Help Me With My Dad - Keeps Disconnecting His Catheter Bag

[Anonymous]

About a week ago my dad (79) was diagnosed with a medical issue that requires him to permanently wear a catheter. He is supposed to empty the bag twice a day. At the hospital they did a quick tutorial on how he should do this. However, when he got home, we realized that he was having difficulty reattaching the bag to the catheter so I called his medical provider and asked that we bring him in to re-train him. My dad had a stroke about 10 years ago and does not have full use of one of his hands so we explained that he needed additional help/support. They provided this extra assistance and he showed them that he could do it before he was released.

During this past week, we realized my dad (who used to be a heavy drinker/quiet drunk type but had stopped) has resumed drinking again - he has several hidden bottles of liquor in his bedroom. As a result, he is often drunk and has been detaching the bag from the catheter, completely wetting himself and when we try to help him, he refuses our assistance. He has a relative who lives with him, who is at his beck and call but my dad also won't let him assist in detaching/reattaching the bag; emptying the bag - anything. I hired a local nursing company to come by twice a day to remove the bag and reattach it and each time, the nurses call to complain he won't cooperate and that he risks infection and is going to kill himself if he does not manage the catheter issue appropriately. They have indicated that if he does not cooperate, he may have to be admitted to Adult Protective Services - I don't even know what is involved with that but my impression has always been that it is for abused and neglected elderly people. I have looked into having him admitted to a facility for alcohol abuse but Maryland is one of the rare states that doesn't seem to allow us (his children) to do this without his consent and he would have to participate in intake. I think this is our best option - as I am thinking they will help him dry out and he will be better able to manage this process. We (his kids) have talked to him multiple times, bribed, threatened, offered everything under the sun to get him to cooperate but he just won' cooperate.

When not intoxicated, my dad's mental faculties are fine - he has multiple advanced degrees, is a voracious reader and avid newswatcher. He is mobile - although he is slow - he takes walks and likes to walk to the grocery store multiple times per day. When we ask what why he keeps doing this, he just says, he doesn't like having to wear this bag everywhere he goes. He has always been a strong, independent, physically active person. The stroke obviously affected this but I think this last issue is just too much for him. I really don't know what to do but something has to happen quickly. I don't want him to die over something that I feel is fixable. Thank you.

[Anonymous]

Can you describe this catheter and bag situation a little bit more?

He is keeping the catheter in, but just detaching the tube from the bag it empties into?

He hasn’t bothered by the urine running down his leg? Does he want to be changed into clean clothes when it happens?

I’m not sure where the infection risk is coming from. The urine just runs out of his catheter and down his leg and onto the floor right? Why is that taking a chance of getting him infected?

Would diapers be a solution instead of the catheter?

[Anonymous]

I would suspect cognitive issues from the stroke. The alcohol is a symptom of it. I know you don't want to hear this, but there isn't anything you can "make" him do. He will continue to decline.

Some tricks like making sure the bag & tubing are as comfortable as possible. Bags come in different sizes, they can be put in cotton bags to not irritate skin. Set alarms to notify him when to change it and not do it any other times. Something to keep his hands busy, like a fidget toy, clothing that makes it a little difficult to mindlessly mess with catheter.

My father had a series of strokes that meant he had to wear a catheter. I don't remember the types but the subsomething one he pulled out do often it caused scar tissue & internal damage, had to go to the one in his penis. He regularly messed with that one too. He suffered from regular infections and actually died from complications of a UTI in Jan.

[Anonymous]

I provided nursing care to a man who was catheterized full time - it is a painful condition to endure primarily because of the psychological effects. Clearly your dad is struggling with depression/grief over his deteriorating body and has sought solace in alcohol. Yes the physical effects of messing around with his catheter and not properly caring for himself are something that needs solving asap, but it’s not going to get solved until he gets help with his feelings about it. He’s essentially suicidal because he’s despondent over the condition. He needs emotional support that will be critical to addressing the functional issues.

[Anonymous]

The alcohol thing is so hard. I think people don’t talk about it enough. Unfortunately based on my experience as long as he can independently go to the store, you’re f$&ed. He’ll just buy more. I agree that briefs (don’t call them diapers!) may be a better solution at least for the times he won’t keep the catheter in.

[Anonymous]

He wants to die. Seriously, op, ask yourself if you’d like to live like that?

[Anonymous]

Those suggesting Depends and that don't understand the risk of infection, don't offer advice. His stroke probably caused the bladder to become paralyzed, meaning it cannot be emptied of urine without manual aid from something like a catheter.

OP, do the doctors think bladder control might recover? I'd be doubtful but it would be nice if atleast enough to empty. Then something like Depends could be an option.

My father found elastic "sweat" pants to be the most comfortable.

[Anonymous]

This is a really difficult situation. Your dad is embarrassed and his pride is hurting, to the extent that he does not even want the nurses to assist him. Would he prefer a male nurse, by any chance?

I have the same question as PP because I do not have a medical background. Where does the risk of infection come from if the urine runs down his leg and is he able to clean himself up? Would undergarments (word I use instead of “diapers”) help? Are there any other options besides the catheter?

If I were you I would address this crisis with his physician because I imagine they actually encounter this fairly often. Perhaps they can trouble-shoot this with you (would your dad be open to you going to the appointment with him for a “family meeting” type thing?

I imagine you’ve had a heart-to-heart about your concerns and the risks involved. “Dad, I have to admit that I’m beside myself with worry because I love you so much and don’t want anything bad to happen to you. I totally understand that this situation stinks and you’re very unhappy wearing a catheter. Would you be willing to allow me to attend an appointment with the urologist with you so we can explore your options and figure out how to minimize any risk to your health?”

[Anonymous]

He had a stroke. He probably suffered mild brain damage. His judgement is comprised, hence the messing with catheter and drinking. He may continue to have smaller strokes that are not noticed expect for further decline. His cognitive abilities are compromised. The drinking is a symptom of this.

He also needs to be tested for a UTI. Symptoms of a UTI can look like dementia and/or cause violent behavior. If the UTI isn't discovered, patients can end up being committed to psych wards being misdiagnosed as having severe mental health issues.

The risk of infection can come from the bag not properly being attached to the tube. Urine will build up in the tube which then blocks or forces the urine back into his body. UTIs are common silent killers of the elderly.

[Anonymous]

Anonymous wrote:He had a stroke. He probably suffered mild brain damage. His judgement is comprised, hence the messing with catheter and drinking. He may continue to have smaller strokes that are not noticed expect for further decline. His cognitive abilities are compromised. The drinking is a symptom of this.

He also needs to be tested for a UTI. Symptoms of a UTI can look like dementia and/or cause violent behavior. If the UTI isn't discovered, patients can end up being committed to psych wards being misdiagnosed as having severe mental health issues.

The risk of infection can come from the bag not properly being attached to the tube. Urine will build up in the tube which then blocks or forces the urine back into his body. UTIs are common silent killers of the elderly.

PP here. Thanks for clarifying the cause of infection! OP should definitely keep an eye out for sign ms of UTI like change in cognition; hopefully his current behavior (refusing to let nurse change catheter bag) is not a result of infection.

[Anonymous]

Anonymous wrote:

Anonymous wrote:He had a stroke. He probably suffered mild brain damage. His judgement is comprised, hence the messing with catheter and drinking. He may continue to have smaller strokes that are not noticed expect for further decline. His cognitive abilities are compromised. The drinking is a symptom of this.

He also needs to be tested for a UTI. Symptoms of a UTI can look like dementia and/or cause violent behavior. If the UTI isn't discovered, patients can end up being committed to psych wards being misdiagnosed as having severe mental health issues.

The risk of infection can come from the bag not properly being attached to the tube. Urine will build up in the tube which then blocks or forces the urine back into his body. UTIs are common silent killers of the elderly.

PP here. Thanks for clarifying the cause of infection! OP should definitely keep an eye out for sign ms of UTI like change in cognition; hopefully his current behavior (refusing to let nurse change catheter bag) is not a result of infection.

Meant *empty bag

[Anonymous]

Buckle up. Sounds like there is some delirium or dementia going on, possibly or likely I related to a UTI (and the drinking isn’t going to help - you need to find a way to get the alcohol out of the picture and involve a dr). My father also repeatedly pulled out his cath tube and no amount of taping, hiding, distraction, or trickery helped so we ultimately had to go to intermittent catheterization where someone had to insert the tube 4 times a day to remove the urine so there was not a tube and bag constantly present. I’m sorry you are going through this and I hope you find the help you need. Ditto UTIs being a silent killer in the elderly…I had no idea until I lived it.

[Anonymous]

Anonymous wrote:This is a really difficult situation. Your dad is embarrassed and his pride is hurting, to the extent that he does not even want the nurses to assist him. Would he prefer a male nurse, by any chance?

I have the same question as PP because I do not have a medical background. Where does the risk of infection come from if the urine runs down his leg and is he able to clean himself up? Would undergarments (word I use instead of “diapers”) help? Are there any other options besides the catheter?

If I were you I would address this crisis with his physician because I imagine they actually encounter this fairly often. Perhaps they can trouble-shoot this with you (would your dad be open to you going to the appointment with him for a “family meeting” type thing?

I imagine you’ve had a heart-to-heart about your concerns and the risks involved. “Dad, I have to admit that I’m beside myself with worry because I love you so much and don’t want anything bad to happen to you. I totally understand that this situation stinks and you’re very unhappy wearing a catheter. Would you be willing to allow me to attend an appointment with the urologist with you so we can explore your options and figure out how to minimize any risk to your health?”

When people say “address this with a physician” I have to just laugh. Doctors are so unhelpful with this kind of thing.

[Anonymous]

Anonymous wrote:He wants to die. Seriously, op, ask yourself if you’d like to live like that?

This is OP. Yes, I know this is the answer. But I really can't bear it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:This is a really difficult situation. Your dad is embarrassed and his pride is hurting, to the extent that he does not even want the nurses to assist him. Would he prefer a male nurse, by any chance?

I have the same question as PP because I do not have a medical background. Where does the risk of infection come from if the urine runs down his leg and is he able to clean himself up? Would undergarments (word I use instead of “diapers”) help? Are there any other options besides the catheter?

If I were you I would address this crisis with his physician because I imagine they actually encounter this fairly often. Perhaps they can trouble-shoot this with you (would your dad be open to you going to the appointment with him for a “family meeting” type thing?

I imagine you’ve had a heart-to-heart about your concerns and the risks involved. “Dad, I have to admit that I’m beside myself with worry because I love you so much and don’t want anything bad to happen to you. I totally understand that this situation stinks and you’re very unhappy wearing a catheter. Would you be willing to allow me to attend an appointment with the urologist with you so we can explore your options and figure out how to minimize any risk to your health?”

When people say “address this with a physician” I have to just laugh. Doctors are so unhelpful with this kind of thing.

This is OP. Yes, we have tried. They've essentially told us - well, he's talking and coherent and is mobile without any infections. If you want him to get alcohol treatment, he has to participate in the interview/intake process and agree to treatment, which of course he won't.