My 78yo mother lives independently. Her typical day includes some light housekeeping, binge-watching tv, and eating. She cooks and eats healthy most of the time (she shops for herself and I take her shopping regularly) but snacks on potato chips and orders takeout fairly often. Every few months, I get a frantic call from her requesting a ride to the ER because her catheter is clogged. I order her ride and rush to meet her at the hospital, where she suffers extreme pain, unable to sit, in a packed waiting room while I beg for her to get seen ASAP. Eventually, she gets taken to the back and her catheter gets replaced. Crystals in her urine are the typical cause of the clogging, which she attributes to her salt intake. She says she is cutting back on salt but she is self-unconscious and super secretive about her eating (not because I ask or lecture - I don't), so I can't rely on what she tells me. These ER visits are stressing me out - they can happen at any time, I hate seeing her suffer like that, and I feel they could be prevented with more mindful eating. I'm tempted to arrange for her rides next time but not go and let her deal with it herself. Maybe she will get serious about her diet then. She recently told me this sometimes happened years ago, and she would go to the hospital herself, so it would not be a totally new thing. I just started being involved with this situation in the last couple of years.
Does she have dementia?
I see from another question that you were going to talk to her urologist. What did s/he say?
Maybe adult incontinence briefs would be a better idea?
Call the urologist and have a discussion to be initiated by her/him at an appointment that you schedule for soon.
It is clear that YOU cannot keep doing this.
"Emergencies" are things that are unavoidable. This is an avoidable problem.
"mom, I can't do this anymore" was the hardest conversation I ever had with my mom. But it was honest, necessary and prevented much resentment and difficulty down the road.
Rather than taking away one of life's remaining pleasures I would look beyond her diet for solutions. For example my focus might be - why does she need an indwelling catheter? Would simply increasing her fluid intake help to alleviate her problems? Or can she be taught to flush the catheter herself?
Also, you are on the right track about getting someone else to take her to the ER. Find someone you can pay to do it. Otherwise you’ll be her jumping frog from now on until it’s over.
Have you done so?
You cannot continue to be your mother's only solution to these crises. Someone suggested that you pay for her to get a ride to the ER. Make that be from HER funds.
What is the eventual plan for when your mother cannot live independently any longer?
"The following are the most common types of crystals found in the urine:
Uric acid crystals: Can vary in size and shape, but tend to look like rhomboids or parallelograms. ...
Calcium oxalate crystals: Found in acidic, neutral, or alkaline urine. ...
Triple phosphate crystals or struvite stones: Form in alkaline urine and composed of magnesium, ammonium, and phosphorus.........................."etc.
So the internet is your best friend. Just look up "crystals in urine".
Now on to a question: Why does your Mom, at the tender age of 78, have an indwelling catheter? I am 81, and quite active, but I admit to being an addict in the asles at Trader Joe's. OMG! Those Old-Fashioned Potato Chips! And no one at the ER told your mom her electrolytes are out of balance. No one mentioned high sodium. They only said "crystals". Do you know if mom told her "catheter doc" about her ER visits? There may be a hydration problem here. Mom may need to learn to flush her catheter with sterile saline, a very simple procedure.
I am sad Mom has decided to sit down and watch TV. It will do her entire body from joints to bones to weight to BP and heart and everything else no favor, to say nothing of mind. But that's up to her. I doubt that her occ. bag of chips is what's causing her problem.
As with all medical problems this old nurse always advises "Take Thee to a Doctor". And have Mom see the doc who placed the indwelling catheter. I sure do wish you the very best of luck.
Now I shudder to think of my daughter coming for my blue and gold bag of Trader Joe's chips!
Something like "sorry, mom, but if refuse to get scheduled medical attention for this catheter problem, I can't participate in these emergencies any longer. Let's work together with a doctor to get to the bottom of this the way a person as smart as you would."
My DH and I eat out alot then I get tired of it. Well this is the week I got tired of it and have been cooking. I have lost 1 1/2 lbs I am sure is water weight. I add no salt when boiling noodles. No salt on FF when out. No canned soups. Hotdogs (I do have an occasional one), or canned veggies. Even baked beans are very high in salt. Chinese food, frozen dinners and lunchmeat a lot of salt. Mom has to be a label reader. The average person is only suppose to have 2000mg a day. That's a teaspoon of salt. A serving of potato chips (13) is 170 mg. Almost 1/5 of what the average person is suppose to have daily. Your Mom does not seem to be on the average level.
So what I found out is eating out and take out means a higher level of salt in what I eat. Cooking at home is better because I can control it. And those potato chips Mom eats...should be a treat not an everyday thing. Me, the last place I would want to be is at the ER, all the time, knowing I could prevent it by just changing my salt intake. Your Mom should probably be drinking more water to flush out some of the salt.
https://pubmed.ncbi.nlm.nih.gov/24635559/
It's your MOM who is attributing this to salt intake, right?
Do you accompany her to the treatment room to hear what the DOCTOR says about it?
I started accompanying my mom to the doctor's office when she stopped driving. I discovered that what she thought the doctor said and what he ACTUALLY said were two very different things.
I have no doubt that the ER discharge instructions say "follow up with your primary within 30 days".
Had she done that?
This sounds just AWFUL for the patient.
The OP may want to print this article out, and wave it at the doc. Ugggh. 🤦🏻♀️
No ER doc was able to figure it out. I was the one to figure it out, and EVENTUALLY the urologist agreed.
Salt MAY not be the culprit here.
I would make sure that Mom has a note taker at all appointments.
I too agree with Alva. When I used to work as a technician in an emergency animal hospital part of my job was doing urinalysis's. The different types of crystals can usually be fairly easy to tell apart with proper technique under a microscope to a trained eye. I don’t know how human hospitals do their urinalysis but I wouldn’t be surprised if they had a machine to do it. It may be worth asking about that like everything else these days. Personally I have not heard of salt specifically causing stones, but then again I haven’t worked in human medicine. Human ERs may not deal with urinary blockages often enough to have the expertise and experience with types of stones. They also usually rely on being able to pass cases on to specialists the next day, or refer someone to a specialist and address only the acute issue in emergencies. They don’t follow up on the causes.
If that has not been done I would do that.
Honestly though if this is the cause...
and she knows it is the cause....
and she continues to make the decision to eat foods high in salt content
this is her decision and she is fully aware of the Cause and Effect there is not much you can do other than have someone there that will monitor her salt intake.
Obviously the 2 (ok, 4) ways to do that are...
1.) Mom has caregivers that will monitor but unless they are there 24/7 there is no telling what she will do when they are not there.
2.) Mom moves to Assisted Living or Independent Living where her diet can be monitored. But again in both IL and AL people can shop and eat what they choose.
3. and 4) She moves in with you or you move in with her so that her diet can be monitored. both of these are said with tongue firmly planted in cheek.
Indwelling catheter maintenance is usually managed by specialist nurses. That's who your mother should contact in case of emergency, and I don't believe either that she gets no notice when things are in need of attention.
Anyway, bottom line - not your responsibility, hers, and it is in her best interests that you encourage her politely but firmly to deal with it more methodically and logically than this. Maybe start by praising and agreeing with her general rule of self-sufficiency.
As for your rushing to the ER to wait with her, that's up to you. If you or someone else drives her there, she will wait her turn in the waiting room, sometimes for a long time. If she requires an ambulance ride, she might be seen mote quickly. Catheter maintenance should not be a repeated ER problem. Your tough love may be better employed in getting her to doctors who will diagnose the problem or in arranging catheter maintenance appointments for her if she is not doing an adequate job of this herself.
* If she is able to function well enough in ind living, she makes a choice on how to eat / dietary needs, etc. and pays the consequences. As you say here "maybe she will get serious about her diet then." I believe that the odds are she will not.
* If I were you though - I might try ONE POSSIBILITY ... replace the salt in her shakers with something else that looks like salt. ... or light salt ? There is little to nothing you can do if she orders take out / eating heavy salt ladened foods.
* Often our options are limited even though we do EVERYTHING we can to support / help. As I see it, the change that needs to happen is with you:
1. Tell her you will not be available to manage emergency calls / visits / etc. She will be on her own.
2. Learn to set boundaries, knowing it will be hard ... tug at your emotional and psychological heartstrings. And, yes: Tough love ... for your own quality of life/health needs, and hers.
* Have you considered she might:
- need more caregiver assistance / for meal prep
- move into assisted living or elsewhere with more care / supervision
You need to decide what changes you will make.
The rest will be up to her.
And, realizing this is the hard part. Letting go.
Gena / Touch Matters (and Tough Love matters)
I found this info about catheters that might help you:
https://www.health.qld.gov.au/__data/assets/pdf_file/0026/427508/catheter-blockage.pdf
Hopefully our OP will return and update us. I am amazed that after irrigating the catheter in ER and hearing his story that no one changed it. They have a lifetime. The often need sterile saline flushing.
Also, https://dashdiet.org/
https://www.canr.msu.edu/news/lower_your_salt_and_sodium_intake_with_spices_and_herbs#:~:text=Try%20adding%20curry%20powder%2C%20garlic,be%20kept%20for%20one%20year.