Catheters at home

[Lidlfix]

DFIL has vascular dementia, been with us in a "Grandad" flat for 8 years. Continence has been a severe problem for most of the time. Been on holiday and collected him from respite yesterday and he has a catheter in. We have guardianship and knew nothing. That's not the issue - if he was in pain do what gives him relief. But I am scared and (to my shame) disgusted by the catheter. We knew we were reaching the point where his continuing care at home was in question. Anyone had any experience with elderly relatives and catheters?

Can I ask why the catheter was put in? Was he retaining urine? As far as I am aware, catheterisation should not be done for "convenience"eg. if the person is incontinent with no retention problems, they should use pads.

He should be able to be referred to a community continence nurse-ask your GP.
Catheters should only be used for retention. They can cause urine infections etc.
Other options could be urinary sheaths or incontinence pads, which don't pose the same infection risks.

My dad had catheters for nearly a year while waiting for prostate surgery - he was in total retention without them. Luckily, he only had one infection in that time, but they were a total pain as they often got blocked and then the district nurses had to be called to change them (or not as they were sniffy about doing it).

Bit obv, that was a short term thing. Your fil needs continence advice, and the respite care should have talked to you about why they catheterised him and advised about the ongoing plan if it had been necessary for retention.

Thanks for replies. His prostrate is enlarged and he was retaining. I would have thought that they would try to deal with cause more prior to something so invasive. I'm terrified of him pulling it out and imagining the worst. Had crisis meeting with social worker - feel really crap now basically this might be what leads to a nursing home. Our mantra has always been "so long as his quality of life is better with us". Catheter aside he came out of respite clean, rested and well fed, now he's back to sleeping all day and that's with DDs and I still off school - God knows what he'll be like next week when we're back. Feel crap but got 4 DDs a full time job and a life as well as a once lovely gentle elderly man to consider .

If he was in retention, then short of surgery (which wouldn't be recommended in your fils case as the potential for a massive downturn is strong) theres not much to be done.

My dad really wasn't worried by the catheter at all, so don't worry about the impact on his quality of life from it.

Has he been pulling at the catheter while he's in the home? If not, it's not particularly likely that he'd start pulling it out at home (and it hurts when it's pulled, so most people stop pulling even if they start)

There are many many people that manage catheters at home with carer support if need be, it doesn't mean a nursing home is necessary. Does he have any social carers going in to his home? They would routinely empty the bag / change the bag weekly / attach the night bag / assist with catheter hygiene etc

And I don't know why district nurses should be sniffy about doing catheters - they do it every day. There are potential risks, which can be managed. Infection - risk can be reduced with good hygiene. Blockage - can be reduced by appropriate fluid plus catheter maintenance solutions etc.

Do you know why he went into retention? If it was infection or constipation, then he could trial without it - normally taken out, reviewed a few hours later, would be reinserted if he hadn't weed. if it's due to enlarged prostate, he'd need to have treatment before tril without catheter

Sorry, I should have clarified that the district nurses where my parents live are just difficult generally. Alas my parents have had a great deal to do with them over the last years, so it wasn't a one off.