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There are several complex issues.
1. She isn't able to learn to cath herself and it's been hard to identify help for her. Most HHC aren't willing to help with self cathing 2x daily.
2. Multiple UTIs. She is now on antibiotics regularly. She has slight confusion at times.
3. When she drinks too much water to help the UTI her Sodium gets to low.

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I guess it is different there. When my husband had his prostate removed due to cancer he came home with a Cather and we had to watch a video in order to care for him at home as he had it in for 19 days. I am not sure how we would have managed switching and cleaning bags if we were in Florida. I wonder how that is handled there? Every state must be different. I am very thankful I have been able to do what I have and keep Mom healthy.
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Checking Florida Health law, a CNA or HHA is prohibited from changing sterile dressings, irrigating body cavities such as giving an enema, irrigating a colostomy or wound, performing gastric irrigation or enteral feeding, catheterizing a patient, administering medications, applying heat by any method, or caring for a tracheotomy tube. If they do they can lose their license, sorry.
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You do not need to be a CNA or LPN to do catheter care. The doctors nurse or visiting nurses can teach anyone how to clean and change tubing and proper cleaning of the bags. Peri care is very important to prevent infections. The catheter can be changed by a visiting nurse or in the doctors office by qualified staff usually every month or sooner. Probiotics are good regardless of antibiotics. There is a vaginal product called Luvena that is also very helpful. Vitamin D suppositories vaginally also soothe tissues. Senicare spray helps with E. coli. Cranberry capsules 4 times a day, 1000mg vitamin c, and D Mannose.
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1. catheter care you need a CNA or LPN with written orders from MD
2. Prevent C-diff by giving pro-biotics when on anti-biotics
3. Make sure she replaces electrolytes with Pedialyte or Gatorade or similar.
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I would like to address this question. I have cared full time for my 92 year old Mom for 8 years. My story is too long so I will say that in 2 years she has only had 1 UTI because she has a Foley catheter (silicone). She suffered constantly with infections, hospital stays and the effects of antibiotics. I took her to 3 urologists and was also told to intermittent cath her and keep her on those antibiotics. I have read many times on this site how awful catheters are and that they cause infections. I have a very good routine for peri care and supplements to help prevent infections. She has both vaginal and rectal prolapse. Please know it is an option. She is relieved to not wear those huge wet briefs and not suffer infections. I would happy to share my care routine and supplements. She is diabetic, has had breast cancer, open heart surgery, etc. good luck.
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I would want to know what her medical condition is that led to the need for self catheterization? At the age of 90, would it enable her doctor to order Hospice Home Care for her? And perhaps, consider putting out a ad for a private duty nurse, or even a student nurse, who wants to make extra money but cannot work full shifts. When I was a student nurse, I worked for a couple, whereby I had to go and do colostomy care on this woman three times a week because it was a difficult thing for the husband to do. I had the experience and their insurance company paid $20/hour (this in 1967!!) and it was great extra money for a married student with a baby who couldn't easily work full shifts anywhere.
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Same situation here. My mother has a Suprapubic Catheter...it ought to be a great solution for her. It sounded so good. But when you have an appliance, you have an open wound and you have to be ultra-careful about keeping everything involved clean and germ-free. That's quite difficult for a 90 year old. It is a lot of work for her, and requires a monthly visit to the doctor to change it. There are only certain types of clothes she can wear with the bag, and it is heavy for her when it's time to empty the bag. We are blessed that she can still do the work involved, but it is very difficult for her. It seems your only good options are to keep searching for a nurse agency to come for or use Depends totally. It's a tough situation. Sorry there's not a better answer for us.
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Switch from water to those drinks that contain electrolytes, minerals, etc. I use Propel which comes in different flavors, so try each flavor and see which ones she prefers. Cranberry pills (only) will help flush out toxins, but I suggest you keep trying to find an agency where a nurse can come to the house and help with the catheter.
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