Catheters and Diapers

[Awesomo]

Hello,

I've started a new job, I support a gentleman who uses a catheter, however he wears Pads and the catheter goes into the pad.

The gentleman gets a lot of uti's, am I right to believe that he's getting utis because of the catheter going into the pad.

I'm under the impression that a catheter should lead to a bag. Although, he refuses treatment of care around of care. What tips can I give to prevent UTI's?

(Before anyone asks, it's a genuine question but I am ABDl myself but asking for work as I've not dealt with catheters, incase someone wants to call out my previous threads)

Thank you

 

[COincon]

The foley should always be a closed system going into a urine collection bag. He is diffantly getting uti's because of the open cath leading to a diaper. I am a critical care paramedic.

 

[Diaperman95]

Wow I can tell you this much, not a doctor in the world would be Okay with that. A foley should always be connected to a sterile bag and hose. It should never be left to drain free because it is a direct path for bacteria to inter the bladder. Some times they will prescribe a catheter plug to close it off so the bladder does not shrink and you would go without a bag but never let it drain into a diaper. Most people doing this want to replicate incontinence for what ever reason. I have to use one every now and again and my doctor always puts me on a low dose antibiotic when a foley is in place even when hooked to a bag. Also the catheter should be wiped down with a anti bacteria wipe 2 to 3 times a day when in place.

You most likely wont change his mind until he learns the hard way. As someone who suffers from UTI's I can assure you they can become deadly. I can't count on my fingers and toes the number of times my UTI made it to the kidneys and then the blood stream landing me in the hospital several days to a few weeks. Once it even turned into pericarditis a infection around the heart. It almost killed me and put me in the ICU. My bladder does not empty all the way and have to I self cath daily with a straight catheter to keep the infection pushed out.

I cant understand that mind set at all myself. I would gladly give anyone my incontinence and bladder issues that want them if I could. This is just silly to me and VERY DANGEROUSE BEHAVOR.

 

[Awesomo]

Wow I can tell you this much, not a doctor in the world would be Okay with that. A foley should always be connected to a sterile bag and hose. It should never be left to drain free because it is a direct path for bacteria to inter the bladder. Some times they will prescribe a catheter plug to close it off so the bladder does not shrink and you would go without a bag but never let it drain into a diaper. Most people doing this want to replicate incontinence for what ever reason. I have to use one every now and again and my doctor always puts me on a low dose antibiotic when a foley is in place even when hooked to a bag. Also the catheter should be wiped down with a anti bacteria wipe 2 to 3 times a day when in place.

You most likely wont change his mind until he learns the hard way. As someone who suffers from UTI's I can assure you they can become deadly. I can't count on my fingers and toes the number of times my UTI made it to the kidneys and then the blood stream landing me in the hospital several days to a few weeks. Once it even turned into pericarditis a infection around the heart. It almost killed me and put me in the ICU. My bladder does not empty all the way and have to I self cath daily with a straight catheter to keep the infection pushed out.

I cant understand that mind set at all myself. I would gladly give anyone my incontinence and bladder issues that want them if I could. This is just silly to me and VERY DANGEROUSE BEHAVOR.

Thanks for your post.

The person in question has acquired brain injury. I've recently joined the Service as the new manager. Apparently this has been going on for years . I will investigate further, I just don't know much about catheters but I presumed this was the case from reading on this sub historically. It's a tricky one as he has capacity and the care staff don't actually provide personal care to him.

 

[Diaperman95]

Thanks for your post.

The person in question has acquired brain injury. I've recently joined the Service as the new manager. Apparently this has been going on for years . I will investigate further, I just don't know much about catheters but I presumed this was the case from reading on this sub historically. It's a tricky one as he has capacity and the care staff don't actually provide personal care to him.

Oh wow that makes it harder. If he had nurses or providers that take care of him or he does not have mental capacity you could most likely have DHS or someone do a wellness check on him and possible help him. But if he has his own a decision making and tends to him self it is harder to say. Because anyone can order the supplies on line. Use to you had to have a script to buy them but now everyone sells them online without. The only time they require a script is if they are going to be paid for by a insurance plan. You might talk to a case worker at DHS if you are worried he does not have the ability to make proper choices. But lots of people are into that kind of behavior. But I have Never heard of anyone getting a script from a doctor to use one in that manor. Hope this helps I wish I knew more or had better ideas. Best of luck I hope maybe you can talk him into changing his ways.

 

[winterheart01]

I've used catheters myself (Foley's) for 4 months in z sterile closed loop, silicone ones and still had infections.
First thing you should try to figure out from his medical records if possible is , does he really need Foley's? Is he incontinent or does he have urinary retention? If the former, proper hygiëne and diapers is enough.
If the latter then he should get his catheters inserted by nurse and connected to a closed loop. In addition regular checkup to see if he doesn't detach the bag and put the catheter outlet in z pad again.
Regardless of how clean it's inserted and maintained, bacteria build up will happen.

Chances are like with me, he developed chronic UTI which keeps coming back.
No matter what antibiotics, they can't be cured permanent.
However I had the infected tissue cut away completely.

You need more info to continu from here though i don't know if you get it because of the medical secrecy doctors have to keep.

 

[Diaperman95]

I've used catheters myself (Foley's) for 4 months in z sterile closed loop, silicone ones and still had infections.
First thing you should try to figure out from his medical records if possible is , does he really need Foley's? Is he incontinent or does he have urinary retention? If the former, proper hygiëne and diapers is enough.
If the latter then he should get his catheters inserted by nurse and connected to a closed loop. In addition regular checkup to see if he doesn't detach the bag and put the catheter outlet in z pad again.
Regardless of how clean it's inserted and maintained, bacteria build up will happen.

Chances are like with me, he developed chronic UTI which keeps coming back.
No matter what antibiotics, they can't be cured permanent.
However I had the infected tissue cut away completely.

You need more info to continu from here though i don't know if you get it because of the medical secrecy doctors have to keep.

If it is retention most doctors prefer a person to straight catheter themselves over a foley too. Clean in and out when needed is much safer than a indwelled catheter. I mean there are cases especially if one cant straight cath themselves that a foley can come into play. But I would say it is pretty obvious a doctor has not prescribed it so most likely he is doing it him self. I mean if they are or they put it in for him I know they did not drop the drainage bag and have him leave it open in the diaper. If he is able to insert it and inflate a balloon then he should be able to use a straight catheter for retention.

Hello,

I've started a new job, I support a gentleman who uses a catheter, however he wears Pads and the catheter goes into the pad.

The gentleman gets a lot of uti's, am I right to believe that he's getting utis because of the catheter going into the pad.

I'm under the impression that a catheter should lead to a bag. Although, he refuses treatment of care around of care. What tips can I give to prevent UTI's?

(Before anyone asks, it's a genuine question but I am ABDl myself but asking for work as I've not dealt with catheters, incase someone wants to call out my previous threads)

Thank you

If his insurance or state is paying for you or a agency to care for him but he is refusing to use it proper then I would say he most likely has a case manager. That would be a good place to start. Or who ever is employing you to support or take care of him. They should be able to contact his doctor so they work what ever channels if he is not of sound mind. But it is hard to understand all the details from what we have been told. But you are correct to be worried about it.

 

[winterheart01]

If it is retention most doctors prefer a person to straight catheter themselves over a foley too. Clean in and out when needed is much safer than a indwelled catheter. I mean there are cases especially if one cant straight cath themselves that a foley can come into play. But I would say it is pretty obvious a doctor has not prescribed it so most likely he is doing it him self. I mean if they are or they put it in for him I know they did not drop the drainage bag and have him leave it open in the diaper. If he is able to insert it and inflate a balloon then he should be able to use a straight catheter for retention.

true, in my case though I could not tolerate frequent CISC because of the scar tissue in the urethra. It's like when you walk in 10cm snow, it'd dig a path and grow right back at 3 regions.
plus the pain it caused because of the scar tissue, with a foley I'd have to endure it less often, although the pain while walking was just as bad or worse :s Also insurance wise, they'd pay for the catheters and bags but I lost my insurance coverage for diapers for a whole year, so that was a sour bite in the back.

Truly I am happy this is behind me. But you are confirming my suspicion something is off, not a single doctor or nurse would approve putting the open end of a catheter of a foley in any kind of pad.
As strange as it may be though I read it is done with infants, with 2 diapers, one for the BM and with a hole in the front to pass the catheter through to let it drip in the second diaper, for unknown reasons infants are less susceptible to UTI's with foley's, I still do not understand and find it hard to believe but I read correct. However with adults it's a totally different story as we all know.

"If" I were to believe the OP client's case, then the only situation would be that the person is uninsured and not able to afford drainage bags, only cheaper pads and also lost complete sense in the bladder, not being able to feel pain down there, but as you can guess this is probably far fetched :s

 

[Diaperman95]

true, in my case though I could not tolerate frequent CISC because of the scar tissue in the urethra. It's like when you walk in 10cm snow, it'd dig a path and grow right back at 3 regions.
plus the pain it caused because of the scar tissue, with a foley I'd have to endure it less often, although the pain while walking was just as bad or worse :s Also insurance wise, they'd pay for the catheters and bags but I lost my insurance coverage for diapers for a whole year, so that was a sour bite in the back.

Truly I am happy this is behind me. But you are confirming my suspicion something is off, not a single doctor or nurse would approve putting the open end of a catheter of a foley in any kind of pad.
As strange as it may be though I read it is done with infants, with 2 diapers, one for the BM and with a hole in the front to pass the catheter through to let it drip in the second diaper, for unknown reasons infants are less susceptible to UTI's with foley's, I still do not understand and find it hard to believe but I read correct. However with adults it's a totally different story as we all know.

"If" I were to believe the OP client's case, then the only situation would be that the person is uninsured and not able to afford drainage bags, only cheaper pads and also lost complete sense in the bladder, not being able to feel pain down there, but as you can guess this is probably far fetched :s

But even then a drain bag is only 3 to 4 bucks and can be used a week. That is cheaper than any diapers I have had to buy. Also one of the reason i started using some condom catheters. Is they are cheaper than good diapers. If he does have insurance most all will pay for catheter supplies but very few diapers.

 

[winterheart01]

But even then a drain bag is only 3 to 4 bucks and can be used a week. That is cheaper than any diapers I have had to buy. Also one of the reason i started using some condom catheters. Is they are cheaper than good diapers. If he does have insurance most all will pay for catheter supplies but very few diapers.

Also true, I forgot about that
and yes, condom cath's would be a better financial solution for me too but even the smallest size no longer fits, after a large number of urethrotomy, prostate and several bladder neck surgeries, I am 80% impotent and things down there shrunk a lot, this was said on before hand and is normal. So I have no choice but to use diapers, or order those plastic shaped things that connect to those bags but some complained about it and I can only order it from amazon.com instead of a more local source.

 

[Diaperman95]

Also true, I forgot about that
and yes, condom cath's would be a better financial solution for me too but even the smallest size no longer fits, after a large number of urethrotomy, prostate and several bladder neck surgeries, I am 80% impotent and things down there shrunk a lot, this was said on before hand and is normal. So I have no choice but to use diapers, or order those plastic shaped things that connect to those bags but some complained about it and I can only order it from amazon.com instead of a more local source.

I had low T pretty bad too. They got it back up with injections. But i am not nearly as easy to arousal sown there ether. I can but not like before. Plus I think just the warmth of a diaper over years shinks things too. I can still fit a intermediat size one. I been married so long it not a big deap in my life.

 

[ElChancho]

I switched to a new indwelling catheter that has 2 balloons and will never go back to diapers. No pain from spasms and haven't had a UTI in 6 months. No point that hurts like hell. I can ride my motorcycle and exercise. I've tried everything and told my urologist I'm going permanent. It's a new catheter that has 2 balloons and the drainage hole is between the balloons. So comfortable. Obvious drawbacks is bag drainage.

 

[Diaperedff1]

I must agree an open cath. is very dangerous!! I'm glad my retention has been fixed and now I'm just uic . But even with diapers hygiene is key to staying uti free. Sterling area, sterling hands and change when wet, don't sit in it! Stay safe stay healthy

 

[durgan87]

Part of that is dependent on where the catheter is going into. If it's a standard foley going into the urethra the chance of a UTI has increase in the patient by 75-80% just by putting and in dwelling catheter in the patient. As that areas unlike most other tracts in the excretory tracts in the body was solely dependant on the urine that passed through it to clean the space. Now it's blocked by something that will act as as irritant as well. A Supra-pubic has less of a chace of infection as they catheters themselves longer and only enter a stoma that does clean itself. As for things traveling up the catheter, I've taken intermittent sample on mine and found nothing in the last few month. I have had two infections, a cellulitis in my Left leg and a bilateral ethmoid sinus infection. An open standard foley I would not recommend, maybe capped and drained every two hours, but find out why he has it first, if it's for retention that could be dangerous. Supra-public gives you more leway, but they are far less common in active people for one, and much more difficult to manage as well. If you have any question, for me I'm just an APN, so we can talk.