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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Will A Catheter Help An Elderly Dementia Patient Who Sleeps For Long Hours?

I m caring for my mom with advanced dementia. She can longer walk, speech is garbled and appetite is decreasing. Sleeps sixteen or more hours a day. I ve got hospice care for her. We are getting ready to have her be in her bed for the majority of the day. I m trying to decide if I should have the hospice nurse insert a catheter or not? My mom is 86. Thank you- Jana
Mon, 11 Jun 2018
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Internal Medicine Specialist 's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

The straightforward answer is no! Let me explain what's going to happen in both cases though (catheter or no catheter).

If a catheter is inserted then you're going to have to change the catheter every so often (once a month usually although some will argue that changes are only required when the catheter stops being functional).

Taking care of the a patient with a catheter can be a little tricky particularly regarding moving the patient around. The catheter can easily get stuck somewhere and injure the patient. The carer will notice the presence of blood in the urine (red urine perhaps with blood clots). Sometimes the clots may obstruct the catheter and require urgent replacement.

One more thing to consider is that catheters get colonized by bacteria very soon after staying in place. Within the first week you're going to be finding bacteria in her urine whenever a urinalysis or urine culture is done. Although having bacteria in the urinary tract does not always mean infection (and necessity for treatment) she will have an increased risk for urinary tract infections. On the other hand she's going to be needing less diaper changes and she's going to be cleaner.

The "no catheter" approach may cause trouble to her skin if the diapers cannot be changed right after she gets wet.

The currently applying guidelines do not recommend placing a catheter to such individual.

I hope you find this information helpful! Please get back to me if you'd like more help.

Kind Regards!
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Will A Catheter Help An Elderly Dementia Patient Who Sleeps For Long Hours?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. The straightforward answer is no! Let me explain what s going to happen in both cases though (catheter or no catheter). If a catheter is inserted then you re going to have to change the catheter every so often (once a month usually although some will argue that changes are only required when the catheter stops being functional). Taking care of the a patient with a catheter can be a little tricky particularly regarding moving the patient around. The catheter can easily get stuck somewhere and injure the patient. The carer will notice the presence of blood in the urine (red urine perhaps with blood clots). Sometimes the clots may obstruct the catheter and require urgent replacement. One more thing to consider is that catheters get colonized by bacteria very soon after staying in place. Within the first week you re going to be finding bacteria in her urine whenever a urinalysis or urine culture is done. Although having bacteria in the urinary tract does not always mean infection (and necessity for treatment) she will have an increased risk for urinary tract infections. On the other hand she s going to be needing less diaper changes and she s going to be cleaner. The no catheter approach may cause trouble to her skin if the diapers cannot be changed right after she gets wet. The currently applying guidelines do not recommend placing a catheter to such individual. I hope you find this information helpful! Please get back to me if you d like more help. Kind Regards!