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Dad being discharged with a catheter - experiences?(36 Posts)
My lovely, frail, elderly dad is being discharged from hospital tomorrow with a catheter following an admission in acute urinary retention due to a massive prostate - he'll be awaiting a TURP. But this could be some time apparently
Any experiences of issues he might find? I'm not local enough to them to just pop in, so ideas of things to watch for would be good so I ask the right questions
ggirl I was discharged from A&E with a catheter and nobody knew about it.
GPs said they couldn't remove one put in by the hospital . I had to do so much chasing around but in the end a DN took it out.
I ended up wearing it for about three weeks though and was so worried about infection etc.
What if an elderly person was discharged with one and couldn't chase up?
Sharpkat- you're catheter may be a latex short term one and due for renewal, short term ones last for about 4 weeks .
Bad discharges are so common now, I visited a gentleman today who had a catheter put in 5weeks ago in hospital , no referral made to District nursing or GP , he asked in the surgery about his catheter that was causing him a lot of pain and the practice nurse asked us to vist..unbelievable!!!!!!!!! We had no clue about him ..poor chap.
NHS direct can put you in touch with the DN team (I remember from when dh had an incision that wouldn't stop bleeding they called them out to re dress it), but you may still have time to go through your GP - call up and ask to speak to the nurse practitioner for some advice, and don't take no for an answer. Someone needs to help you out
Sharpkat - yes we have district nursing teams in London .
Your GP practice can /need to refer you .
Or phone hospital ward where they gave you catheter .
Or go to A&E or your GP's .
But don't suffer in silence .
Don't think I have a district health team. Not sure we have them in London. Would have no idea who to call unfortunately.
Am only 33.
Good luck with everything with your Dad. My mum is going through similar with my grandpa so I know how stressful it is.
sharpkat, can you call your district nursing team and get them to have a look? They should be able to tell you how to sort out night bags too.
Poor dad has already had a blocked catheter, and had it changed by the DN this morning - and a gentle telling off for not calling them in the night when it blocked. DN team seem really on the ball, and have been asking questions about how they are coping.
Rollator ordered, meals delivered from Wiltshire Farm foods (mum went shopping on her own and didn't do very well on bringing home appropriate food), and dad is now more receptive about a cleaner.
My stress levels are sky high though!
It is just uncomfortable to sit - general discomfort. I feel like I just want to yank it out. It is draining fine. I just feel as though I want to wee normally.
I only have day bags and drink quite a lot during the night so was up and down like a yo yo. Lying down is most comfortable but the tube seems to pull when I get up.
The urine is very dark today. Have been drinking but probably not enough.
Spoke to urology today and despite A&E saying it would come out on Monday, apparently the first appointment is not until 22nd March I will go mad. Already had to cancel my lunch plans tomorrow and feel so lonely at home as I cannot go out.
Your advice above has been helpful so thank you
Where is it uncomfortable? What does the discomfort feel like, stabbing, dull, cramping etc. Is it constant or intermittent? Does it feel like the waves of spasm you get if bursting for a wee? Is it draining ok?
Do you have a elasticated strap on your thigh anchoring the catheter at the y-shape bit? Is it draining into a bag or does it have a tap you use to drain it at intervals?
What is the reason for having a catheter - this info might be relevant in considering cause of discomfort and what might be available to you to improve things.
I have just come home with a catheter in. It is horrible. How can I make it more bearable. I feel like I just want to go all the time.
It is until Monday. This is a long time being uncomfortable.
Glad to hear he's home despite the hit and miss discharge.
Just another tip, if he rings the GP to order more bags and catheters they will usually need to know the type/size of the catheter as they are not all the same. If the ward didn't give you this information, it should be on the DN referral and it may be better to let them do it first time for you.
Good luck, hope he gets on ok.
Well, it wasn't the best discharge ever, and really the time to decide that maybe the patient having three hypos needs advice from the diabetic team is before you've told them they can go home . And patients with very impaired blood flow/severe neuropathy in their feet shouldn't be in compression stockings - I really hope it hasn't done any harm as his feet as so borderline.
But dad is home with lots of spare bags, and strict instructions from me to get on to his gp tomorrow for a prescription for new bags and a spare catheter (they wouldn't give him one).
I will find the DN team number and harass him to use that early if necessary - apparently they don't visit routinely but will make contact.
Bless him though, hes really struggling to walk now. But he agreed on having the fabulous rollator I saw when I was buying him new shoes, so that is progress.
Mum pleased to see him, but still thinks they'll do something to his hip <sigh>
That was not clear - swapping leg and night bag is not an alternative method some people use - I meant it is a (very) wrong thing that lots of people do. (I find them out during the night when I see their leg bag rinsed out and on the side to dry
Make sure the hospital state clearly in the discharge information that your Dad is suitable for community recatheterisation. I send probably two patients a month into hospital for recatheterisation who could well be suitable for it to be done at home but it is not stated (during the night time nobody to check with).
If his catheter stops draining encourage him to check for simple mechanical problems - leg bag higher than bladder (water will not drain uphill), kinks in the tubing - two most likely areas being where the catheter exits his underwear and at the point where the tubing of the leg bag enters the leg bag. Another cause of 'blocking' or bypassing (where the urine will go round the catheter and come out of the penis) for new catheter patients is a full leg bag .
If it stops draining contact your DN team straight away, they will not be able to be there immediately - many patients try and hang on, hoping it will get better, not wanting to trouble anybody. Don't let him! Also, if it does not drain, he may not feel discomfort or need to pass urine as his bladder will probably have a ridiculously large capacity due to the retention he had previously. So do not use discomfort or not as a guide to whether he needs attention- or let anybody do so during a telephone call.This will probably improve over time.
If it was my Dad I would not let anybody near it with a syringe to flush a blockage or a catheter tip irrigation solution to clear a blockage, if it is blocked it needs changing.
And make sure he attaches the night bag to the bottom of the day bag (and opens the tap at the bottom of the day bag) - a lot of people take the leg bag off and swap them over at night.
That's probably enough for now, any specific questions, just ask.
Brilliant CPtart - I will make sure that happens.
I'd add to make sure they send some of the very large syringes and some sterile water in case it needs to be flushed. I was sent home with a catheter but nothing to flush it with so ended up in A&E.
As an ex district nurse I would also add just make sure they send your dad home with sufficient supplies of leg and night bags and at least one spare catheter. I have lost count of the number of times I have gone to someone with a catheter problem only to find no supplies in the house.
District nurses don't usually have instant access to these, normally they are re-ordered on a prescription. Something else to check.
Thanks again. He's been changing bags today, so he seems ok with that.
My mum got lost in the hospital for an hour visting him today though...
aww poppypebble what a lovely thing to say..thank you .I love my patients and my job!!!
What ggirl said. My elderly neighbour was sent home wi
th one last year and I helped him with it, am also a nurse but not community.
He will usually have a smaller bag strapped to his leg, and a larger bag to attach at night while in bed. He will need to be able to get this on and off or carers in to do it. If it stays in, he will need the supplier phone number so he can get more bags delivered when he needs them. The bags also need to be changed fairly frequently and it needs a bit of dexterity. Hope he gets on with it ok.
My Dad had a catheter for two years as he needed to be on extremely high dose diuretics to lower his blood pressure. He was visited regularly by the District Nurses (who, incidently, are fab, thanks for all you do, ggirl) and just got on with life. In fact, as he was permanently in a wheelchair, the catheter made life much easier because he didn't need to worry about accessible toilets as much.
We normally see a pt the day after discharge to check they are coping with catheter etc. The ward staff need to stipulate what they need the district nursing team to do on the referral they fax us,with dates etc.
It'snot uncommon for referral to not be sent on time so it's worth checking before your father leaves the ward that a referral to the District Nurses has been done.
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