Living with a long term catheter for older adults
Long term catheter guidance for older adults
If you have recently had a long-term catheter inserted, or you are caring for someone who has, you may have questions about what life is like with a catheter and the information you need to know. Here, we are covering what a catheter does, the different types, why older people may benefit from one, how they affect quality of life, how to look after it yourself at home, activities you may want to avoid, how to care for someone with dementia who has a catheter inserted, and other ways caregivers can help.
At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about catheter care, we can help.
What is a catheter?
Aurinary catheteris a thin, flexible tube that is inserted (by a trained medical professional) into the body to help empty the bladder when normal function is impaired, and collect urine in a drainage bag. Catheters are typically made from silicone, latex or polyurethane, and they come in different sizes depending on what they are being used for.
They can be inserted in two locations; a urethral catheter is inserted into the tube that carries urine out of the bladder, and a suprapubic catheter goes into a small opening made in your lower abdomen.
Why might an older adult need a catheter?
There are a number of reasons and medical conditions that might lead to an older adult requiring a urinary catheter, such as:
- Urinary retention caused by an enlarged prostate gland
- Neurological disorders affecting bladder control, such as Parkinson’s or dementia
- A recent surgery which requires management of urinary retention post-anaesthesia or during recovery
- Urinary incontinence due to weakened bladder muscles – studies have found urinary incontinence is common in older people, with a reported prevalence of 25-45% in women and 5-35% in men
Catheters can help to maintain normal urinary function and prevent urinary tract infections (UTIs) that may occur if urine is not efficiently expelled from the body. By creating adequate drainage with a catheter, an older person’s comfort and quality of life can be increased. Depending on the person’s diagnosis, a catheter may be inserted on either a short-term or long-term basis.
What types of catheters are there?
The term ‘catheter’ is used to describe several devices that administer or draw from the body, for example, central venous catheters provide access to the bloodstream for administering medications, fluids or drawing blood, while cardiac catheters enable interventions within the heart or blood vessels, and dialysis catheters help manage medications for kidney patients. When it comes to urinary catheters, there are2 primary types to be aware of:
- An Intermittent Catheter – This is inserted into the bladder on a temporary basis and removed when the bladder has been sufficiently emptied
- An Indwelling Catheter – This is a long-term catheter held in place by an inflated balloon inside the bladder for however long the person requires it (days, weeks or longer)
For those who need catheterisation on a long-term basis until they regain normal bladder function, an indwelling catheter is usually preferred as it avoids the discomfort of an intermittent catheter being inserted over and over to empty the bladder.
How can a catheter change a person’s quality of life?
Catheters may be used in hospitals for those who cannot get up and down to use the bathroom frequently, but they can also be used at home for those with bladder issues, allowing them to move around in daily life with their catheter still inserted. Living with a long-term catheter can significantly impact a person’s quality of life in both positive and negative ways.
On the positive side, a catheter can:
- Relieve the discomfort of a full bladder if a person cannot naturally empty their own
- Enable normal daily life and social participation without fear of incontinence
- Allow normal daily routines without frequent bathroom trips
- Provide uninterrupted sleep free from night-time bathroom visits
- Increase mobility without fear of accidents
On the negative side, a catheter can:
- Cause feelings of stress due to worry over leaks
- Inhibit normal mobility due to fear of dislodging the device
- Cause feelings of embarrassment when out in public
- Lead to social isolation due to negative feelings about having one
- Malfunction or stop working on occasion – a 2023 study found that 70.9% of participants reported problems with their catheter function
- Cause possible UTIs – there is an increased risk of UTIs with a catheter inserted, with studies recommending the careful use of urinary catheters to reduce UTIs
While living with a urinary catheter won’t affect the daily activities of an older person much, many people do find this to be an adjustment to their daily life, and cause feelings of shame, embarrassment, worry and other negative emotions.
Can someone look after their catheter themselves at home?
With appropriate training and support from the medical professional or nurse in charge of care, an older person living at home can manage their own catheter if they wish to do so. Establishing a routine can help with this, and maintaining hygiene is of the utmost importance.
Managing a catheter at home usually involves:
- Washing hands thoroughly before and after handling your catheter, drainage bag or valve
- Cleaning around the catheter site regularly (a bath or shower is best)
- Drying the catheter site thoroughly after washing
- Ensuring the catheter is securely attached
- Monitoring for signs of infection or blockage
- Emptying drainage bags before they get too full
- Changing leg bags
- Attaching overnight bags
- Performing catheter irrigation / a bladder washout (if necessary)
- Disposing of drainage bags appropriately
If you are stressed about managing your own catheter, complex care professionals can help to provide appropriate support so you can worry less about leaks and any other complications.
What should someone with a catheter watch out for?
Caring for your own catheter at home can promote independence and help enhance your overall comfort and wellbeing, however if you feel there are complications or you need assistance from your nurse or GP, do not hesitate to contact them with any questions.
You should seek support if:
- Your urine has not drained after 2-3 hours – this could be a sign of a blockage
- You experience any pain
- You have noticed blood in your urine
- Your urine is cloudy or smells
- You feel a burning sensation
- Your urine keeps leaking
- You notice irritation or pressure ulcers around the catheter site
- You experience symptoms such as a fever or chills – this could be a sign of a UTI – catheter-associated urinary tract infections are thought to be the cause of 40% of all hospital-acquired infections, and can affect home patients too
- You experience symptoms like redness or tenderness around the insertion site – this could be a sign of urosepsis, which is an infection in the urinary tract
- You notice any other signs that something may need to be checked
- You are struggling with your mental health due to having a catheter
Should any activities be avoided with a catheter?
While catheters enable an older person to continue life as normal, there are certain activities which are best avoided or approached with caution in order to prevent complications. If you are living with a catheter, you should avoid or take caution with:
- Vigorous physical activities
- Heavy lifting
- Wearing tight-fitting clothing, belts, or anything else that could put pressure on the catheter site – there are many catheter-friendly clothing options online for those who do not feel comfortable in their normal clothes
It can help when leaving home to bring along the equipment needed to empty your catheter on the go, as well as a change of clothes for unexpected leaks.
Does a person’s diet need to change if they have a catheter?
While a catheter doesn’t requireany specificdietary changes (unless instructed by your doctor), those with a catheter inserted should aim to maintain a healthy diet in order to support general wellbeing and prevent complications. Aim to drink at least two litres of fluid a day to ensure adequate urine production, as this can reduce the risk of UTIs. Avoid excessive consumption of caffeine, carbonated drinks or alcohol as these can irritate your bladder and increase urinary frequency. Also, ensure there is plenty of fibre in your diet to avoid constipation, which can put pressure on the catheter.
What catheter-related challenges might come up for caregivers?
Caregivers supporting a loved one with a catheter may come up against challenges, such as maintaining catheter hygiene, noticing signs of infection, handling drainage bags, securing catheters properly, assisting with changes, addressing blockages, leaks or other complications. Also, caregivers must ensure the person retains their dignity throughout catheter care tasks, which can be difficult when you are caring for a family member.
In addition, caring for someone with a memory loss condition like dementia or Alzheimer’s might mean the person forgets they have a catheter in place, which can cause them distress. Older people with dementia are at an increased risk of developing a UTI due to reduced personal hygiene, which can increase the need for a urinary catheter to be inserted. Dementia and similar conditions make catheter care extremely challenging, so often families will enlist the help of a professional home carer.
How can a caregiver help an older person living with a catheter?
A professional caregiver can help put your mind at ease if you are living with a catheter, by providing frequent changes and support no matter how long you have had your catheter inserted, or how long you will likely have it in for.
Catheter care involves ensuring the catheter remains in place, clean, and free from infection, and this includes emptying or changing the catheter bag, taking samples when requested by healthcare professionals, monitoring fluid output, and more.
Our Care Professionals are trained in dealing with catheters and informing your clinical team of any issues that arise, so we can work in tandem with the medical professionals in charge of your care. As catheters can be used on a short-term or long-term basis for a variety of conditions, we can provide flexible support to meet your individual needs and help you manage your catheter care at home.
Reach out to your local Home Instead team to discuss your needs and allow us to create a personalised package to support you. We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.
Michelle Tennant, Clinical Governance Lead
I am a Registered Nurse of 20 years and have been in the care sector since I was 17 years old, I have had experience in every role that exists in a care company, including Registered Manager, care consultant, recruiter, scheduling, auditing, complaints, and networking! My role in the National office is Clinical Governance Lead, and most recently have been working with DHSC and Chief Nurse Deborah Sturdy to develop a clinical governance framework for the delegated healthcare activities in social care, I am continuing to take the lead on our Healthcare at Home service and drive this in the network. In addition to my nursing role, I’m 4 years into my PhD in Aging at Lancaster University, with a key focus on the retention of Care Professionals in the social care sector.