urinary problems for wheelchair users

[jon650]

after my sons tbi a year ago whilst sat in his wheelchair he asks for a wee. We do our best to pull his pants down slightly and his pad and then try to put his willy in the cardboard urinal. quite often this is at the wrong angle. the staff at the unit just tell him that he wears a pad and to do it in that. At 21 we feel this is not helping in his rehabilitation. My question is does anybody know of any other urinals he could use he has tried a convene but these are only for short term use.

thanks in advance john

[Broken_Doll]

Hi John,

As a former Rehabilitation Practioner within an NHS hospital (prior to my BI) that is bad practice on behalf of the staff who are telling him to "just go in his pad". It will hamper his recovery, also end up depressing him (if it's not already) and it's undignified!

There are pieces of equipment you can purchase, which aid wheelchair users to pass urine. Basically, it's similar to a convene in shape and function, except when the user requests to P.U, its a plastic receptacle which is attached to tubing and can either be used to direct urine into a urine bottle, or the toilet.

It is called a "drainage urine funnel"

Hope this has helped

Send my best wishes to your son

Emma

[Kirk5w7]

I understand the need for normality here. Once I was out of my coma and regaining normal functions, including bowel and bladder, I was catheterised so had no control over that function, but I would ask for a bed pan if I got sensations of bowel functions but I was told on many an occasion that because I was wearing what amounted to a nappy I could do it in there.

The reason being I presume was because it was easier for the nurses, but I used to insist on a bed pan, on occasions they made me wait til I was in agony!!

So I hope you get this resolved it's very important for your sons dignity and well being. Love Janet xxx

[cat3]

I'm so glad that Emma has offered an alternative solution to your son's problem. What a shame that staff aren't sufficiently sympathetic or trained to how profoundly this will affect someone in your son's situation.

Thank goodness for sensible, intelligent parents. I hope you will bring this issue to the attention of the consultant or neuropsychologist.

All best wishes to you and for your son's progress.

Cat x

[headwayuk Partner Headway]

Hi jon650

It really is poor advice to suggest he just use a pad for urinating, strategies used now may improve his ability to pass urine.

It would also be a good idea for your son to be seen by a continence specialist advisor, these are available across the country. The GP looking after your son in the unit will be able to refer him through to this service.

Here are the Nice Guidelines for Urinary incontinence in neurological disease - which includes TBI

nice.org.uk/guidance/cg148.... could take some of the information into the unit from this document to support your request, if there is a problem getting referred to a specialist service for continence.

Regards

Victoria

Helpline

[Hidden]

Sounds really AWFUL to be told to wee/poo in nappy and then have to sit in it = just coz 'easier\ for staff, SHAME! And causes skin breakdown/infection, dreadful - PLUS, most important: choice, feeling human - humans always have gone away to wee/poo. If none of what's available now is perfect maybe time someone invented better?

[Broken_Doll]

Not even a "thank you". My reply took ages for me to type and written when extremely poorly but I felt the need to reach out!

[sporan in reply to Broken_Doll]

Hi Emma,

I supect a thank you was meant to be given but guess that because of their situation they were chacing after getting it sorted and as a lot of people in their worried state simply forgot, not nice for you, but probably not intended to upset or ignore.

However I will say thank you because my father-in-law had prostate cancer and was left partially urinary incontenent and has used a convene system for many years now but has developed dementia and the hospital staff in his dementia ward just put him in pads, which he didn't understand because of his dementure, and despite us supplying htem with father-n-laws own sheaths and bags, still put him in pads. My belief is because it was easier and quicke to deal with. But even then we would vist to find him sat in wet smelly trousers with saturated bed linen because they didn't check his pad.

My father-in-law is a proud man and despite his dementure still gets ambarrased about wetting himself and hides the trouses and linens etc and because he doesn't understand or cope with the pads he then goes without any system and ends up in a worse state.

We fear we will have the same problem in the care home he has now been moved to.

The demnture nurse said that despite the bag he will still have the urge to pee and be able to deal with it. However, as I tried to explain to them, he has used the system constantly for so many years now that his mind has lost the ability to acknowledge that sensation and the demtia means he sticks with what he knows and that unfortunately is to just let it out regardless.

Only reading this did I remember about your nursing back ground. From the sound of it the patients you cared for they were extremely lucky to have you to look after them.

I do hope you are feeling a bit better now and if not that you soon are.

I'm trying to find my usual funny quip to finish but at mo brain seems to have gone missing.... perhaps that explains the echo I'm getting when I speak

Take great care and please remember you are truely valued here.

Bestest wishes

Geoff x

[Broken_Doll in reply to sporan]

Thanks Geoff for bringing me back down again..

Awwww sorry to hear about your father, bless his heart! I didnt treat patients any differently if they had dementia/Alzheimer's, even if they were incontinent, I would often ask if they'd like to sit on the lav/porcelain throne and sometimes they would say yes and we'd have success (obviously not all the time) but it's important they still have some choices in life (especially if they aren't that mobile and require a lot of assistance/prompting)

Often they would be terrified of being left in the bathroom, so I'd sit in there with them whilst they were doing their business! Like I've said before, I have seen pretty much everything!

I'm still feeling much the same, sadly.. I can barely walk because of the pain in my back I've had lots of seizures and I'm covered in bruises, I actually came around lying on top off knife I was carrying (and thankfully my arm just suffered a scrape!)

Hope you are doing ok?!

Emma x

Ps even the most confused/disoriented patients have fleeting moments of lucidity and people should respect that

[sporan in reply to Broken_Doll]

Hi Emma,

I did just write out a nice long reply and pressed wrong button and bingo it's disapeared into the nether world.

Sorry to hear you still suffering. Have the excluded kidney probs from the back pain and given any meds for the seizures yet?

The bit with the knife sounds real scary to me. Best keep them locked away in a box and go for the take away delivery food.

I'm OK. Tired after second of speech and verbal language assesments and got to go for third in early march. Go for follow up to neuropsyc assesment on Monday.

Guess then I'll just have to wait to see if they think the risk of biopsy is less than continued slow drop in condition. Originally they said leave well alone and don't poke the sleeping tiger with a biopsy. Now it's check all out and be prepared for biopsy, even though surgery not an option 'Even if I did awake surgery you wouldn't come out complete' the main man said. Biopsy if goes ahead, just to confirm definitely a tumour 'Very unlikely to be anything else' the main Kahuna says, then dependant on result radiotherapy. At moment nothing set in stone and this flurry of tests and assesments might be all that happens.

Just hoping all these test show it's all psycological and just need some councelling and some dope.

Just proud that the MRI scans proved all my teachers wrong.. I'm definitely NOT empty headed lol . Or as Dolly Parton once said when accussed of being a dumb blonde, "I'm not dumb and sure as hell NOT blonde".

Take care Emma and hope thing begin to improve.