Do the elderly with catheters need 24-hour care?

Patient

Q: My father is 91 and last week started to suffer from acute urine retention due to an enlarged prostate. My sister took him to the hospital and he was catheterised and sent home, the nurse telling him that "it's easy to manager your own catheter, people do it all the time". Dad has lost his fine motor skills and can't manager the catheter at all. He developed a urinary tract infection with a day and was taken back to the hospital, who gave him antiobiotics and sent him home, insisting that the should be able to manage the catheter himself. His GP says he needs 24-hour care while he is catheterised. Which is correct? Should a 91-year old really be able to manage his own catheter or does he need 24-hour care?

Symptoms:  Acute urine retention, enlarged prostate, urinary tract infection
Doctor

A:   Hi.
Thanks for your query.

I have read and understood the problems of catheterisation in a 91-year-old male (Your Father).
Actually the catheters are indwelling, meaning they have a balloon which is filled and keeps the catheter in place. With the silicon coated catheters, the duration for which the catheter can be kept in is long, up to 3 weeks.
The only care which need to be take are:
-Catheter should not be pulled.
-External part of the penis and catheter be washed with liquid povidone iodine twice daily to avoid
infection locally and ascend to the urinary bladder.
-Ask your father to take plenty of oral fluid so that the catheter is flushed and the concretions do not block the catheter.
-Watch for any sign of infection, urine getting dark or muddy, blockage of the catheter in the form of bloating and pain in the lower abdomen, absence of urine in the collecting bag.

-Please discuss about the possibility of surgery for prostate. If done, this will solve the problem permanently. Of course, this will the decision that the Urologist will take after considering all aspects of the problems.

And most important: your question about the possibility of managing a catheter by a 91-year-old man or need a 24 hour care. The above discussion covers it all.

I hope this answer helps you.

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