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My 95 year old mum and terrible catheter problems - can you help

(13 Posts)
carosanto Mon 15-Dec-14 14:43:37

Some time ago I posted on aibu on my mum almost being coerced into taking statins. Luckily GN rode to the rescue and commonsense prevailed with her medics taking your comments on board (via me). Thankyou.

Mum went into hospital 4 years ago with a severe uti; she was discharged infection free, having weed normally for a week. She got as far as the hospital front door to get her transport home and was literally dragged back by a nurse who told her she couldn't go without having a catheter fitted. No explanation, no consultation, no choice. Mum, being in her 90s is generationally programmed to be compliant, so did not question. She was despatched home (to me) with a catheter, scant instructions, and the promise of a catheter nurse, who turned up 2 days later. We muddled along meantime.

Of course inevitably she now gets regular catheter infections involving ravaging bouts of painful thrush, and lots of Canesten and antibiotics. This cannot be good for her.

About 2 years ago the make of catheter was changed and she has, added to her woes, the fact that the catheter falls apart, leaks, and seems to cause excruciating pain on passing stools. Her 3 monthly internal catheter change fills her with dread, it's so terribly painful, and her community nurses are ineffectual helping her get over these problems.

Of late she had to get up in the middle of the night with a soaking bed, and another day found herself sitting in a pool of wee because, in both cases the external bag had become uncoupled. Things came to a head yesterday when she had to call in emergency nurse help because her catheter bag male/female spigot just would not stay put. The nurses themselves could not achieve a successful closure and in the end decided on a complete catheter change internal and external. Mum, already imprisoned by this thing, has now said she will not leave the house even for Christmas, she is so afraid of accidents.

A new GP earlier in the year questioned this long term catheter use whilst examining Mum for yet another dose of extremely severe thrush. The GP was not happy, and next day, unannounced, 2 nurses turned up on the doorstep to remove Mum's catheter entirely. No phone call, no nothing. But to mums joy that day she weed normally, until, that is, her bladder, no doubt irritated by the terrible thrush and unexpected uric acid, closed up, she retained urine and that evening the nurse came back and REINSERTED the catheter through swollen and inflamed tissues and my mums distress was awful to hear on the phone that day. Why not wait till the infection was over to try removal, it might have been successful. Now they say they won't try again cos mum will retain urine.

I wept with frustration, and still do. I live 300 miles away. I recently spent a month with Mum and can vouch for her problems.

I am going to war on this thing. At Christmas I will leave a letter for the community nurse detailing all the above (mum says they just shrug and say other people are worse off). If nothing happens I will go to the GP, thence to PALS. BUT COULD I DO MORE????

This has reduced my compos mentis, lucid, intelligent (but far too compliant) mum to a quivering wreck who keeps blaming herself for the inadequacies of this substandard piece of kit which keeps letting her down.

Sorry for the rant, I just don't know who to turn to. GN you helped so much last time, could you help again?

Carosanto

janeainsworth Mon 15-Dec-14 15:00:09

Carosanto I'm so sorry you and your beloved mum are going through this.

The only thing I can think of to suggest is to ask the GP who questioned the catheter use for a referral to a consultant. From what you say, it sounds as though there might not have been been proper follow-up by the GP who questioned the catheter use.

I would try to go down the road of asking for help from the GP, rather than complaining via PALS, initially anyway.

I do hope things improve.

jinglbellsfrocks Mon 15-Dec-14 15:13:29

Could you see your way clear to going to stay with her again for a while, and perhaps insist that the catheter be removed, and she be given a proper chance to live without it. (Once all infection has cleared up and the tissue has repaired itself of course) It would be good if you could be on hand to watch how things go. And express your concerns directly to the healthcare people.

kittylester Mon 15-Dec-14 15:13:50

Good advice from Jane. Recurrent UTIs are a hazard at your Mum's age and need to be managed well. Good luck! Let us know what happens. flowers

Charleygirl Mon 15-Dec-14 15:20:00

I agree with jingle and Jane. The catheter it would appear should come out, she needs to be treated for whatever infections she has. She needs to drink copious amounts of fluid (the amount taken should be noted) and be a near a loo, if necessary going 2 hourly to get the bladder trained again. As Jane said, the GP also has to be involved. What a way to treat an elderly lady,

Anya Mon 15-Dec-14 15:45:29

I despair. What happened to 'primum non nocere'?

Riverwalk Mon 15-Dec-14 16:05:56

There is no excuse for the mechanics of the spigots/drainage bags etc not to be sorted shock

If it's leaking the wrong size spigot/connection has been used.

If your mother went into urinary retention there was no alternative, unfortunately, but to re-catheterize her.

Mishap Mon 15-Dec-14 16:54:42

She needs to see a urologist and get this sorted. He/she can take a proper look at why she has it in the first place and what will suit her best if she continues to need it. This is what would happen if she were younger and her age should not make a difference.

It must be so hard for you being so far away; but it would be good if you, or another member of the family, could go with her to the GP to discuss a referral, if she is willing.

I spent a long time organising my father's care from a distance and it was a very frustrating experience, so you have all my sympathy. It is awful to know that something is going amiss with the care but you are too far away to have much control over what is going on. Your poor Mum.

Is there a relative a bit nearer? If not, then next time you are there it might be worth getting your mother's permission for you to ask that the nurses and GP contact you before any major decisions are made. We did this with Dad and I felt a bit more in control - I would ring Dad to see if he was happy with the decision and then I would convey that back to the professionals.

Katek Mon 15-Dec-14 18:16:52

She needs a proper assessment by a urologist and specialist catheter nurses if that is the correct course of action. I cannot understand why she was arbitrarily catheterised on leaving hospital if she had been passing urine normally? I agree with others, her infection needs treated, her tissues need to heal and she should be given a chance to see if she can retrain her bladder. Even if she's not 100% successful does she need an indwelling catheter or can she be treated symptomatically? My dd had to use catheters for 6 months following spinal surgery and I do know that there are several very small easily used catheters on the market. There are so many incontinence products as well to keep her dry and comfortable and embarrassment free. I wish her well.

Galen Mon 15-Dec-14 18:24:52

She needs referral for urodynamic studies.

Gracesgran Mon 15-Dec-14 18:33:37

carosanto I have no wise words to help. So many on here have experience and are able to do that. But someone must help. Your Mum is a human being and so are you and this is an awful way to treat both of you.

Anya I couldn't agree more.

carosanto Wed 17-Dec-14 15:00:26

Thank you all once again. I have already instigated or researched some of your suggestions. GN is so much more than a networking site!

Carosanto

Grannyknot Wed 17-Dec-14 16:03:21

So much more indeed.