How to Prevent Someone with Dementia from Pulling Out a Urinary Catheter

It's not uncommon for individuals with dementia to pull at their catheters, which can lead to injury and complications. Here we will discuss some practical strategies to help prevent this distressing behavior, ensuring both the safety and comfort of your partner. Although it may be tempting, it’s important to avoid reacting with heightened responses, such as yelling, fussing, or smacking their hand, as these can escalate the situation and increase their discomfort.

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Understand the Reason

First, it’s essential to understand why your partner might be pulling at their catheter. Common reasons include:

• Discomfort or pain: The catheter may be causing physical discomfort or pain.
• Irritation: The area around the catheter may be irritated or their could be infection present.
• Confusion: Your partner may not understand what the catheter is for or that it is attached to their body.

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Strategies to Prevent Catheter Pulling

‍Ensure Proper Catheter Care:

Regularly check the catheter to ensure it's not causing irritation or discomfort, that it's draining properly without any kinks in the line, and consult healthcare professionals to confirm it's correctly positioned, functioning as intended, and free from infection.

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Secure the Catheter Properly:

Consult the physician or nurse for guidance on properly securing the catheter. Ensuring the catheter is securely fastened can make it harder for your partner to pull it out. Use skin-friendly adhesive tapes and avoid securing the catheter too tightly, as this could cause discomfort and increase the likelihood of tampering.

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Use Distractions:

Engage your partner in activities they enjoy, such as simple puzzles, fidget toys, or purposeful repetitive tasks like folding towels, matching socks, or sorting objects by color or shape, to keep their mind and hands busy. If they are pulling at the catheter due to confusion or sensory-seeking behavior, consider using a decoy catheter—a harmless, non-functional device placed over their clothing or nearby, allowing them to touch, play with, or remove it without risking the actual catheter. The goal of these distractions is to shift their focus away from the catheter.

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Create a Calm Environment:

Creating a calm and soothing environment can help reduce agitation in individuals with dementia, potentially decreasing their inclination to tamper with medical devices like catheters. To achieve this, ensure the living area is clutter-free to avoid confusion and maintain a serene atmosphere. Keep noise levels low, as loud or sudden sounds can be startling or distressing. Consider introduce soft background music or nature sounds that your partner enjoys, which can have a calming effect and distract from discomfort. Additionally, consider using mild aromatherapy with essential oils like lavender, being cautious with the intensity to avoid overwhelming the senses.

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Consider Clothing Adjustments:

Use clothing that limits access to the catheter and keeps it out of sight, such as specialized garments designed for catheters, long pants or tights, or adaptive clothing with back closures, hidden zippers, or hard-to-reach buttons. These features help prevent access to the catheter, reducing the risk of tampering. This can be especially helpful at night when you partner may not be supervised. Just ensure the clothing is comfortable and does not promote additional irritation.

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Now, you might come across mitts recommended online or in support groups as a way to prevent catheter tampering. However, mitts are considered a form of restraint, which should always be a last resort. Before resorting to any restraint, such as mitts, it's crucial to thoroughly investigate and address potential underlying issues like pain, discomfort, or infection. Whenever possible, we should avoid restricting individuals with dementia from using their hands in meaningful and engaging ways.

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Increase Monitoring:

Closely supervise high-risk patients, especially during the night. If feasible, consider hiring a sitter for those at very high risk to ensure continuous monitoring. For professional senior care sitters, you can find qualified individuals through online caregiving platforms such as care.com or goinstacare.com.

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Seek Help

If your partner continues to attempt removing their catheter despite these strategies, consult their healthcare provider for further evaluation. The provider can determine if adjustments are needed or if alternative management methods might be more suitable. If the catheter is pulled out, seek immediate medical assistance by contacting the doctor or nurse right away, or visit your local emergency department to address any potential injuries and to ensure the catheter is properly reinserted if needed.

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For additional support in managing toileting challenges, consider joining our "Tackling Toileting Challenges" mini course, available with a Paw Pass to the Treehouse—our all-in-one dementia care resource library. This comprehensive 5-module course equips caregivers with essential knowledge and practical strategies for effectively addressing toileting issues in dementia care. It covers everything from understanding common incontinence problems to creating supportive environments and managing challenging behaviors. Empower yourself with the tools and insights needed to provide the best care possible.

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Already a Treehouse member? Click here to access the mini course. Paw Pass members will have immediate access, while House Pass members will be prompted to upgrade for access.

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Not a Treehouse member yet? Learn more about the Paw Pass and the Treehouse here and join us today!