom he can 'get together'. (He may also find that, as a result of demographics, there are more female residents than male and that might make him very popular! )

[jenny lucas]

PS - if the home doesn't have internet (odd if it doesn't, but you never know), then one possibility might be the following:

By chance I discovered that BT offer a kind of 'piggyback' service whereby if you try and access the internet in an area where BT have a lot of internet customers already, the lap top you use will pick this up and BT will put up a screen 'automatically' asking if you'd like to buy any spare capacity that is 'floating in the ether'. It's called FON and it's very usueful (it might be something to do with Wifi hotspots but I don't know anything about that!!).

Anyway, there are various rates of purchase - about a fiver plus for just an hour, a five day 'pass' for under eighteen pounds, and then a 30 day pass for something like 40 pounds I think. With the five day pass you can use it a day at a time, ie, you use 24 hours, and then it asks if you want to use the next 24 up, or 'store' it. So if you don't use you can save that day's pass for another time. ie, the usage does not have to be continuous.

However, I think for the 30 day pass it IS continuous, so if you use day one and day two, but then don't use it day three, but use it day four, you will have 'lost' day three. I've never risked the 30 day pass, so am not sure on this.

I think so long as your lap top is 'internet enabled' it will pick up BT Fon 'automatically' if you check which networks are available. (You'll probably be offered lots of the neighbours' networks, but will need their password to access them!)(shows how essential it is to have a password for your own internet access of any parked car outside your house can help themselves!)

[Stephen_1512]

Irene and Jenny, thank you both for taking the trouble to reply.

Last night I was very frustrated by the "narrow" view taken by some of my elderly friend's friends, and their various levels of understanding of care.

I have not yet resolved the issue, but am due to visit over the weekend and will hopefully speak to someone in charge. I think the best way to overcome the "he can't possibly go out" approach is to take him out myself (if he and staff are willing), and then present his friends with a "fait accompli". Look, see, I know it's possible because I've already done it!!!

Hopefully that will clarify the matter.

I'm not sure yet if the home has internet access. I will find out more in due course.

Thanks again for your replies,

Stephen.

[jenny lucas]

Good idea - try a modest outing at first. Be aware, pushing a wheelchair is quite hard work - especially up hill or over uneven ground!!!

If there is no Internet, I wonder if your friend might like to do something like learn a language, or a new skill of some kind, eg carpentary, or something that will both entertain him and stimulate his mind.

It's good he's got you looking out for him. All the best with the project - KR, Jenny

[Pet66]

Jenny I really wish my husband would allow me and my family to take him out. When asked, he looks panicky, and says no, .I'm going out later. In his mind he really believes he is! We keep trying, and I know the staff do. So, it's not always a case of families just visiting​, sadly.

[jenny lucas]

Sorry, yes, I should have allowed for that. I think that when dementia is in the picture, then perhaps familiarity is more important to some patients, who understandably may as you say panic at the thought of going beyond what has become perhaps 'safe boundaries' for them?

The important thing is that they get the choice, I feel.

I also know that the time will come with my MIL when she won't physically be able to get out at all anyway, as her mobility deteriorates, and of course eventually her mental state too. But while she seems to enjoy it, I'll keep doing it! (Selfishly, it's actuallyk loads 'easier' to take her out and about than make laboured one-sided conversation with her, so it's for my benefit too. I do think that for her, seeing the seaside and countryside etc must surely arouse some form of mental stimulation for her) (ironically, it's now SO much easier to 'return' her as she is far more 'passively accepting' of being in a care home - previously, she would say 'Oh no!' when we arrived back, and it was so awful to have to 'put her back in'......).

But really, as you say, it comes down to what they as individuals want to do. It's nice that your husband thinks he'll got out 'later' and perhaps that vague anticipation is all that is needed to reassure or cheer him.

[Stephen_1512]

Hallo everyone,

I have just returned from a visit to the care home.

I have spoken to the staff. My friend can go out in a wheelchair if he wishes. The catheter is no obstacle. It is drained before he goes out, and drained when he gets back. Standard procedure.

The only niggle might be the weather - he is not to go out in bad weather and catch a chill. I agree, so we are all happy about that.

At the moment, he has no interest in using the internet. We'll cross that bridge when we come to it.

Thanks again for your support.

It is appreciated.

[jenny lucas]

Great that you've got the all clear from the care home - and since warmer weather is coming now with summertime, hopefully you'll be able to get out and about with him. Do remember he'll probably need extra layers - eg, jacket and rug, because he'll be static, so will feel the cold more, whereas you will probably be sweating by the time you've finished pushing him uphill!!!!! (Take a bottle of water with you to refresh yourself!)

You may need to plan your routes, as things like kerbs can suddenly become huge barriers. My MIL's care home has a sloping drive, which is a challenge in itself, made worse by having cobbled sections to act as speed-bumps for incoming cars. Trying to push a wheelchair uphill over cobbles is definitely a challenge!

If he's happy not to touch the Internet yet, fine - but maybe that will come later.