District nurses catheter

[Flyhigher]

84 year old FIL. Might need a catheter.
He can't do it himself. Will district nurses come four times a day? Has anyone had this with their parents ? He's not super flexible and very uncoordinated. Any advice?

Ex District nurse here.
Sounds like the most sensible solution is a flip flo valve. No bag on the catheter and just a tap on the end of the catheter which you turn on to empty your bladder and turn off when you've finished. This would be the best way for your dad to keep bladder sensation, helpful especially if the catheter is only a temporary measure after surgery. They should be able to put one on while he is in hospital and make sure he has got the hang of it before he is discharged. If he can turn on a tap and still goes for a wee by himself at the moment then he will manage that OK.

If he can't manage it and his wife is willing, she could turn the tap to drain the bag. If the catheter gets blocked by sediment or infection, you call the District nurses who will come out and change it.

If he can't manage the tap on the bag, he won't manage a catheter valve. It's basically the same system, except omitting the bag, so urine collects in the bladder not the bag.

They have a house and savings. So am assuming there will be no free care. House is left out of the calculation if he's still living in it, or if his elderly wife is. So financial assessment will be done on his savings plus half of any joint savings.

Thanks. Another DN told me about this my neighbour. And I've mentioned it to the nurses and the docs. And they just say that's urology. Nothing to do with us. We don't know.
A junior doc looked into it a bit. But the nurses then over rode him. I don't think they keep those in hospital. They are £26 each and you need one every 7 days. So I guess there's your answer. I'm guessing bags are cheaper.

@Flyhigher I know your saying they are incompetent but it's a valve on a bag. That will stop the need for carers. I don't understand the reticence (and I do get it. I have a colostomy permanently. They take some getting used to and then-poof- it's like it's always been there)

A catheter bag is absolutely easy to empty. He would just go to the loo, turn the valve & the pee will go in the loo.

If he cooks, perhaps he may have the dexterity to open the valve a few times a day to empty?

Are you sure about that price? I think that's for a pack of 5 or 10.

They're not going to be vastly more than the bags because the bags also have a valve/tap on them.

They can't put a plaster on. You have no idea how incompetent they are.

He can't put Velcro on anything. Neither can she. Can't lift levers and aim them anywhere. Can hardly drink from a cup without spilling it. Always drop food down themselves and on the floor.

So do you put your leg on the loo seat and open the valve? Surely wee goes everywhere?

@Stomacharmeleon it's not reticence. They can hang pictures. Can't plant bulbs in the garden.

Put a jug under it, open the tap, empty the bag, close the tap, tip jug down the loo. Thousands of elderly and disabled people managed to do this all day every day. I think you maybe need to give a bit more credit to them. Just because they are elderly doesn't mean they are completely useless at life. They've managed until now. If they are as infirm as you say then an assessment for social care should have been in the pipeline long ago. And yes you may have to pay for a care package.

Stand in front of loo. Lift tube so it is over the pan, use other hand to open tap. It then just trickles down into pan.

Alternatively, sit on loo, aim tube into loo and open tap.

If he can't manage velcro, he will have difficulty with the velcro strap supporting the bag. It's advised to switch legs each day to avoid penis getting sore through tube always being pulled to the same side of it.

But basically, there's no trouble with controlling the jet of urine. If you're ever caught short in the countryside and have to go "behind a bush", emptying a leg bag is easier and more discreet than peeing normally.

This thread has taken a funny turn 🤔

They have always been impractical. I think they both have dyspraxia. Or he had hemiplagia.
They cannot use Velcro. Nurses not helpful showing him anything. I had a debate with one. They've had him in a room sitting in a chair for 9 days. He's 84. They are not helping him. So he cries every day gets anxious. They just come in and say. It's fine. I had to really push to put a leg bag on him. 9 days with a night bag. They are nice but useless. No good sisters in.

So... what kind of care packages are there? Help!!

He's now ranting incoherently. And crying a lot.

In my experience of my elderly fathers NHS discharge they arrange NHS funded careers to come for a few days while paid-for care was organised. The Local Authority (Social Services) suggested carers and my father had to pay around £300 set up fee plus then the ongoing cost of the carers. It's not cheap. He has savings so didn't even attempt to get any funding as would not have qualified. It's a difficult time. My father felt he carers were unnecessary and was quite resistant.

Carers not careers!

If they have savings, I would start researching private care companies near them now. District nurses do not visit to empty catheter bags. Its classed as personal care, not medical.
The discharge team at the hospital should arrange carers for a limited time to give you chance to organise your own .
Whoever you choose will come and do an assessment and write a care plan.
When we were in the same position with my mother in law (who lived with us) we worked full time so would have a carer come for an hour each morning to get her up, showered, dressed, breakfast and bed change and all her personal care, half an hour at lunchtime and teatime then instead of an evening call, we would do it. It used to cost around £1,400 per month but that was 10 years ago.
After a year of doing this, my husband had to take early retirement because she couldn't be left alone. We continued with the carers though because she wouldn't have wanted her son doing her personal care.

@Flyhigher has he got a uti do you think or is this normal behaviour for him?
I would repeat again emptying a catheter with a valve is super straightforward after you have been shown a few times. You don't need to cock your leg or even go to the toilet. You can use a vessel to empty it and flush it away.

If they are so incompetent why do they not have carers already? It sounds like they are at huge risk to themselves if he is cooking yet can't safely drink from a cup.

Arrange a social services assessment asap

If they are so incompetent, they can't drink from a cup then they need 24 hour care. Surely they can't be cooking and cleaning? None of this makes any sense to me and I deal with this as a job. A catheter is simple to empty, if he was independently toileting previously, he will be able to empty the bag or use a flip valve.

I’d definitely contact your parent’s local authority adult social care services and ask for a free care needs assessment. They can advise your parents on carers, packages of care etc. I’m a social worker and if those in my local authority have savings under £23,250 we will help with their care costs.

If he can switch on a light switch he can empty a catheter. Sounds like neither are coping at home though?