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HarvardCare at Home 
Wound Care
An indwelling urinary catheter — commonly called a Foley catheter — is a medical device that drains urine from the bladder through a thin, flexible tube into a collection bag. Millions of patients are discharged from hospitals each year with catheters in place, and managing this device at home can feel intimidating, especially for patients and caregivers who have never dealt with one before.
The primary concern with any indwelling catheter is infection. Catheter-associated urinary tract infections (CAUTIs) are among the most common healthcare-associated infections, and the risk increases the longer a catheter remains in place. Proper catheter care at home is essential to reduce infection risk, prevent complications, and maintain comfort. This guide covers everything patients and caregivers need to know.
Understanding Your Catheter System
A standard indwelling catheter system consists of three main components. The catheter tube is a flexible, sterile tube inserted through the urethra into the bladder. A small balloon at the tip is inflated with sterile water to hold the catheter in place inside the bladder. The drainage tubing connects the catheter to the collection bag. This tubing should remain free of kinks and loops that could obstruct urine flow. The collection bag comes in two types: a larger bedside drainage bag used at night and a smaller leg bag used during the day for mobility.
Understanding how these components connect and function helps you troubleshoot common issues and maintain the system properly between nurse visits.
Daily Catheter Hygiene
Maintaining cleanliness around the catheter insertion site is the single most important thing you can do to prevent infection. Follow these practices every day.
Wash your hands thoroughly with soap and water before and after touching the catheter, drainage tubing, or collection bag. This is non-negotiable — hand hygiene is the number one defense against introducing bacteria into the system.
Clean the catheter insertion site at least twice daily — during your morning hygiene routine and again before bed. Use mild soap and warm water. For women, clean the area around the urethra from front to back to avoid introducing rectal bacteria. For men, if uncircumcised, gently retract the foreskin, clean around the catheter, and replace the foreskin to prevent constriction. After cleaning the insertion site, wash approximately four inches of the catheter tube extending outward from the body, using gentle downward strokes away from the body. Never push the catheter inward during cleaning.
Shower daily if you are able — showering with a catheter in place is safe and encouraged. Bathing in a tub is generally not recommended while a catheter is in place because sitting in water increases the risk of bacteria entering the system.
Drainage Bag Management
Proper bag management prevents urine from flowing backward into the bladder, which is a major infection risk.
Always keep the bag below bladder level. This is the cardinal rule of catheter care. Whether you’re lying in bed, sitting in a chair, or walking with a leg bag, the collection bag must be lower than your bladder at all times. Urine flows by gravity — if the bag is raised above your bladder, urine can flow backward through the tubing and carry bacteria with it.
Empty the bag regularly. The drainage bag should be emptied when it reaches about two-thirds full — never allow it to become completely full, as the weight can pull on the catheter and cause discomfort or trauma. To empty the bag, wash your hands, place a clean container beneath the drainage spout, open the spout without touching it with your fingers or allowing it to touch the container, drain the urine, close the spout securely, and wash your hands again.
Switch between bags appropriately. During the day, many patients use a smaller leg bag that attaches to the thigh or calf with straps, allowing mobility and discretion under clothing. At night, switch to the larger bedside drainage bag, which holds more urine and doesn’t need to be emptied during the night. When disconnecting and reconnecting bags, clean the connection point with an alcohol swab before attaching the new bag.
Clean drainage bags daily. When a bag is not in use (the leg bag at night, the bedside bag during the day), rinse it with a mixture of one part white vinegar to three parts water, then drain it and allow it to air dry. Replace bags according to your nurse’s instructions, typically every one to two weeks.
Securing the Catheter to Prevent Trauma
An unsecured catheter can move, pull, or tug — causing pain, urethral trauma, and increased infection risk. Always secure the catheter tubing to your body.
For women, secure the catheter to the inner thigh with a catheter strap or medical tape, leaving a small loop of slack so the tubing doesn’t pull when you move. For men, secure the catheter to the upper thigh or lower abdomen, again with enough slack to allow comfortable movement. Check the securing device regularly. Adhesive tape can loosen with moisture, and straps may shift during activity. The catheter should feel secure but not tight.
Recognizing Signs of Catheter-Related Infection
Despite proper care, infections can still develop. Knowing the warning signs allows you to seek treatment early, before a urinary tract infection progresses to a more serious condition like a kidney infection or sepsis.
Contact your home health nurse or physician immediately if you notice fever of 100.4°F (38°C) or higher, which is the most reliable sign of infection. New or worsening pain in the lower abdomen, back, or sides. Urine that appears cloudy, dark, bloody, or has an unusually foul odor. Sudden decrease in urine output despite adequate fluid intake. Burning or pain around the catheter insertion site. New confusion or agitation in elderly patients, which can be the primary sign of a urinary infection in seniors. Chills or shaking.
If you experience fever with chills, confusion, or signs of severe illness, seek emergency care. A urinary infection in a catheterized patient can progress rapidly.
Common Catheter Problems and Troubleshooting
No urine draining into the bag is a common concern. Before calling your nurse, check for kinks or bends in the tubing, ensure the bag is below bladder level, verify that the drainage spout is closed (urine won’t flow if it’s leaking from the spout), and check that you haven’t been lying on the tubing. If none of these resolve the issue, contact your home health nurse. A blockage from blood clots, sediment, or catheter malposition may require professional intervention.
Urine leaking around the catheter can indicate the catheter is blocked (urine bypasses the blockage and leaks around the catheter), the catheter balloon has partially deflated allowing the catheter to migrate, or bladder spasms are pushing urine around the catheter. Report persistent leaking to your nurse.
The catheter falls out. If the catheter comes out, do not attempt to reinsert it. Cover the urethral opening with a clean gauze pad, call your home health nurse or physician immediately, and if you cannot urinate on your own and feel increasing bladder pressure, seek urgent care.
Blood in the urine may occur after catheter insertion, after a catheter change, or due to irritation. Small amounts of blood that clear quickly are usually normal. Persistent or heavy bleeding should be reported to your nurse.
Fluid Intake and Catheter Care
Adequate hydration is essential for catheter patients. Drinking enough fluids keeps urine flowing, which helps flush bacteria from the bladder and prevents sediment from building up in the tubing.
Unless your physician has placed you on a fluid restriction (common for heart failure patients — talk to your nurse about balancing these needs), aim for six to eight glasses of water daily. Cranberry juice has traditionally been recommended for urinary health, but evidence for its effectiveness in preventing catheter-associated infections is mixed. Focus on plain water as your primary fluid source.
How Long Will You Have a Catheter?
The duration of catheterization depends on the reason it was placed. Post-surgical catheters are often temporary, remaining in place for days to weeks while you recover. Catheters placed for urinary retention may be needed longer, depending on whether the underlying cause is reversible. Some patients with chronic conditions require long-term or permanent catheterization.
Regardless of the reason, the goal is always to remove the catheter as soon as medically appropriate, because infection risk increases with every day the catheter remains in place. Your home health nurse will communicate with your physician about catheter removal timing and can perform the removal at home when your doctor gives the order.
How Skilled Nursing Supports Catheter Patients at Home
A skilled nurse visiting your home provides several services that go beyond what you can do on your own. The nurse performs sterile catheter changes when needed, typically every four weeks for long-term catheters. The nurse assesses for signs of infection, urethral erosion, or other complications at each visit. The nurse trains you and your caregiver in proper catheter hygiene, bag management, and troubleshooting. The nurse monitors your urine output and characteristics, reporting changes to your physician. And the nurse coordinates catheter removal with your physician when appropriate.
Learn more about our catheter care at home services. Our skilled nurses also provide comprehensive care for patients with PICC lines, ostomies, and complex wounds — all managed at home through coordinated skilled nursing services.
Getting Catheter Care at Home in Los Angeles
If you or a loved one has been discharged with a catheter and needs skilled nursing support at home, HarvardCare at Home can help. We serve Medicare and Dual Eligible patients throughout Los Angeles County, including Glendale, Pasadena, Burbank, Long Beach, Santa Monica, and 97 communities across LA County.
Contact us at (323) 484-4440 to verify your Medicare coverage and schedule your first skilled nursing visit. We can typically begin services within 24 to 48 hours of your physician’s order. Read more about what to expect during your first home health visit.
