Children start when they’re ready, and that varies. I saw a child yesterday who was six who’s been doing it for a year with no trouble, and I saw another child who was ten who still hasn’t really gotten it. It really depends on the child, on the family dynamics, on how many children a family has, what the parents do, how much they work, if they both work, is there a caregiver, is there not, is it day care? A lot of factors come into play, and it’s the whole family dynamic, their extended care providers, and the children themselves that determine when a child can do it. Some kids are self-starters and some aren’t – that’s okay. I just have to work with them, but eventually they get it. Certainly by adolescence, it’s the exceptional adolescent that still is not doing it.

Carlos Estrada, MD, Myelodysplasia Program, Department of Urology

 

With the older kids, there’s usually a period when the family will do it initially or help or be there, but soon after the kids pick it up. If they buy in and pick it up, they become pros, they do it better or as good as anybody! It’s always good when you see a kid and say, “I want to cath you and see…” and they’re like, “Nope! I’ll put the catheter in.” Because they know exactly how to do it, they know their body, they know exactly how they like it, and they can do it. Great! That’s what you want to happen.

I just had a 13 year old girl come back, and I don’t think the mom has ever cathed her once since she started. She’s been doing it all on her own, and she’s done very well. Sometime after the age of five, maybe to the age of seven, kids just need reminders, or they might need help dexterity-wise. But soon after that, they’re good to go! They may need reminders to do it, but the actual act of catheterizing, they’re usually good to go.

Richard Lee, MD, Department of Urology

 

It depends on developmentally where they are. Many times the tweens don’t want to be taught. They want their parent to learn, and then once they get home they’ll take it over. Once they realize that, “This is okay, and this is going to work, and now I’m dry in between cathing, and things are working better…” they’ll see an improvement and then they might start taking it over themselves. So that’s why I don’t push the kids – a lot of the time they’ll go ahead and start picking it up once they get home.

Then if you have the children with myelodysplasia who’ve been cathed since birth, at like five, six years old, they’re ready to learn themselves. Sometimes the parents say, “We’ve been doing this and I now want them to learn how. Can I bring them in and can you teach them how to catheterize themselves?” And we do that too, when parents aren’t quite sure exactly how to explain to the child how to cath themselves.

Diane Manning, RN, Department of Urology