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Hi, my Mom is in a nursing facility in the AL unit for rehab and cannot walk so she gets moved around with a lift. When she has to go they put her in bed when they get around to it and then at night she is without a pullup because she gets sore from the plastic so they just have a large washable bed pad under her and she pees all over herself which she hates because it is not normal. Sometimes lays in the bed all night wet because the third shift is basically there to keep track of who knows what. I have been told that a cath causes infections but the sores she gets from laying in urine all night take forever to heal. What is your take on this??? Thanks

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Seems I try hard to protect Mom but I realize I cannot do it all. I had her sign a paper for Medicaid last Friday and she cannot even write anymore. She gets nothing out of TV and is getting to where she does not make much sense either. Just back in May when she broke her leg at least she could still write as she was writing down all her activities everyday. Guess the Alzheimer's is moving quickly huh!
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You might want to discuss this with the Director of Nursing, not as a complaint, but approach it as an issue and ask how it can be addressed/solved.

6:29 p.m. EST, 28 August
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Your profile says that your mom is 80 and has dementia. After my mother broke her hip and couldn't be transferred, even with a lift, without great pain, the nursing home used a catheter for her. This was not perceived as "normal" by mom. We explained and explained but she kept having the sensation of needing to pee and we could not convince her that the tube would take the pee away and she didn't have to do anything. This went on for weeks. I think she finally for used to it.

When she'd feel the tube against her leg she didn't understand what it was. She pulled it out three times before we came up with the solution to put pajama bottoms on her instead of just a nightgown.

When her hip healed well enough that she could be transferred they removed the catheter. It had been in longer than they prefer, but she did avoid infection, thankfully.

So a catheter is not necessarily a solution without its own problems.

In your place I would be advocating for the pad to be changed promptly on the third shift as well as the other shifts.

How do you know it isn't changed all night, by the way? I spent several overnights in my mother's room to get an idea of what was going on. Have you done that? Is that how you know?
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Glodeo, my Mom was bed bound, on Hospice for 51/2 months, with a catheter, being changed every 10 or so days, and she never got an infection, but that is not to say that it didn't take getting used to, or that it was without problems. Are they using a good barrier cream on her nether parts, bottom, and legs? I don't understand why she can't be in an adult diaper at night at least? I'm sure there are rulings on why they do this, but suggesting another solution due to soreness and sores, should definitely be pursued! Jeannegibbs suggestion of popping in during the late/middle of the night makes good sense! Heck, brings donuts and coffee for the Nursing staff, and get to know them! Ask them how they do with others who have problems, make yourself known, you've got to be her advocate for good care! I know that you are, but something definitely needs doing to make her feel comfortable, and not laying around in her own pee! Thats no good!
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Glodeo, don't wait to discuss Hospice with your Mom's Dr, if you feel like things are moving in that direction. Hospice would provide an amazing amount of support, plus all of the comfort needs for your Mom, especially pads, adult diapers, see to her skin needs, and catheter care, should it come to this. Also an air bed, which blows a steady stream of air up through the mattress, which is not cold, but does keep them dry. Medications, bandages, creams, Ensure, EVERYTHING, so if you and her health care team feel that she would qualify, and its something that you have researched and want, but when that time does come, request the Hospice care, in my opinion. I'm not sure if your Mom will eventually be coming out of the Nursing home, but Hospice can be done at home too! Take care!
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My dad had a catheter for almost two months. That was three years ago, and so I'm not sure of the details anymore, but I think that he got at least one UTI while he had the catheter. I do remember one of the medical personnel telling us that UTIs are a likely result of catheters. The other drawback of the catheter is that it restricts movement in bed. Dad didn't complain, but I know that he would have slept better if he had been able to move around freely.
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It all comes down once again to understaffing and a few slackers. I do see why they use the pee pads and not pull ups but it is essential that patients who can not communicate their needs be checked regularly at least two hourly so their position can also be changed. Your Mom has dementia and is not capable of understanding what is going on so a catheter may not be the answer here just better nursing care. It is also possible that Mom's condition may improve if she recovers and you are able to care for her at home. It is well known that things like a hospital stay and/or surgery will make symptoms much worse but once back in familiar surroundings can improve.
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Glodeo, it could be that the pad is not changed at night -- how would I know? But it also could be that like many of us she does not pee during the night but then has a high-volume of urine early in the morning. The fact that the bed is soaked early in the morning may or may not be evidence that the pad isn't changed.

I agree with Stacey about considering hospice care.
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staceyb

The NH her mom is at is probably understaffed and overworked, hence no checking on her mom as often. Glodeo also may not be able to stay overnight, and honestly, she should not have to do so. As much as many NHs charge, Glodeo's mom should be getting great care.
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Seems she is getting sores whether she is wearing a diaper or just left without, so you might want to go back to something wearable if it would make her feel more comfortable. There are products with tabs that open at the sides rather than pull ups, and there are different brands that might fit her better. My mom is finally recovering from chafing caused by one product we have tried, they were supposed to keep her dryer but they are very wide and bulky in the crotch and the elastic rubber her raw :(
And I hope they are using some type of barrier cream?
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