Issues with mom's catheter, is home care an option?

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GreyGhost Asked May 2023

Issues with mom's catheter, is home care an option?

My 78yo mom has had a suprapubic catheter for the past 25 years. She lives independently. Recently her catheter has been failing to flow urine into the bag between scheduled replacements, causing emergency room visits where it can take hours for her to be seen while she grips the back of a chair, moaning in severe pain, unable to sit. I always meet her there and push for her to be seen right away, but results vary. The first few times this happened was right after she switched providers when her doc retired - it seems her new nurse may not have been replacing the catheter correctly. When she switched providers again, the problem went away for a while but it recently happened again. The nurse said it could be sediment in her urine or possibly an infection clogging the device (though mom says she takes Bactrim for this). Does anyone know what causes this usually? My mom is a bit of a secret eater and can binge, so I'm not sure what her diet is like. She does consume a lot of water, which I think is supposed to help. Also, are there RNs or techs I can hire to do these emergency replacements at home?

Care Decisions Family Caregiver Home Health Care Urinary Incontinence

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score 1 · Answer 1

GreyGhost: Your mother should be seen by her urologist routinely.

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score 2 · Answer 2

Tell her PCP you want a referral to Home Health Agency for in home care. Get a case manager assigned to her case to further assist you both with in home care options and or possibly facility care if when needed. Have PCP provide a " level of care needs assessment".

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score 3 · Answer 3

Mom's urologist should be able to recommend some regularly scheduled catheter checks. Home care R.N. should be able to flush a catheter and replace the catheter properly.

In the case of an emergency blockage she would still need to go to the ER unless......

The only way to make this easier is to hire an R.N. from an agency and schedule
her regular visits and ask about care during crisis events.

This is a difficult situation and I wish you luck with a better solution.

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score 2 · Answer 4

We took care of my FIL for a few years. He had supra public catheter. Unfortunately, yes sediment builds up. They can be flushed with saline in between visits. I believe your urologist can prescribe in home care for this. Even middle of the night emergency care where they come to you to flush or switch it out. It got to where we were trained and could flush it too. The supplies were delivered to our house and we had extra catheters(confirm size), sterile saline and flushing kits. Hope this helps. God Bless.

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Wonderful idea about family education and training.

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score 4 · Answer 5

Mom ALWAYS had to go to the Drs office to deal with any issues surrounding her supra pubic catheter. Nothing would be done 'in home'.

After many issues with it, although she loved not having to go to the bathroom, she had to have it removed and went into Depends with 2 extra pads stuck in there.

She sure smelled better with the Depends than with the catheter, which made me believe that she wasn't cleaning the cath bag properly.

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score 1 · Answer 6

Thank you. I knew the standard visiting nurse care model would not work here, but I wondered if there were other options...you don't know unless you ask, right? I plan to have the talk with her urologist asap.

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score 0 · Answer 7

Your problem here is you would need a visiting nurse but it is not feasible to have one come on an emergency basis. Most care companies provide scheduled nurses and a minimum number of hours. What would be the sense of an as needed nurse waiting around for a call plus cost of milage?
Did you seek answers to your questions to her urologist?

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Issues with mom's catheter, is home care an option?

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