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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?

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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.
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I kind of know how you feel. I had to help my mom with the recovery after a mastectomy-tube, drainage, etc. Not like a catheter but still not something i ever planned on doing. Mom could not do this by herself-dad would not have been a good helper either. My dad had a foley catheter for a few months. Then the doctor did some testing that determined the urge and muscle function to say go pee was not going to work anymore. Then they said get the superpubic catheter-tubing goes thru the abdomen. would be less irritation etc. I would take dad to the dr. every 30 days to have the equipment changed. I never offered to do this job at home for him. I have since told my mother that i want nothing to do with the area below the belt for my dad-period. They have home care that can do the daily empty of the bag and keep him clean and dry. We have a cat who is diabetic needs a shot of insulin every day two times. I can not watch family member who does this i can not stand the sight of a needle-I will never be able to do this job for my cat. Maybe you could look into home nursing care/assistance for this job if you can't get the hang of it. empty the bag is not too bad but the rest of it-i would arrange for backup for sure keeping that area clean is a must-if it is clean and dry it won't smell as bad too.
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mally1 Sep 2020
Poor cat; it doesn't know why someone hurts him twice every day....
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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?
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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.
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worriedinCali Sep 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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Thankyou Alva!
In/out catheter gets an instant NO from me too. I'd do myself, but not my relatives.
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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.
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Beatty Sep 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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I wouldn't get ahead of yourself. It's not so much nurse as plumber.

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.
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Beatty Sep 2020
My Conveen tale: both quite green, the RN & I had attempted & failed so were (shyly) describing the problem to the Nurse in Charge. I said "we tried the Conveen, but it.. couldn't be seen". Not my most professional moment. She didn't blink. Said, no it doesn't work well with 'innies' you need a good handful.
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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.
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When you go home the will certainly set you up with HOME HEALTH; I wouldn't worry as they will teach you and make sure you're comfortable.

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.
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I'm assuming that what you mean is that she is being sent home with a Foley catheter "in place" and they want you to learn how to empty it. The bag fills up and needs to be emptied a few times a day. So, unless you want to pay for a home health aide to come into her home 3 times a day, you need to learn to empty it.

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.
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JoAnn29 Sep 2020
Not the same thing when its another person. Toileting for me was the worst part of caregiving. I would never, unless my husband, toilet a man. Can u believe my daughter is an RN. 😊
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JoAnn29 - If a person is being sent home with an indwelling catheter, it's either because they have urinary retention (cannot pee voluntarily) or they leak urine constantly. Either way, they would need the catheter.
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JoAnn29 Sep 2020
Thank you
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There is nothing to it. All you'll be doing is emptying the bag of pee once in the morning and once in the evening.
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.
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cetude Sep 2020
There is a lot more to it than that
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Its now 3 days later, so how did u do?
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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."
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gdaughter Sep 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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IM assuming they want you to EMPTY the bag of urine 3x per day. I dont think they can expect you to take out the catheter and insert a new one - ie usually every 3-4 weeks i think - you will need a nurse to come to house to do that part. If she needs a catheter - she needs it but find out for sure since UTIs are all too common with catheters esp if they are not replaced. My father had a catheter when he was recovering from hip surgery and he developed a SEVERE UTI - he was doubled over in pain - took the rehab 20 hrs to take it out and relieve him of his pain - sadly it turned into a MRSA infection that infected his blood stream and heart and he passed away. I dont mean to scare you - since many many people have catheters but you have to be on constant lookout for infections, etc......if there is any chance she can urinated on her own - then choose that option otherwise be vigilant with catheter.r
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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.
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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!
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disgustedtoo Sep 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.
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My husband had one for months. All I had to do was have him stand or sit by the toilet untie the leg band and open the cap on the tubing which empty’s into the toilet. Re cap the end re tie the leg band And that was it. Of course she needs to stay clean in that vicinity as usual. UTI could occur but my husband only got one. The bag is changed out about once a month by a nurse.
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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.
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NYCARETAKER, how did it go when you went in on Friday?
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She should qualify for a visiting nurse to come change it at home, depending on how ambulatory she is. The nurse came when my grandfather, who could use a walker, needed his cath changed. He had an aide several times a week for personal care. I had no problem monitoring color, volume and changing the bag.
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JUST SAY NO. NO. NO.
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.
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JoAnn29 Sep 2020
Yes, I agree with this. They try to push as much as they can on the Caregiver.
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Ask that home health nursing or aides be scheduled. A nurse can come weekly and change out the catheter when its time. Do not allow her to be discharged until this is set up. Tell hospital social worker you cannot accommodate her needs.
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Does she only need it for a short while? If so why can't she have a Home Health visiting nurse do this function?
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I so often read how the hospitals send a very needy elder home, expecting others to do their jobs for them. In this instance, if it was needing to care for oneself and oneself was capable, fine. When it is for another, THEY think it is a piece of cake, but THEY do this all the time. Many of us have NEVER done anything like that!

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.
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LittleOrchid Sep 2020
So right. I was kept in the hospital for a week after a kidney infection when all they did was take a blood draw in the morning and administer an antibiotic in the late afternoon. I finally demanded to go home, insisting that I would be happy to have my husband drive me to a lab for a morning blood draw and report to the doctor's office or a clinic in the afternoon for an IV. They were switching around the antibiotics, trying to find one that was effective so I was technically under observation. However, the lights and the noise of the hospital floor kept me from sleeping and the lack of opportunity for personal hygiene was a real stressor. My blood pressure was dangerously high by the end of the week. I was also pretty disgusted at the lack of sanitation, particularly in the bathroom. Neither my room nor the bathroom was cleaned while I was there. Within 3 days of returning home my blood pressure was normal and I was feeling much better. I think that hospitals are pretty awful and can only be tolerated by those who are too sick to notice or care.
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We all have limits on what we are prepared to do.

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.
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LittleOrchid Sep 2020
I agree so much with you. My husband and I have each been discharged with catheters after kidney ailments. Each of us has dealt with our own after care. We both agree that, while we can do our own, it would not be a great option to care for another in this regard. Mainly, I think, it is because if a person can't do this simple care for themselves then there is a whole lot more going on that a need to keep the urine flowing. We all have our limits. It is the best for both the proposed care-giver and the patient if we recognize those limits and don't take on more than we can handle.
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I hope things went ok for you. I am constantly amazed at the things that the medical profession expect of family members without any conversation or information up front. Any time aftercare is required the family member expected to provide the care SHOULD (but rarely is) get a description of the care ahead of time and be allowed to have a chance to think it through before being asked to commit to accepting the medical care of another. I have NEVER heard of this being done. The family members do not have to do anything that they feel they cannot do. There are a lot of things I have undertaken in order to get my sons, husband or myself home, but it needs to be a choice, not an order given by the doctor or nurses.
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Mysteryshopper Sep 2020
So true.  I once had a morbidly obese stroke patient discharged to my care with little more than "She's fine.  We'll get some you in-home therapy - no problem" from the medical staff.    Once I got her home was when the adventure began.  She was confused, rapidly lost her mobility and her desire to try, urinary accidents (incontinence??) and stool urgency such that she often could not get to the bathroom.   This was among a multitude of other problems  - some new and some old.  At the time, I didn't know what questions to ask so I believed their baloney that I not only COULD take her home safely, but that I HAD to.    I had a bullseye on me and didn't even know it!    I do have to say that there is nothing quite like being at home as a caregiver with someone who has needs greater than you can provide.  The despair and fear that I felt are difficult to describe and I don't wish that on anyone.  The helpers eventually came, but it was too little help, too late,  and it ended too soon.  Kind of seemed like it was all for show and there wasn't much actual help being provided- - it was on me.    Never again.  Staff needs to be transparent with families as to what care is needed and what it really takes to provide that.
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My wife's Foley is stays put. it is changed at least every 30 days and 2 weeks if there are any problems.

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.
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My husband has a catheter and all I do is drain the bag in the morning and before he goes to bed. Since he is on Hospice, the nurse changes it once a month. If your mom has Medicare, she could have Home Health Aides come in to bathe her atleast 3 times a week, but she will need Dr's. Orders requesting Home Health or you can pay privately and contact an Agency on you own. Don't be afraid, there is nothing to it.
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You get used to what you have to do.. its that simple and easy. The more you do it, the easier it will be. I have friends who adopted a daughter with spina bifida from another county,,and she needs to be "straight cathed" every day, several times, so her urine does not build up. Could I do this,, maybe if I had to,, but she and her hubs and teenage daughter have learned to do, and do it without a qualm. They were taught how to do it at the orphanage in that county,, and even got it done in the plane on the way home, Then they taught their daughter. To empty the foley you will not have to be all up in stuff so much, at least that is good!
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!
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Conflicted55 Oct 2020
Perhaps you were able to learn and be comfortable with catheterization, but many people will NEVER become comfortable doing this. I am an RN, and a Nurse Practitioner. I do not think a layperson should be forced to do this. Nor should they be made to feel guilty if they cannot do this. There are many reasons someone may be uncomfortable performing intimate tasks on others. I recommend trying to get home care. If not possible, return your mom to facility that will meet her needs.
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