How to wean an elderly mom (82) after being catheterized for two years? How to bladder train her?

Downunder: You're welcome!

Thank you everybody! All the responses have been very useful.

Is there such a thing? Why don't you work with Depends first and then try toileting?

My father began having serious prostate issues effecting his ability to urinate in late February. It reached a crisis point in early march and he became quite sick. After an ER visit when a catheter was put in and a five week rehab stay dad went home with the catheter to spend the following two months getting strong enough for surgery. His surgeon had done tests and expected my fathers bladder to be able to return to normal function. Guess what? Never happened and daddy spent the last year of his life mostly incontinent. This was after little over three months dependent on a catheter.

Retraining has alot to do with how much range of motion your Mom has retained if she has had PT , getting her up with a shortened leg could be a catastrophy if she has not had good care, also as stated previously putying s flip flow on the cath for progressively longer periods will tell the tale on wether this is possable, start well she is still in bed with timed voiding just know this will be very time consuming because someone has to be responsible for monitoring the time and ensuring that she does void, it will be along time before her bladder ramps up in size and poower to be continent again, after 2 years with a foley she probably has a bladder that will hold 20 to 50cc's at best. Take that into consideration with what does your Mom want ? How much mobility will she have ? How much care and monitoring will she have in attempting to repotty train , have you consulted a PT who specializes in bladder retraining and then made an educated decision taking her mobility and age into consideration , without all of this factored in you could be setting your Mom up for failure and alot more stress both physicaly and mentaly and even if all of these things are considerd it is still possible that your Mom is not up to it , it will be a slow tough road and will certainly involve alot of vigilance on the part of yourself or other carer, bladder retraining does not stop at our bedtime or when we are exghested , so go into this eyes open with as many facts as possable, your Mom will still require some form of protection for the next two years well trying to retrain, so pullups or diapers will be a fact of life and need changing and certainly tape on diapers will be prefrered for ease of use and not requiring disrobing to change they can teach you and Mom how to apply in bed on toilet or standing useing the wall depending upon her mobility after the cath comes out.

The reference to depends in the first sentence should not be there - computer again.

Are there problems with the catheter such as depends frequent UTI's or bladder spasms?
If you are not getting her out of bed for BMs then I would tend to leave well enough alone. If she does not have fecal incontinence wearing Depends will be uncomfortable and may be make her sore. One way of retraining a bladder is to clamp the catheter off for increasing lengths of time to help expand the bladder.

Just want to say that Walgreen brand of pull ups, serenity, is just as good as Depends and is cheaper. I buy when they are buy one get second 50% off.

A doctor can do a test called Urodynamics to assess if your mothers bladder can go back to functioning in a more typical manner. At your mothers age and due to the two year lack of use, it is very possible your mothers bladder has loss much of its elasticity. If your mom can use her bladder, kegel exercises are her best bet. As mentioned above, starting and stopping the flow of urine is the most effective way of preforming kegels.

Depend has a new women's pull-up called "Night Defense" and it works. We tried it the first time yesterday and it kept Mom lead-free during one of her all-day naps.

FYI - I have yet to have one of the male incontinence briefs leak. They are great for my husband.

Just curious...who is pushing removing the catheter? You or the doctors? Also, will she going outside, shopping etc where she will need to use a restroom? As mentioned above, think of as many situations as you can to understand all the issues that may occur. And any way you look at it it might be a slow process.

Even with the risks of UTI with catheters I think your Mom is better off having one.
After 2 years it will be almost impossible to re train her bladder and her mind.
Most muscles after 2 years will have atrophied to the point that they will be unusable.
Also with the one leg shorter she will have balance problems IF you can get her to stand. If she has been bed or chair bound and not walking for 2 years I go again back to the atrophied muscles.
My husband has not walked in 1 year and there is no way those spindly legs would now support his weight even with help.
You also have to consider the cleaning issue that you will have with getting her on the commode.
The peri area will have to be cleaned and dried well. She will have to wear a pull up or tab brief to absorb any "dribbles" as well as absorb any accidents and there will be many.
An area left unclean or damp can lead to irritation and infection.
You will have an increase in laundry due to the fact that ...wild guess here...99% of all incontinence products leak or get soaked through.

I suppose the question also is is she aware when she has a Bowel movement that she needs to be on the commode or is she wearing a pull up or tab brief all the time anyway? I guess if you are getting her up for a BM then my argument about getting her up being potentially dangerous has little merit.

I guess the bigger issue is how does she feel about it, would she want to be transferred every 2 hours or so to the commode? Is she willing and able to cooperate in trying this. And the big question...how does her doctor feel about it and is it a realistic expectation that she can successfully transition from a catheter? 2 years is a very long time.

With one leg shorter than the other, she will be off-balance. Additional risk of falling. Instead of trying to get her onto an uncomfortable "potty" chair, have her wear disposable leak proof undergarments (Depends make a pink Silhouette, I think), allowing her bladder time to readjust if it can. Unless she has had physical therapy for her other leg in two years she is going to need lots of PT. Medicare pays for that with doctor's order. I hope you got her a great attorney!

After two years, her bladder has probably shrunk a lot. She has to have her wits about her and practice stopping the urine flow repeatedly. If there is any cognitive decline, it's not going to be remembered. Risks? If she falls again, additional injury. If she is a big woman, there is a big risk of falling, since her legs are most likely atrophied.