"Watch out for being catheterised"

Anything else?

My elderly Dad has a degree of vascular dementia and was admitted to TGH in July 2012 after suffering a fall at home with unknown cause. During his 3 wk stay he was transferred twice - from MAU to W31 and then to W43. Prior to his fall he was certainly not urinary incontinent and there was no evidence to support that he was when admitted via A&E, however for some reason - still not explained to this day - he was catheterised whilst on the MAU. As he became more mobile he graduated from a bedside bag to a leg-bag, however as these hold far less urine capacity they have to be emptied much more regularly and this was just not being done. On many an occasion we would visit and find the leg-bag so full that it was uncomfortable for Dad, both from the point of view of being heavy to walk around with (he needs sticks or a frame anyway) and on some occasions because it would hold no more urine he could have been put at risk of having urine retention or worse, back-flushing up to his kidneys with the obvious associated danger (an out of hours GP informed us about this risk when it happened again at the continuing care nursing home he was released to). I was present on the occasion he was transferred to W43 from W31 as it took place during evening visiting and again when I checked his leg-bag it was full. The staff refused to delay the transfer to empty it (Dad was already in a wheelchair when I arrived) saying I should mention it to the staff receiving him on arrival @ W43, but such mayhem was ensuing there when we arrived due to a mix-up as to who was being discharged to vacate the bed for my Dad that we were kept waiting another 20-30 mins before I could speak to anyone, however a nurse did attend to it at the first opportunity once I’d managed to draw attention to it. When Dad was eventually discharged into a local nursing home for continuing care assessment he was still wearing the catheter & leg-bag. Although it should have been normal procedure instigated by TGH staff at discharge (we later found out) at no point was Dad referred to or assessed by the “Continence Team” as he should have been at any point up until the catheter was removed at home because it had reached the end of its recommended 12wk life and it wasn’t replaced because of other complications it had caused in the meantime. To this day - almost 12 months later - and whilst there has been some slight improvement, my Dad still needs continence aids costing him around £12/week not to mention the damage done to his dignity and as a family we feel this was all brought about by the decision to catheterise him needlessly in the first place, hence my warning to anyone out there reading this. So please do take note & do not be afraid ask questions about whether there is a clinical or medical need to catheterise in the first place. If it is done make sure you know what is supposed to happen about reviewing the situation either on discharge from hospital or after. Best of luck.