I found out today that my Mom (88 and ambulatory), who is currently hospitalized, will continue to need a Foley catheter when she is discharged. I have done some some research on what is involved in this process.
I am going to the hospital tomorrow to learn this procedure. I am already sickened by the thought of it. I don't know how to handle medical equipment and I am very unsettled by the whole idea. My mother tends to smell "down there," and I'd rather do just about anything but this.
I am not a natural-born nurse. I never had children, so I haven't even changed a diaper. I am also curious as to how my Mom will respond my doing this, or how I let her and the staff know I REALLY don't think I can (or want to do this.) Just thinking about it makes me shake my head.
I have been helping Mom out with other things, but this?
Or is this an 'in/out' catheter to be inserted manually each time to drain?
Or a permanent suprapubic catheter? If so, the tube comes out of the abdomin instead. Not too icky.
Go along for training if you want. Find out what's actually required.
But remember - you can say no!
Ask, if I say no, what's the plan?
You are basically going to empty it about three times a day as needed; not hard at all.
NOW, IF they are talking in and out catheterization (some men do this themselves) I would refuse to do it. It would have to be done often, is almost impossible to tell when the bladder is distended and it is needed without having access to ultrasound machine. It makes for MUCH MORE certainty of infection. Moreover, it is, to this nurse's mind, too intimate to do to one's own Mom. (I said I was and OLD nurse, but I would not want to do this on my own.
My advice to you is to go and see what this is about and if it is too much for you to tell them NO. They will say there is no other way than for you to do this. Repeat slowly as needed "N-O". And then take it from there.
You may be seeing the day coming when Mom needs more than inhome care. Why are they placing an indwelling catheter? It is rare. They often prefer incontinence because of the risk of infection.
I hope you will update us. As I said, I am an old nurse; I would NOT have wanted to do this for my Mom. It is much much more intimate than just washing her. This is legs spread. Hard to do in a low bed, a STERILE procedure in which contamination occurs if the tip of the cath hits skin or mucous membrane. Not easy and WAY intimate. Even learning to don sterile gloves is not easy. And your hands and catheter, which is long and wiggly, must stay sterile. Urethras also vary a bit, aren't always easy to identify. You will see new nurses trying to poke catheters in any number of "wrong " places. It amazes me what medicine expects us to do at home now.
I don't want to scare you. But I want you to be prepared to say "NO, I am sorry; I will NOT be doing this. What is plan B" if you need to.
I wish you the very best of luck. Let us know how this goes for you.
In/out catheter gets an instant NO from me too. I'd do myself, but not my relatives.
My Mom broke her shoulder and we took her to the ER. When put in a cubicle the RN thru a gown at me and said "dress her". I told her I was not comfortable doing that because Mom had a broken arm and "she" was the nurse. She said "yes, I am the nurse" and did it. Another time a dr wanted urine sample from Mom but expected me to do it. I said no that I was not getting down on my knees in his tiny little bathroom to try and get my Mom to go in a little cup. I have a hard time doing it for myself. Told him to give me the stuff and my RN daughter would do it at home. He agreed and she did, grudgingly. When Mom was in the AL, if she had an accident, I called the aide. Paying big bucks to live there, they can do the dirty work.
So if this is more than emptying the bag and ur uncomfortable doing it, speak up. They can order "in home" care.
But for relatives? I have already had to say NO to this loud & clear too. I suggested the 'witch hat' & may have considered helping with this (just pour into bottle after, no catching required) but as the patient took zero responsibility to try to suggest this/arrange this/do anything for their own problem, I declined fully. I believe a home health nurse had to attend instead.
The bit you're likely to be handling (and this is assuming that your mother can't manage it herself, and most people can) is not - how can I put it - at the business end. All you'll be learning is how to turn the tap on and off. Surely to goodness you're not so squeamish you can't empty a bag of urine down the lavatory? You're allowed to wear gloves. Nothing terrible will happen. You won't even have to look "down there" (or, rather, "up there" because you'll be concentrating on the leg end of things).
But it would be sensible and useful for you to learn as well what problems to look out for and what to do if they happen - discomfort, pain, spasms (rare), blood or cloudiness in the urine, etc.
Just be glad it's not your Dad and it's not a Conveen. That's all I can say.
If you find you cannot manage going forward arrange for a carer who can come in and do the necessary. I have sympathy with your position as I refused to do personal care for my elderly mother it just turned my stomach - but we found a carer who came in just for an hour for the purpose when necessary. You'll find a way to deal with it.
You will need to be careful that the catheter doesn't become twisted and keep the catheter line patent; you will actually find it rewarding when you become comfortable.
Emptying a Foley is FAR easier than dealing with having to wash a person's genitals due to incontinence. You just wear disposable gloves, empty the urine into some type of re-usable large plastic container, flush the urine down the toilet and rinse out the container. This process is repeated, on average, 3 times in 24 hours.
In terms of being "squeamish" - let's just say that every woman on the planet has wiped her own a** after bowel movements and touched her vulva for menstruation hygiene. So, assuming that you have bowel movements and have menstruated many times during your life, dealing with a Foley is no big deal by comparison.
It's easy. I do this for my 96 yr old dad.
Your mom's pee won't smell any more than your own and your nose or hands aren't going to be anywhere by her privates, you're only touching the tube and the bag which are at least a few feet away.
If she has to have it for a long time, they'll be sending a Nurse out once a month to change it or you'll take her in to have it done.
You've got this, you're only emptying pee from the bag by using the tube to drain the pee.
The cathiter /(urine/pee) bag must be emptied or tge urine/pee will go back inside your mom and poison her.
Mare sure the Cathier bag hangs lower than your mom's butt so the pee will drain.
When she has a bowel movement some stool can get on the catheter and travel into her bladder. Catheters can be VERY dangerous.
Unless there is a good medical reason for the catheter--your doctor should order to take it out.
With her weight, age, BP (she takes meds, but it still tends to run high), dementia, unable to ambulate, toilet, bathe, etc without major help, she is likely a candidate for additional strokes. But, they consider her stable. SMDH.
Be honest w/hospital staff so they very clearly understand that you can or cannot do this. Once you get her home, you could be on your own for several or many days. Just because they tell you they will arrange help for you does NOT mean it will happen...or when it will happen. Trust me on that.
If you cannot do it - then tell her it would be dangerous to her health to send her home. Make that clear to them too. And go see the hospital social worker or case management person.
You can't. It's an unfair burden to caregivers to risk their (mental/emotional or physical) health with care they are not able to provide. You're human. You don't need to give them any excuse. It's not possible. They try to burden us with this stuff. Not okay. Sending hugs and hope.
When I was in the hospital (almost 4 weeks!), I was BEGGING them to let me go home. Sure, I was on TPN and industrial strength IV antibiotics, all through a PICC line (not allowed anything by mouth), but still, was it *really* necessary to keep me there THAT long? I was not that old, I was able to get around, care for myself once they gave me towels, etc to facilitate that (for days, there was nothing and NO ONE bathed me!) I had no need for pain medication (finally demanded they take it away - when told I can't have it back if I need pain meds, I told the nurse the only pain I have is from the stupid plastic case it is in, to prevent theft, when it hits me in the head trying to move the IV pole around!!!) There really was no reason other than $$$$$ to keep me there. I absolutely HATED IT.
They finally relented and ordered home nursing and supplies to be sent. I had a pump to do the antibiotics 4x/day, a feed bag the nurse would prep each day with the vitamin additives, and various supplies. Nurse would also do a blood draw, and clean/change the dressing on the PICC line periodically, so they could monitor and adjust the meds as needed. It was SO much better for me to be HOME! But again, I was capable of doing what was needed to care for myself and do the antibiotics. Other than prepping the feed bag, blood draw and dressing, I didn't need help! Yet people with dementia and/or major medical issues who need a LOT of support and help are sent home tout de suite!! No regard for how much work is needed, no concern about whether the family can do what needs to be done, no concerns about behavioral issues or whether family needs help because they have to work!!! Go figure.
There is no shame in stating, I am sorry, but I cannot do this. It does not make you a bad person.
You need to talk to the hospital discharge planners about other options. I know nothing at all about catheters, but ask about having home care come in to manage it.
All I have to do is empty the bag, keep her clean, and find ways to keep feces out. Since she is bed or wheel chair bound and doesn't know when she has a BM this can be difficult. I also change the bag and exterior tubing as necessary. This is an easy 2 minute task.
Home health comes when the catheter needs to be replaced usually timing it with their regular weekly visit. If I was expected to change the catheter, I would not be willing to do it.
I work with trach patients, and we have to teach the families how to suction the trach, and change the entire thing out every month if home care doesn't do it. Scarey yes, but they learn and it becomes second nature after the first few times. I promise you can do this.. you are stronger than you think!