Page 1 of 2 12 LastLast
Results 1 to 10 of 21

Thread: Learning to Self Cath

Hybrid View

Previous Post Previous Post   Next Post Next Post
  1. #1
    Junior Member ForMyCousin's Avatar
    Join Date
    Apr 2011
    Location
    North Richland Hills, TX
    Posts
    17

    Learning to Self Cath

    My cousin swears she can't cath herself.

    She was taught to cath in rehab by using a mirror positioned between her legs in a lying down position. During her last two weeks in rehab and in the two months since she has returned home, her mother or another family member has been cathing her, and she has never tried again. (As a side note: she claims that it is too icky).

    I know it is difficult to try to get her to do something while she is totally unmotivated, but do you have any ideas for ways to help her self cath?
    Last edited by ForMyCousin; 07-26-2011 at 09:32 PM. Reason: Removed personal info

  2. #2
    If she knows how to cath and is physically capable of cathing, then she should be encouraged to wear gloves if that gets her over the "icky" factor. Most of us who are caregivers use gloves when we catheterize those for whom we care. It is probably more hygienic for her to cath with a clean pair of gloves for each cath anyway. Your profile says, "your little cousin." How old is she?
    If she is a child, I believe there are several threads on Care Cure Community posted by mothers whose very young male and female children cath themselves. You might try searching for these threads.
    If she just can't come to terms with self cathing, maybe she (if she is a child - her mother) should consult with her urologist about getting a supra pubic catheter (SPC). This is a minor surgical procedure that places a stoma just above the pubic bone into which a catheter (which is changed monthly) is placed and a urine collection device that is worn on the belly, thigh, or lower leg collects the urine.
    The key is for your cousin to gain as much physical independence as possible and she (if she is a child, her mother) may have to give some thought and make some choices about her physical care and needs that will help achieve that independence for her.

    NL (GJ's wife and caregiver)
    Last edited by gjnl; 07-26-2011 at 03:27 PM.

  3. #3
    Senior Member zillazangel's Avatar
    Join Date
    May 2004
    Location
    North Carolina, USA
    Posts
    3,399
    Based on the posts you've put up, I think you are a little pushy. And perhaps overly involved in her life? Its clear that you want the best for her, but consider backing off because your approach may be off-putting to her.

  4. #4
    Is she in counseling? Are other family members? Getting outpatient therapy and seeing a good outpatient rehab nurse for follow up? Seeing a physiatrist?

    What was she like before her injury? Immature and clingy? Active and athletic? Is this just her usual type of behavior? She sounds very depressed to me.

    What was said about all of her abilities at her discharge team conference? Where did she have her inpatient rehab? Is she on medications for pain mamnagement.

    If she is not committed to doing intermittent cath, perhaps she should just put in an indwelling Foley for now. If everyone is willing to enable her dependency by doing this care for her, she has no incentive to take on these tasks or become as independent as she can. She needs some incentive to do this work.

    Are there goals she has that would require her to become more independent to achieve them? For example, if she wants to go to a concert our out with friends, does she understand that in order to do this, she needs to learn how to cath herself? Is she going to school in the fall? Does she have friends who will take her places and push her as well?

    What did she do for menstrual management before? I find it amazing to see a 18 yo female who is squeamish about touching her own genitals...most girls that age have discovered masturbation and are very used to inserting tampons, etc. Guys are usually much more reluctant to insert a catheter into their urethra than women are, in my experience.

    Is she starting to go without the Kydex? It is easier to self cath for a female with out it on.

    (KLD)

  5. #5
    Senior Member flicka's Avatar
    Join Date
    Oct 2004
    Location
    California
    Posts
    3,553
    Quote Originally Posted by zillazangel View Post
    Based on the posts you've put up, I think you are a little pushy. And perhaps overly involved in her life?
    If ForMyCousin is in the position of cathing her it sounds to me that FMC has been forced into 'over involvement'. Also, if the paralyzed cousin isn't taking an active involvement in her own care she needs to be pushed. (IMO)
    ____________________

    "We are the ones we've been waiting for. We are the change that we seek."
    - Barack Obama

  6. #6
    Senior Member
    Join Date
    Mar 2006
    Location
    connecticut
    Posts
    8,272
    KLDs thought on a foley may be just the thing.

    There really shouldn't be any reason in my mind that other people should be cathing her at her level and age. Altho I am sure it will be easier once the brace is off, but it sounds like she was capable of doing it when taught in rehab?

    But at 18, maybe having a bag of pee on her all the time might be "ickier" than cathing herself? It might be a nudge in the right direction.

    She is very new, and maybe needs time, but thinking the time has come to tell her that she needs to step up and take more responsibility for her own care. (Or at least what she is truly capable of, not saying to throw her to the wolves here or anything .....)

    I know in rehab, had I refused to cath myself, it would NOT have been accepted. Same for anything else I was capable of. Once I was taught a skill, and was able to do it independently, the nurses and aides would no longer do it for me. And if that meant it took me 2 hours to get dressed, so be it. (And the first time an aide got in trouble b/c I let her help me get dressed because I was feeling lazy, I learned my lesson!)

    And I bet this will be harder on her mom than it will be on her.
    Last edited by sjean423; 07-26-2011 at 07:28 PM.
    T7-8 since Feb 2005

  7. #7
    Junior Member ForMyCousin's Avatar
    Join Date
    Apr 2011
    Location
    North Richland Hills, TX
    Posts
    17
    GJNL - She is 18, and her mother isn't in a position to care for her at the moment. I explain a little more below.

    Quote Originally Posted by SCI-Nurse View Post
    Is she in counseling? Are other family members? Getting outpatient therapy and seeing a good outpatient rehab nurse for follow up? Seeing a physiatrist?
    The answers to most of these questions is NO. She is only going to outpatient PT & OT. She didn't even get these services started right away after rehab as suggested by her care team. It was almost a month after leaving rehab before she had her first sessions.

    Things aren't happening like I feel they should which is why I am being pushy. As far as I am aware, before the accident she was seeing a PA in an urgicare-type clinic if she had problems. She does not have a regular family doctor, urologist, or GYN. I have been given some recommendations in the last week and began setting up appts. We have relied on the rehab doc to write her Rx since leaving rehab almost two months ago. Health insurance / affordability has been the issue.

    Quote Originally Posted by SCI-Nurse View Post
    What was she like before her injury? Immature and clingy? Active and athletic? Is this just her usual type of behavior? She sounds very depressed to me.
    This is & was her usual behavior - full of immaturity and rebellion. Officially, she isn't a child, which makes things difficult. My aunt lets her do whatever she wants under the excuse that "she is an adult." Unfortunately, that adult isn't caring for herself right now. My mom (my aunt's sister) told me to leave that issue alone right now because there is nothing that I will be able to say to convince my aunt otherwise.

    Quote Originally Posted by SCI-Nurse View Post
    If everyone is willing to enable her dependency by doing this care for her, she has no incentive to take on these tasks or become as independent as she can. She needs some incentive to do this work.

    Are there goals she has that would require her to become more independent to achieve them? For example, if she wants to go to a concert our out with friends, does she understand that in order to do this, she needs to learn how to cath herself? Is she going to school in the fall? Does she have friends who will take her places and push her as well?
    There are no incentives. Her mother will not tell her 'no.' This has strained her mother so terribly that she is not able to participate in my cousin's care for the time being. My aunt and uncle were together longer than I have been alive. My cousin was their late child (45 & 50yo). Six months to the day after my uncle dies, my cousin had her accident.


    Quote Originally Posted by SCI-Nurse View Post
    What was said about all of her abilities at her discharge team conference? Where did she have her inpatient rehab? Is she on medications for pain mamnagement.
    Baylor Institute for Rehabilitation in Dallas. She is on pain medications. During the team conference, they HEAVILY pushed her need for more therapy.

    Quote Originally Posted by SCI-Nurse View Post
    What did she do for menstrual management before? I find it amazing to see a 18 yo female who is squeamish about touching her own genitals.
    No clue. I figured the IUD would give me less things to worry about, so I was going to talk to her about it this week if I got good feedback from other users. We have an appt with the GYN next month.

    Quote Originally Posted by SCI-Nurse View Post
    Is she starting to go without the Kydex? It is easier to self cath for a female with out it on.
    She is still wearing it. She can't bend forward. In rehab, she was taught to cath using a mirror, but she has not done it since leaving rehab at the end of May.

    Quote Originally Posted by zillazangel View Post
    Based on the posts you've put up, I think you are a little pushy. And perhaps overly involved in her life? Its clear that you want the best for her, but consider backing off because your approach may be off-putting to her.
    I'll be the first to admit that I am pushy. Please believe me when I tell you that I have seriously scaled back over the past two months. When I stopped being so involved, she cried to me saying that I don't care about her any more. I'm having a hard time finding a balance. Reading the responses to my posts today have given me a greater understanding of how I can help her without being so pushy. I know I've posted a lot today, but it is the accumulation of things I have found I needed help with over a four month period all coming out at once.

    Quote Originally Posted by flicka View Post
    If ForMyCousin is in the position of cathing her it sounds to me that FMC has been forced into 'over involvement'. Also, if the paralyzed cousin isn't taking an active involvement in her own care she needs to be pushed. (IMO)
    I do feel like I've been forced into over involvement. At first, I did everything my cousin asked, and my family acted like I was the most wonderful thing that could have happened for my cousin. When I backed off after starting my new job on July 1st, my family brought me to tears last week blaming me for being unhelpful. They asked me to postpone my position so that I could stay home and care for her.

    Quote Originally Posted by sjean423 View Post
    I know in rehab, had I refused to cath myself, it would NOT have been accepted. Same for anything else I was capable of. Once I was taught a skill, and was able to do it independently, the nurses and aides would no longer do it for me. And if that meant it took me 2 hours to get dressed, so be it. (And the first time an aide got in trouble b/c I let her help me get dressed because I was feeling lazy, I learned my lesson!)
    I really wished this would have happened for us, but it didn't. The rehab people were great, but they let her (& us) get away with too much. Our family has allowed things to be this way. I'll admit that I was guilty too. I cathed her, bathed her, and did her bowel program more than once. I have a big family. Most of them live 10 hours away, and several came to visit during rehab. Very few of them didn't learn to cath her while they visited.

  8. #8
    I'd have been kicked out of rehab for refusing to try to cath, and I'm a quad (incomplete injury, pretty darned complete during that spinal shock period.) The only thing I ever refused was my husband being taught my bowel care. I had a snotty nurse at home until my c-collar came off, and having been spared maybe 80% of my left hand function, I took it from there.

    Does she know the consequences of being cathed by apparently everybody? The risk of infection? I'd rather keep my own germs to myself.

    But I do know that paras in clamshells have a hard time cathing, even w/ 10 good fingers.

    I'm torn between believing she's depressed or just spoiled. I've heard of sci's like her but never have I met one. This is a tough road, she has got to sack up or her life will suck. Doesn't she want to wear cute clothes w/out that damned brace?

    Sorry, I'm a quad w/ para envy. Rehab told my family to do NOTHING for me if I could remotely do it myself. My husband got yelled at for dressing me-and it never happened again.

    I can't believe she wants to be so dependent, it's just unnatural in my eyes.

  9. #9
    Senior Member feisty's Avatar
    Join Date
    Jun 2005
    Location
    Midtown, Sacramento, CA
    Posts
    2,744
    Quote Originally Posted by ForMyCousin View Post
    No clue. I figured the IUD would give me less things to worry about, so I was going to talk to her about it this week if I got good feedback from other users. We have an appt with the GYN next month.
    ok, sorry, but this is the wrong way to think... it's nice you're helping her and all, but medicating her for any reason to make YOUR life easier is pretty twisted thinking.

    along those lines, why don't you give her a little bump of adderal so maybe she has the energy to do more of the shit you want her to.
    An administrator made me remove my signature.

  10. #10
    Senior Member
    Join Date
    Mar 2006
    Location
    connecticut
    Posts
    8,272
    Quote Originally Posted by ForMyCousin View Post
    I have a big family. Most of them live 10 hours away, and several came to visit during rehab. Very few of them didn't learn to cath her while they visited.
    Wow, that is really weird. I am surprised that the rehab would do that. Mine taught me, and no one else.

    It is really a risk as to added germs and uti's. Does she know that? (And a uti means that she needs to cath even MORE often, make sure she knows THAT too.)
    T7-8 since Feb 2005

Similar Threads

  1. Replies: 10
    Last Post: 12-20-2010, 05:04 PM
  2. Replies: 4
    Last Post: 09-28-2009, 08:28 PM
  3. Replies: 18
    Last Post: 01-09-2009, 01:26 AM
  4. Learning to self cath
    By soundguy in forum Care
    Replies: 1
    Last Post: 12-04-2008, 07:24 PM
  5. Replies: 1
    Last Post: 04-19-2002, 04:39 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •