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  • Caregiving Problem.

    Hi all,

    I was searching the web looking for a good forum to post a question and I feel I found the right place after viewing a few other posts.

    My 87 year old father is dieing of lung cancer. He is unable to sleep in a bed so he is moved from his recliner to his transport wheelchair several times a day. He can not move at all without gasping for air so for him to urinate he stands up and holds on to a walker while the urine bottle is held in place for him. It is starting to get to a point where his legs are too weak and he is unable to stand up for the length of time it takes him to finish. He is also unable to pull himself up to stand so he now needs to be lifted by hand out of the chair for him to stand. His doctor suggested a tube into his penis so he can urinate but just the thought of it is very disturbing. Dippers is a last solution when the time comes but for now I was wondering is there any other solutions? He is still mobile to the point where he is at the dinner table 3 times a day for meals so I would like to keep it that way.


    Thank you for any replies
    -Tony

  • #2
    How about a tall stool or table for him to lean back against to hold some of his weight? How about oxygen?
    Give him an atta boy from me. That's one tough old dude!

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    • #3
      Yes he is on Oxygen, Sorry I failed to mention that. I also failed to mention that if there was a way he didn't have to stand would be great but if not, then how to avoid having to be hand lifted?

      Thanks for the kind words
      -Tony

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      • #4
        Tony sorry you are having to go thru this. I am in no way an expert but you may want to check into a suprapubic cath. This is tube that is surgically put into the bladder right below the belly button.
        Also you may want to check into a patient lifter, such as a hoyer. I know there are other kinds available and hopefully someone will chime in to provide name brands but that would make it easier to move him.
        I am uncertain with him being terminal if insurance would pay for anything like I have mentioned above but it may be worth checking into. I know there are used lifts on ebay and craigslist.
        Good luck and stay strong!

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        • #5
          Hi TonyC, glad you found us. I understand your hesitancy about the catheter for urinating. For the first couple of years after my son broke his neck, he was able to use a condom catheter (excuse the name) but it perfectly describes what it is. It does not have to be inserted and works great as long as the patient can void on their own. It is hooked to a tube that goes to a leg bag or bed side bag. Be sure to try this solution before considering a sura pubic since any invasion of the body like that can cause complications.

          There is a bit of an emotional hurdle to get over in the beginning of using a catheter, but it is a great solution and believe me you will get so used to putting it on in no time at all. There is no bad smell. Best to you and your Dad. And good for you for stepping up to the caregiving plate.
          "A smooth sea never made a skilled mariner"

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          • #6
            Excellent idea darthe...I had used those for David before the suprapubic cath and totally forgot about them.

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            • #7
              Hi Tony, A friend of mine took care of her father at home. She used the condom catheter and Medicare paid for rental of a manual Hoyer lift.
              It has been a while, but if I remember the social worker helped make some of the arrangements.
              Sorry I don't have much advice.

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              • #8
                go with the foley. it may him suseptable to urinary infection, but I think comfort and dignity are important too. having someone empty the bag is easier too than having to hold something for him to pee in so many times a day. If he is in a wheelchair, there is a moisture proof bag you can hang underneath and the urine collection bag can go into it and it isnt visble to everyone.
                when I use a foley, and eventually just a night bag, I kept it in a little plastic trash can under my bed, or next to my desk.
                those bags can leak, and if they do, its a matter of just emptying the trash can too, rather than cleaning up pee.
                visiting nurses can change the foley if needed, and its no big deal to flush it out if need be, you can do that without him having to expose himself to anyone.
                I think its wonderful that you are taking care of your dad. bless you for being there for him.

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                • #9
                  I forgot the condom cath option. I dont think at this point surgery would be considered due to his terminal condition.

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                  • #10
                    Have you contacted Hospice? Even if you don't want their services at this point they might be able to give you some resources.

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                    • #11
                      I agree. If you are not hooked up with Hospice now, get on that tomorrow. The hospice nurse will help you get the equipment needed to care for your father, and will be familiar with the options available. A portable commode chair, hospital bed, and mechanical lift are usually most helpful. A pressure reducing mattress to prevent painful pressure ulcers is also a good idea.

                      A SP catheter at this point would not be advisable, and it would be best for both his dignity and comfort to avoid an indwelling urethral catheter. A UTI is much more likely with this as well, and he would not do well fighting that off at this point.

                      Can your father void at all while sitting. I know when I cared for my father when he was dying from cancer, sitting on a toilet or a portable commode worked well for him to be able to urinate in spite of his prostate cancer. We did eventually go to adult "pull up" type diapers, which he resisted at first, but finally agreed to, but did work well and were pretty easy to change (we used the male Attends briefs with elastic waist).

                      If he is a large man, a portable lift would be a good idea, but difficult to use on carpet. Because my father lost so much weight, we did a "quad pivot" transfer to a bedside or chair side commode chair for both bowel and bladder care throughout his illness and all of us were able to do that for him until the last two days when we used kept in in bed and used the diapers (he was only semi-conscious at that point).

                      Hospice was invaluable for medications for both pain management, and at the end to ease his air-hunger. They provided a HHA to bathe and shave him, a chaplain who prayed with him, and even a massage therapist to give him some back-rubs to ease his constant back pain. This let him stay at home with all of his family providing the rest of his care, as he wanted, instead of going to a hospital or nursing home.

                      (KLD)
                      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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                      • #12
                        With a little practice, he may be able to use his urinal from his chair. Ryan does this all day long. Granted he only wears shorts (so that he has access from underneath). Even in 20 degrees, he will not wear long pants, only puts a blanket over his legs to go outside. Ryan uses a wash cloth under the urinal to catch any drips and so we go through several wash cloths a day, no big deal.

                        We also use a condom cath at night as using the urinal while lying down is asking for a mess and while he has bladder control, he needs to void frequently and would need assistance at night.--eak
                        Elizabeth A. Kephart, PHR
                        mom/caregiver to Ryan-age 21
                        Incomplete C-2 with TBI since 3/09

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