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Elderly parents

Anyone's disabled.confused dad been able to do "intermittent self catheterisation?"

21 replies

bizzey · 28/05/2013 19:55

Hi dad has got mobility problems which means he cannot stand unaided...he needs sticks mimimum..

He also has RA which means his hands and finger's ....well he cant even do buttons up.

He has now been diagnosed with Alzheimer's so I am not sure how much he is taking in .

We have an appointment soon to see nurse about ISC and I have been reading the booklet they sent

No way will he be able to do this ...and I am NOT !!

Any one had any luck in getting a regular time/appointment with a DN to do it ??

He lives with mum and I am around every day ..but ..........!!!!

TIA

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scoobdoob · 28/05/2013 20:00

From what you explain isc doesnt seem appropriate at all. You certainly need good dexterity.

Who instigated the referral with the nurse?
Why did they feel he needed it?

If it needs to be done daily, can sometimes be 4x daily, it is doubtful a district nurse service would be able to offer this level of support.

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CMOTDibbler · 28/05/2013 20:03

With ISC, he'll need to catherise every 3 hours, so dns won't do it. Why are they recommending it?

My dad (78, frail, barely mobile) currently has an indwelling catheter as his prostate is huge and blocking the urethra. The DNs come and change it, but even though he is reasonably with it he finds it all pretty difficult.

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bizzey · 28/05/2013 20:17

Ok maybe ISC is not what he is going to have ....that is what the wording says on the booklet.

He has a problem that his bladder never empties...they have done measurments and ultra sound and he is always left with approx 400ml of old wee (we are under urologist)...
We had 1 appointment with him and he mentioned self cathertising probably 1x or 2x week ?

Bit confussed now and need to know my facts before I take him so I can explain it before

Prostrate is ok but he is on Tamsulosin and fiinestride (?sp)

Thanks for replys !

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bizzey · 28/05/2013 20:19

Forgot to say ...Doctor gave us the impression it could happen over one night ?? But he did say that he was referring us to a more expertised clinic ...hence the appointment .

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scoobdoob · 28/05/2013 20:20

Sometimes isc is recommended just once or twice weekly if there is a urethral sticture just to stop it narrowing altogether.

District nurses would (should) give this level of support. An indwelling catheter may well be more suitable but there are lots of factors to be taken in account. It is usually last resort but as dibbler says in her dads situation there is no choice.

Write down all your concerns before you go. Nurses are normally the best to talk about catheters to!

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Madratlady · 28/05/2013 20:24

If it's only a few times a week, or even daily then the DN should be able to do that. If it's any more often then a long term catheter sounds like it'd be more appropriate

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scoobdoob · 28/05/2013 20:30

The drugs he is on relaxes the urthra making his flow better if that makes sense.

His bladder not emptying is a common problem. Anything over a 150ml is considered abnormal. We normally consider isc at about this. I have certainly seen much higher residuals.

The concern with a non emptying bladder is recurrent utis as the urine is "hanging around in there". Also that it may turn into acute retention where he cant wee at all.

They may try the once/twice a week option or maybe a low dose, long term antibiotic. There are lots of options so please dont worry. Just be honest and say you cant carry it out. I wouldnt be able to for my own dad either

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bizzey · 28/05/2013 20:32

scoobdoob...I think I know ...but is indwelling =permanent with bag attached to leg thing ??

Mum and I know how to empty/change bags and stuff as we were both Home Carer's ...but the psychological impact would be massive for them ....even though I know it would be better for him .
Thanks ......I might need to bring up the subject so he is not shocked .

I will be at the appointment( I always do his appointments) not mum...it is all getting to much for her now

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scoobdoob · 28/05/2013 20:55

It is must be hard for your mum.

Yes it means permanent. Attached to a bag on the leg. It is very hard thing for people to accept. Especially the older generation. Lots of people understandably cant/wont tolerate a catheter

Does he need to go to the toilet frequently? Get up a lot at night?

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CMOTDibbler · 28/05/2013 21:12

My dads coping with the actual catheter fine, and is enjoying not getting up lots in the night. Hes waiting for a TURP after going into acute retention (1.8l of urine drained!), but as mum who has dementia had surgery recently he's been putting it off

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scoobdoob · 28/05/2013 21:17

That certainly is an impressive residual. Your poor dad he certainly had no choice then. No wonder he is getting on with his catheter.

Lots of people do say its the best thing they did. Ie manage to get some sleep! Buts its the unknown that is scary. That is why it really needs to be discussed properly.

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bizzey · 28/05/2013 22:18

OPPS sorry ...got distracted with the BGT thread !!

Dad was catherterised for the first time 18 months ago while in hospital for a minor opp ...and to be honest where everything has gone down hill from .
He I think always had had problems with his wee but never said anything.

Heis in a catch 22 with his wee...needs to go alot for a little bit ...but srtuggles to get there in time ??

I have got him a bottle for night time use ...which mum thinks is.....well she is a negative person ...so instead of seeing the positives that it is easier for dad ....she does this funny thing of showing me the bottle she has to empty ??

CMO...what is a TURP ?

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scoobdoob · 28/05/2013 22:47

A bottle is a brilliant idea. Something I would definitely recommend. Gosh anything to make life easier.

Frequency is often the symptom people just cant cope with. There are also conveen type products. It isnt inserted into the body. Wont empty the bladder but can just be used at night if wanted to get some sleep.

Continence really is the thing most familys find hard to cope with.

A turp is a trans uretral removal of prostate. Where an enlarged prostate is shaved to make it smaller and easier to wee.

Make sure your dad isnt constipated as that can impact on the bladder. Plenty of non caffeine, carbonated fluids. And trys not to drink to much in the evening.
Good luck

I also love bgt

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bizzey · 28/05/2013 23:29

AHHH the constipation bit ....I had thought about it but got it the other way round !
He is severly constipated...but no proper help yet apart from different medication to try ....

I thought the fullish bladder might be causing these problems and not the other way round.

I have got an appointment for him on thursday for I think "bowle" area and was going to cancell for now as he has had to much to take in lately and thought I would wait for urology appointment results ....

I will take him ...and see if they can work together .

TBH I am am not 100 pc what this appointment is for ..

He had a big GI Bleed 18 months ago and for 12 months our appointments have been getting messed up ..

I think I will not cancel the appointment ...but he has really had enough and so have I

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oneandnomore · 28/05/2013 23:46

Hi bizzey. This is not catheter related, just wondering if you and your mum are being adequately supported. I know services differ depending on the area you are in, but where I live there is a carer support service.
They offer advice on a range of matters, support with practical issues, problems with home care, advice on different services and a listening ear.
It sounds like you need to offload to someone who can support you and your Mum.

Also, your local Alzheimer's Society branch will have info on support groups. Memory cafes are a way of meeting with other families who have a loved one who has a diagnosis of Alzheimer's. Also, Admiral nurses are an invaluable source of information and support.
Hope this helps you in some way. If you want to talk some more then feel free, pm me if you would rather. Take care.

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bizzey · 29/05/2013 00:15

oneandnomore.... Thank you for your lovely thoughtful reply.

Yes, mum and I are still on the begining stages of our "journey"..and sometime we get hit with too many "wammy's " in one go///all at once ??

I have booked her an appointment with GP next week ...as you are right she does need a professional listening ear ...and I am not good at that ...and we argue

I am a very much ..pick yourself up ...dust yourself down sort of person but mum will just want to TALK !!!

Thank you

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oneandnomore · 29/05/2013 22:14

That's ok bizzey,

Have you and your Mum got a list of things to speak with the GP about? Just some ideas as I don't know what has already happened re your Dad's care, has he had a referral to Older People's Mental Health? They will assess for medication that can assist to preserve memory. Also, they will support as your Dad's illness progresses, and liaise with adult social care.
Do your parents currently have any services? If not, ask the GP to refer to adult social care for a joint assessment. This will ensure that services are available to support your Mum also, such as carer's sits.

You need to take care of yourself too. I am much the same as you, just get on with things. I have both personal and professional experience of caring for parents, so if there is anything I can help with, let me know.

Sending and

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scoobdoob · 30/05/2013 13:10

Hi
Hoping the appointment goes well today. Many prople including doctors under estimate how much constipation can impact on general health.

I understand the constant appointments. We live for the next one and hope for answers but never really getting them!

Happy to chat anytime because even though I work in health I know how different it is when its a member of your own family.

Take care

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bizzey · 30/05/2013 15:33

scoob...thank you ....as it turns out I was glad I did try to cancel the appointment as I decieded neither of us could face it right now ...bacause we were never even bookedin for it !!!

I should have had this appointment 3 weeks ago but the car started blowing white smoke when i went to pick him up so I phoned to cancel ..explained why and was given today ...

But on trying to cancel we were down as a DNA on the other appointment ...refer back to GP !!

Got it sorted and reversed (the person who took our call did not log it properly) and we are going next week .

AM appointment for this (general surgery /colon stuff) and PM appointment for Alzheimer's on the same day ....picnic and a flask I think !!!!!

So glad I did not go and be turned away...horrible hospital to go to in the first place trying to sort out parking and wheelchair stuff.....

Big " SW London teaching hospital" with one disabled parking bay !!!!!......and the extra space is for the driver not the passenger....and lift not working from car park so I huffed him up the hill !!!!

Nevermind ....It is wine o clock soon and BGT !!! [GRIN]

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bizzey · 30/05/2013 15:42

I should say ...I do feel bad at even thinking about canceling an appointment of his ...but I am sensible enough to know when I need a break...and it is DS1 birthday tomorrow and I want to focus on that !

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scoobdoob · 30/05/2013 21:40

Oh dont feel bad. I very often go to appointments and think why did we bother. I think you know your dad best and what matters.

It might be good to get the dn team involved even just to help co ordinate care and support. And its shame there cant be more community appointments. I think its so much more relaxed than in the big acute hospitals. Nhs buildings are always so rubish for disabled clients. Its a disgrace.

Enjoy the birthday. We have one coming up soon that I am getting quite stressed about with the different demands. At the moment its i want a dog! I was hoping for an I want an i pad x

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