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?

I am one of the old retired nurses on this site. I am pretty certain they are speaking of an indwelling catheter, and I am HOPING they are simply wanting you to learn to do basic care, emptying, infection prevention (difficult in itself. They will claim often enough that it is contamination from feces; but actually in female the urethra is short, the catheter holds the urethra open a bit, the catheter moves up and down in the area a bit, and infection is common. I would use one D-Mannose capsule a day for prevention of e-coli bacteria adhering to the wall of the bladder when it gets in (works like cranberry juice but easier and not acidic and better). The capsules are large (I use source natural product on Amazon, about 32.00 for 120.00 and capsules are large, so open and sprinkle on food if Mom has trouble swallowing.
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.
Helpful Answer (15)
Reply to AlvaDeer
worriedinCali Sep 16, 2020
thanks for the d-mannose info Alva, I found it personally helpful. I’ve been going back and forth on whether or not to start taking it to help with UTIs
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I worked with RNs, was their secretary, and we had one who refused to put in a catheter so don't let anyone into guilting you. Now I think some stay in but are removed periodically. Either way, I don't think you can be required to do anything you are not comfortable with.

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.
Helpful Answer (14)
Reply to JoAnn29
Beatty Sep 17, 2020
I still remember a job interview with medical... that little bottle & a tight pencil skirt did not mix well 😂.

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.
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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.
Helpful Answer (10)
Reply to gdaughter
JoAnn29 Sep 19, 2020
Yes, I agree with this. They try to push as much as they can on the Caregiver.
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NYC -- Oh my, I get you! No advice just empathy. I cannot handle anything that comes out of a body except blood, I guess because it isn't waste matter. I have to keep my eyes off the urine bag in a hospital room. I can't handle someone coughing up junk and then telling me to look at it. Nope. Not sure how I managed to change diapers for four kids and ten grandkids, must have been God's grace because I'm definitely not gifted with pee, poo, vomit, or mucous. I'd be telling the hospital, "Not me, make other arrangements."
Helpful Answer (9)
Reply to graygrammie
gdaughter Sep 19, 2020
It's okay. And here's one for you: my recent few day stint in the hospital did nothing to reassure my life long suspicion of all things medical. THE ER doc who did not talk to me saw a CT and decided I had an obstructed bowel caused by an enlarged uterus with a fibroid (which has been no problem for decades and was identified officially 3 years ago). They wanted to do surgery and I refused for multiple reasons...before I could ask questions or completely understand, they were putting an NG tube in, and whatever was being sucked out of me was in that receptacle behind the bed in all it's revolting glory. When I was put on the liquid diet finally, I ordered pretty much everything. I asked for iced tea and when it arrived it was the color of what was in the receptacle and that was the end of that!
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Why does your mom need a foley catheter? There BETTER be a good reason. You do realize she is at high risk of urinary tract infection. IF there is a genuine medical necessity (if urination is dribbling, which is incontinence, she would be better off with diapers), there should be no reason why home health nursing can help with you.

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.
Helpful Answer (9)
Reply to cetude

Tell her doctor you want hospice in place then with doctor orders you can schedule the initial meeting with hospice. Do it right away because it takes a few days to set it up. Hospice isn’t just for people dying. They can be temporary short term but the longer they’re in place, the easier things are. Plus Medicare covers everything & even supplies & I think also meds. Hospice has a nurse that visits along with aides after it’s all scheduled. The nurse can do the catheter & teach you if it comes out, how to clean it, etc. Good Shepherd is the one that comes to my house for my mom who qualifies at 87 yrs old with dementia. They are very professional, helpful & caring. Good luck!
Helpful Answer (9)
Reply to Kelkel
disgustedtoo Sep 19, 2020
My mother has been in MC over 3.5 years now. Went in ambulatory, eventually graduated to a rollator and then, more out of fear of falling and lack of use (she sits a lot, instead of using her legs!), she's now in a wheelchair. She's been half or more incontinent for a while, but given all her various issues, we haven't requested hospice (she just turned 97.) Recently she had a stroke, which has left her mostly unable to use the right side (arm/leg.) It now takes TWO people to transfer her, to toilet, bed, wheelchair, etc. Some of the slurring of words and drooling resolved, but being more or less wheelchair bound, we opted for hospice. DENIED! I even called to ask why. They consider her "stable", hasn't lost weight in SIX months (she JUST had the stroke!), is attempting to feed herself (left handed, she's probably wearing more than she's eating.)

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.
Emptying the catheter bag will be easy. Open tap, drain into bottle, flush. Washing around the catheter should be same as washing the area. (Maybe Mom could do this in the shower with a handheld shower head?)

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?
Helpful Answer (8)
Reply to Beatty

Try to keep an open mind. This may be a temporary, may simply be in place and have a tap, or need replacing but this is not worse than doing a personal wash and a bit of plumbing it isn't complicated so don't worry in advance.
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.
Helpful Answer (7)
Reply to TaylorUK

We do have some nurses on this sight maybe they can give some input. I too would not want to be doing this. Why do they feel she needs a catheter? They can contribute to UTIs.
Helpful Answer (6)
Reply to JoAnn29

If she is in hospital, perhaps dr can send her to rehab to get her stronger before she goes home. Or could order in home nursing to handle this task.

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.
Helpful Answer (6)
Reply to my2cents

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