When do you know its time for a cathetar?

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When do you know its time for a cathetar?

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For over a year I have been dealing with my 86 year old mom wetting herself because she claims either she doesn't want to bother anyone to go or she doesn't know when she has to go. Personally, I don't believe either her but she does have dementia. When I am really upset with her, she asks me to go all day long. I am only home on Sundays, I work about 65 - 70 hours a week and she has caregivers when I am not home. She claims she is wet because either she is to lazy, or she doesn't want to bother anyone. However, she does know how upsets it gets me cuz I know she knows when she has to go. I was considering a catheter so she isn't sitting in wet all the time. But I am not sure if that is the right choice. Please help me determine when the time is right for this. When people ask her if she has to go, she gets mads and says "I will tell you when" but she never does. I am really frustrated with this and do not not to be upset with her anymore. My patience is really wearing thin with this, any suggestions will help and be appreciated.

Incontinence

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When my MIL lived with us she developed this problem. She had dementia as well. She was in denial; but difficult to distinguish if it was strong will or the dementia. She started wearing Depends 24/7. I was her caretaker and had to check her pants frequently so that she would not contract a urinary tract infection. This was difficult and truly sad as it is degrading for the elderly. But, we had a good relationship and I tried to humorize it when possible.

As far as I have heard, catheters are a last resort and the medical community don't like to use them long-term until absolutely necessary. They can cause infections, etc. Often, my MIL either forgot she had gone in her Depends, or would tell me that were dry when they were wet. I had her washing her private area throughout the day and she never got anymore UTI's

She still went to the bathroom with assistance as well as in the depends. This is a tough one and such a sensitive one. Take care.

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Catheters tend to cause infections and the elderly get pretty adept at pulling them out. Good adult diapers work the best. I know they can be expensive but they are almost like underwear and help keep some dignity intact. A good diaper should pull away the urine so she is not sitting in wetness.

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This is probably one of the biggest challenges in caring for someone with dementia at home. Like 3pinkroses, I cared for my MIL for most of the last two years of her life, from age 91 - 93. She became bowel incontinent long before she lost control of her bladder. In fact, she mostly seemed to know when she had to urinate right up to the very end, but, during the last year, I had to learn to read the signs of how she expressed this need. We, too, had gone mostly to adult diapers for the last several months of her life. To expect someone with dementia to control this and avoid the diapers is unrealistic and will lead to frustration for everyone. I tried to make sure that she visited the toilet every 3 to 4 hours during the day, and for the last few months had to cue her by turning on the water in the sink as soon as she was seated on the stool. It worked like a charm. I took her to the toilet as late as possible at night before she went to bed, but even so, waking during the night was still pretty much a constant condition up until the very end. I began ordering really good diapers, and liners for extra abosrbency during the night from an online source. I wish I had discovered them much earlier, as it was only about the last four months we were using them, but they were great! They were more absorbent, fit much better (she was a tiny woman) and were much softer and I'm sure were much more comfortable for her than any of the other brands we had tried before. This did seem to help wth much of the nighttime waking. Catheters come with added problems of their own, not the least of which is the torture of insertion, and except for extraordinary circumstances, are probably best limited to NH use. I wish you well in working this out.

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Yes, yes, yes, an investment in really good adult diapers, and the use of liners with them for overnight, is something to seriously consider. The ones we used were Tranquility brand, and I ordered them through the online alzheimer's store. One of the best things we did during that time.

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We purchased depends for my Mom when the accidents happened too frequently. She would argue about it in the beginning. I started to call them "panties" which actually adjusted her attitude. Getting her to go the bathroom was always a challenge. What worked best for me was to ask her come with me for some walking "exercise" around the house. When we neared the bathroom I'd say "let's go the bathroom since we're here". Most of the times it worked. Getting creative was always key in her participation.
Sometimes when asking her if she had to go she would argue and ask why I insist but I'd always calmly (staying calm is so important, preferably with a smile) say "let's go and you just try." I would bring her with her walker whether she wanted to or not.
She may get angry no matter what do you but that's OK. Just bring her to the bathroom.

My mother is a nursing home now with other dementia patients. They all wear diapers. I would guess that if catheters were a good choice it would be done in a nursing home.

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two possible solutions. I knew when my Mom needed the catherer and that was when I tried to help her up and put her on the portable potty next to her bed, but when done she couldn't stand, I couldn't hold her and we both went down on the floor. Thank God it wasn't a bad fall as we went down slowly, but I couldn't get her back up and this scared me to death. I myself pleaded with her to get a catheter so I wouldn't hurt her. She was able to do it for me mostly. On the other hand, yes adult diapers are expensive, but if she's in hospice they will not charge you anything. Just let them know you need them. My father used them and didn't like them at first, but because he had Alzheimer he shortly forgot about them. I wish you luck my friend. Perhaps try to serve the solution as a favor to you rather than for her. She just might want to do it for YOU. God Bless.

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So glad someone asked this question. My Mom is 94, has dementia and a very bad incontinence problem. She has her days and nights mixed up and gets up around 1 o'clock in the afternoon, at that time I give her her meds, which include 2 fluid pills. She is good for a little while, and then it is a constant "I have to pee", so up and down and down and up, all afternoon and evening. Then when she goes to bed, it is the same thing until at least midnight. That is why she sleeps so long afternoon. She has no idea she has wet her depends, but yesterday I was getting her out of her chair because she needed to go to the bathroom and when she stood up, she said, "I'm peeing now". We had her in the ER for a "recharge" after her stay with pneumonia for about 5 hrs and my daughter suggested a cathetar to the nurse and PA. It was so nice, except she kept saying, "I have to pee" and I would tell her to go ahead. Yes, I go to bed at night and the words "I have to pee" haunt me all night long! When she goes the most is of an evening at about every 15 to 30 minute intervals. Same as when she goes to bed. I have thought about waking her up around 9 or 10 in the morning and giving her her fluid pills and letting her rest, but I am afraid she will start wetting the bed. Does anyone have
any helpful suggestions. She has a history of pulling cathetars out unless she is in the hospital where she can be watched. Thanks, it is appreciated!

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I am so sorry that you are facing this situation. I am very aware of how frustrating it is to deal with. I think some of the frustration also comes from seeing the losses our loved one is going through. I would ask you to try to be patient with your mom just as much as I would ask a parent to be patient with their toddler who is not the easiest to potty train. If they sense you are mad and upset, it does not help. I am sure your mom who still has some understanding of what is going on does not want to be a burden and still wants to maintain some control and dignity.
I have Multiple Sclerosis and though I am no where close to being really disabled, I do understand the feeling of "lazy" and just not feeling like moving. It is also something neurological with knowing you need to do something and actually making the judgment call to ask for help or do it yourself. It is a little hard to explain. I did not decide on a catheter until my mom had been on hospice for a few months and all other avenues had been tried and exhausted. Catheters can create their own problems, the biggest being urinary tract infections and they are also uncomfortable. I would try depends or other adult diaper products as well as "chucks" or liners as the others recommended. Does she have a potty chair near her bed and is the toilet easy for her to get to? I think occupational therapists are the ones who have training in this area and might be able to help, too. Best to you and your mom.

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Unfortunately, physicians do not like to order indwelling catheters for 2 reasons: One is because the patient may attempt to pull it out if they are totally confused with Alzheimer's or Dementia with "balloon" inflated, thereby causing a male patient to have an instant "TURP," or a female patient causing damage to her urethra. The MAJORITY of physicians will not prescribe an indwelling Foley catheter and tell you the reason is because of "the risk of infection." As a nurse, this is NOT true in all cases. If one does "Foley catheter" care every 8 hours, there should not be a problem with infections. (Physicians are used to dealing with nurses in a hospital or nursing home setting and not all nurses nor nursing assistants perform their jobs properly). My dad has an enlarged prostate and wakes my husband up several times each evening to urinate, and it would certainly be convenient for both dad and my husband (so both can sleep throughout the evening). Unfortunately, I can no longer perform the duties of a registered nurse that I was absolutely dedicated to because of a patient "surprising" me with an upper cut to my chin. This injury resulted in bi-lateral TMJ replacements (titanium), and a C-5 fusion. Unfortunately, I had an attorney that filed a "personal injury case" instead of a "worker's compensation case" as I had requested. (The case was extended by not only the attorney, but also the largest hospital in Tampa, FL, and I was told under duress by my attorney that, "If I took the case to trial that any assets that I had would be frozen and the LARGEST TAMPA TRAUMA HOSPITAL would take every dime that I had). I do keep up with my nursing studies and hope to be able to provide care for patients in the future, but the nursing future does not appear to be possible for me ever again.

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When do you know its time for a cathetar?

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