Senior dementia patient recently was in the hospital for UTI. He was treated with IV antibiotics and had a Foley catheter inserted because he was retaining urine. The Foley catheter was removed about two weeks after his hospital release. He now takes flomax. We are monitoring his urine output with a condom catheter bag. He drinks about 2/3 8oz cups of liquid a day (not much), but is well.
Anyone have experience monitoring for urinary retention? Without an ultra sound bladder exam at home, it is difficult to check. What does one look for; especially when urine output fluctuates?
Also know that as the bladder fills there is often and increase in agitation as you can imagine. No output of urine is a clue you are headed to trouble. For some elders they have already lost enough sensors that they cannot tell, or cannot express where the agitation is coming from. Lightly pressing a full bladder will often get an instant reaction, legs pulled up, grimace, groan, and etc.
Without being there, don't know how else to help you ID what is happening. Just wish you good luck.
A PA-C would do an ultra sound in the doctor’s office. However, I just realized that the patient would need to be transferred from the wheelchair to the examination bed. The patient is hemiplegic. Unless they get a lift or have some strong people they do not do the transfer, nor do they want to.
My mom left hospital after a uti with a catheter bc she twice failed the urine void tests. Once cath was removed, home health was supposed to scan her bladder. That didn’t happen and we faced a weekend of worry as to whether she was retaining urine. During this time, after she felt she was done urinating, I had her (per Dr. Google!) bend forward while sitting on the toilet. Always more urine came out! When she later got her void test with her urologist, she passed! She has had no problem since—6 months now. Wishing you the best!! And hoping you can beat the catheter, too. (On a side note, we did this by rehabbing mom at home. I don’t think we’d have had the same results if she’d gone to a residential rehab. The doc seemed resigned to her being on a catheter. I wasn’t.)
A diaper would be better if he is unable to use a urinal. You can feel how heavy they get. Another reason could be due to poor fluid intake, and bad kidneys (which dehydration can cause--kidney damage).
Since your dad is NOT drinking much, you MUST ENCOURAGE him to drink. In other words, have a drinking schedule. Elder people lose their sense of thirst so dehydration is very common--along with it comes urinary tract infection.
If they are having problems swallowing, then the fluids must be thickened.
Failing that, and they refuse to drink your only other options are feeding tube verses hospice/DNR let them die (it can take 2 weeks to die of dehydration). Feeding tubes should only be a *LAST* resort and they require CONSIDERABLE amount of care. My mom had a feeding tube and she did great with it but it required a great deal of care.
DEHYDRATION causes kidney damage.
You must really have a terrible doctor to not explain these things to you. It sounds like your dad needs a new doctor who cares about their patients.
What goes in must come out so just monitor what he drinks and what his urine output is and he'll be fine.