Managing a Catheter at Home: What Nobody Properly Explains Before Discharge
You or your family member has been sent home from hospital with a urinary catheter in place. The nurse gave you a quick demonstration. The discharge sheet has a few bullet points. And now you’re home, facing the reality of managing a medical device that you’ve never dealt with before — with questions nobody fully answered.
This is one of the most common situations our home nursing teams encounter. Catheter care is manageable at home — but it requires specific, consistent practices. Get it right and the catheter does its job without incident. Get it wrong, and catheter-associated urinary tract infections (CAUTIs) — one of the most preventable complications in healthcare — can develop within days.
Here is the complete, practical guide your discharge summary should have included.
First: Understand What You’re Managing
A urinary catheter is a thin, flexible tube inserted through the urethra into the bladder to drain urine continuously. The most common type used at home is the Foley catheter — a balloon-tipped catheter that is held in place by a small, fluid-filled balloon inside the bladder.
The catheter connects to a drainage bag — either a larger bag worn on a stand or bed at night, or a smaller leg bag worn discreetly during the day under clothing. Understanding this system and how each component works makes daily care far less intimidating.
Long-term catheters are typically used in cases of:
- Urinary retention due to prostate enlargement or neurological conditions
- Post-surgical bladder drainage (prostate surgery, pelvic surgery, spinal procedures)
- Neurogenic bladder from spinal cord injury or stroke
- End-of-life or palliative care to maintain comfort and dignity
- Severe immobility where self-toileting is not possible
Knowing the reason for the catheter also helps you understand what “normal” output looks like — and what changes should prompt a call to your doctor.
Daily Catheter Cleaning: Step-by-Step
Cleaning the catheter and surrounding area daily is the single most important thing you can do to prevent infection. This is called meatal care — care of the urethral meatus (the opening where the catheter enters the body).
Step 1 — Wash your hands: Use soap and water for at least 20 seconds before touching the catheter, tubing, or drainage bag. This is non-negotiable every single time.
Step 2 — Gather your supplies: You will need mild soap, clean warm water, and a clean cloth or cotton wool. No antiseptics, iodine solutions, or powders unless specifically prescribed.
Step 3 — Clean the insertion site: Gently clean around the catheter where it enters the body, moving away from the body (not towards it) to avoid introducing bacteria toward the bladder. For women, clean front to back. For men, clean around the tip of the penis and along the catheter.
Step 4 — Clean the catheter tubing: Wipe a few centimetres of the catheter tube that exits the body, again moving away from the body. Do not pull or manipulate the catheter while cleaning.
Step 5 — Dry gently: Pat the area dry with a clean cloth. Moisture around the insertion site encourages bacterial growth.
Step 6 — Wash hands again: Always wash hands after completing catheter care, before doing anything else.
This routine takes about 5 minutes and should be performed once daily — typically during the patient’s morning wash or bath routine. After any bowel movement, the area around the catheter should be cleaned again, as faecal bacteria are a major source of CAUTI.
Managing the Drainage Bag
The drainage bag is where most care errors happen — and where infection risk is highest if handled incorrectly.
Position is everything: The drainage bag must always be kept below the level of the bladder. Urine drains by gravity — if the bag is at the same level or higher than the bladder, urine can flow backward into the bladder, carrying bacteria with it. When the patient is lying down, the bag should hang at the side of the bed. When sitting or walking, a leg bag should be used and secured below the knee.
Never let the bag touch the floor: The floor is heavily contaminated. If the bag brushes the floor and then urine flows back through the tubing, the contamination follows. Keep the bag secured at all times.
Empty regularly: The drainage bag should be emptied when it is about half to two-thirds full — never allow it to fill completely, as this creates backpressure. Use a clean container each time. Open the drain valve, empty fully, close the valve, and wipe the valve tip with a fresh alcohol swab. Never allow the valve tip to touch any surface.
Changing the bag: The catheter and drainage bag should be changed only by a trained healthcare professional, on the schedule recommended by your doctor — typically every 5–7 days for leg bags and every 7 days for night bags. Never attempt this yourself unless you have been specifically trained.
Hydration: The Simplest Protection Against Infection
Adequate fluid intake is one of the most effective — and most overlooked — strategies for preventing catheter-associated infection.
When the patient is well hydrated, urine flows steadily through the catheter and drainage system, continuously flushing bacteria before they can establish themselves in the bladder. Concentrated, low-volume urine — the result of poor hydration — is a significantly higher infection risk.
Unless your doctor has specifically restricted fluid intake (as may be the case with certain kidney or heart conditions), aim for 2–3 litres of fluid daily. Water is ideal. Coconut water, diluted juices, and soups all count. Caffeine and alcohol are mildly dehydrating and should not substitute for water intake.
Monitor the urine in the drainage bag. Pale yellow and clear is the goal. Dark yellow or amber suggests dehydration. Cloudy, malodorous urine with sediment suggests possible infection — contact your doctor.
Do’s and Don’ts of Catheter Care at Home
| ✔ Do’s | ✘ Don’ts |
| ✔ Wash hands thoroughly before touching the catheter or bag | ✘ Don’t pull or tug on the catheter — it can cause injury |
| ✔ Clean the catheter insertion site with mild soap and water daily | ✘ Don’t let the drainage bag touch the floor |
| ✔ Keep the drainage bag below bladder level at all times | ✘ Don’t allow the drainage tube to kink or loop below the bag |
| ✔ Empty the drainage bag when it is half to two-thirds full | ✘ Don’t disconnect the catheter from the drainage bag unnecessarily |
| ✔ Drink 2–3 litres of water daily unless advised otherwise | ✘ Don’t use powders, creams, or antiseptics around the insertion site unless prescribed |
| ✔ Secure the catheter tubing to the thigh to prevent tugging | ✘ Don’t place the drainage bag on your lap — keep it below waist level |
| ✔ Use a separate, clean container each time you empty the bag | ✘ Don’t ignore blood in urine, cloudy urine, or strong odour |
| ✔ Keep a log of urine output, colour, and any changes | ✘ Don’t restrict fluids unless your doctor has specifically advised it |
| ✔ Attend all scheduled follow-up appointments | ✘ Don’t attempt to change or reinsert the catheter yourself |
| ✔ Call your doctor if you notice any warning signs | ✘ Don’t use public restrooms to empty the bag without sanitising first |
Recognising Catheter Complications: Warning Signs You Cannot Ignore
Even with perfect care, complications can develop. Knowing the warning signs — and acting on them quickly — is as important as the daily care routine itself.
Catheter-Associated Urinary Tract Infection (CAUTI): The most common complication. Signs include cloudy or foul-smelling urine, fever (above 38°C/100.4°F), chills, increased burning or pain at the insertion site, confusion or sudden agitation (especially in elderly patients), and lower abdominal pain. CAUTIs require prompt antibiotic treatment — do not attempt to manage with home remedies.
Blocked catheter: If urine output suddenly stops or reduces significantly but the patient does not feel the urge to void, the catheter may be blocked by sediment, blood clots, or kinking. Check the tubing for kinks first. If no kink is present and output remains absent, call your healthcare provider — a blocked catheter can cause bladder distension and significant discomfort.
Leakage around the catheter: Some leakage around the catheter is common initially. However, persistent leakage, especially accompanied by pain, may indicate catheter bypass (where urine leaks around rather than through the catheter), a displaced balloon, or bladder spasms. Report this to your doctor.
Blood in urine (haematuria): Light pink discolouration of urine after insertion or catheter change is common and usually resolves. Bright red blood, blood clots, or haematuria that persists beyond 24 hours requires medical assessment.
Catheter falls out: Do not attempt to reinsert a displaced catheter. Cover the area, keep it clean, and contact your doctor or home nursing team immediately.
Catheter Care for Bedridden Patients: Additional Considerations
For patients who are fully or partially bedridden, catheter care requires extra attention to a few additional factors.
Skin breakdown around the catheter site is more common in immobile patients. Keep the skin around the insertion site clean, dry, and regularly inspected. Any redness, swelling, or skin breakdown should be reported to your nursing team.
Repositioning the patient every 2 hours (standard practice for pressure sore prevention) must account for the catheter and drainage bag — ensure the tube is never pulled or compressed during repositioning. Designate which side the catheter exits and build repositioning protocols around it.
Bowel management is critical. Constipation in catheterised patients can compress the bladder and affect catheter drainage. A high-fibre diet, adequate hydration, and regular bowel routines are important components of overall catheter management.
Daily Safety Checklist — Print and Use
Use this checklist daily to ensure catheter care is complete and consistent. It can be maintained by the patient, a family caregiver, or a home nursing professional.
| Checklist Item | Frequency | Done ✓ |
| Hands washed before touching catheter or bag | Every contact | |
| Catheter site cleaned with mild soap and water | Once daily | |
| Drainage bag positioned below bladder level | Always | |
| Drainage bag emptied | When half–two-thirds full | |
| Urine output and appearance logged | Daily | |
| Fluid intake met (2–3 L unless restricted) | Daily | |
| Catheter tubing secured to thigh | Check twice daily | |
| No kinks or loops in drainage tubing | Check twice daily | |
| Catheter and bag connection intact | Daily | |
| No signs of infection checked (redness, discharge, fever) | Daily | |
| Bag and tubing changed as per schedule | Per doctor’s advice | |
| Follow-up appointment confirmed | Weekly/as scheduled |
When to Call a Doctor — and When to Call Us
Call your doctor or home nursing team immediately if:
- The catheter has come out or appears displaced
- Urine output has stopped for more than 2–3 hours despite adequate fluid intake
- You notice bright red blood or blood clots in the drainage bag
- The patient develops fever, chills, or sudden confusion
- There is significant pain, swelling, or redness at the insertion site
- Urine becomes cloudy, dark, or strongly foul-smelling
- There is persistent leakage around the catheter
Go to the emergency department if the patient has severe abdominal pain, is unable to be roused, has a very high fever (above 39.5°C), or shows signs of sepsis — rapid breathing, low blood pressure, extreme confusion.
At Doctor at Door, our trained home nursing team provides comprehensive Foley catheter care — including scheduled catheter changes, daily meatal care, drainage bag management, infection monitoring, and caregiver training. We work with patients across all age groups and conditions, and we coordinate directly with your treating physician. If you or your family member is managing a catheter at home and you want a qualified professional involved in the care routine, reach out to us — we come to you.
The Bottom Line
Catheter care at home is not complicated — but it is unforgiving of inconsistency. The daily routine of hand hygiene, meatal cleaning, drainage bag management, and hydration forms the foundation of safe, infection-free catheter use. The do’s and don’ts are not arbitrary — each one exists because it directly affects the risk of a preventable complication.
The most important thing a caregiver at home can do is stay observant. Know what normal looks like. Know what changed. Know when to call for help. And have a professional nursing team on call when you need one.
Frequently Asked Questions
How often should a Foley catheter be changed?
For long-term use, most Foley catheters are changed every 4–6 weeks by a healthcare professional. Never attempt to change or reinsert a catheter at home without proper training and a doctor’s instruction.
How do I know if my catheter is infected?
Signs of catheter-associated urinary tract infection (CAUTI) include cloudy or foul-smelling urine, fever above 38°C, chills, increased pain or burning around the insertion site, and blood in the urine. Contact your doctor immediately if these appear.
Can I shower or bathe with a urinary catheter?
Yes. You can shower with the catheter in place. Keep the drainage bag secured and below waist level. Gently clean around the catheter insertion site with mild soap and water. Avoid soaking in a bathtub unless your doctor has cleared this.
What colour should catheter urine normally be?
Normal catheter urine is pale yellow to amber and clear. Dark yellow may indicate dehydration — increase fluid intake. Red or pink urine may suggest bleeding. Cloudy urine with sediment or odour often signals infection. Report any concerning changes to your doctor.
Is it normal to feel discomfort with a catheter?
Mild pressure or the sensation of needing to urinate is common, especially initially. Sharp pain, significant burning, or cramping is not normal and should be assessed by a doctor. Discomfort that worsens over time, rather than settling, always warrants a call.
Disclaimer: This information is for educational purposes and does not replace personalised medical advice. Catheter care should always be performed under the guidance of a qualified healthcare professional. Always consult your doctor or nursing team for guidance specific to your condition.
