My father is 90 years old - hard of hearing - dementia - nursing home.
When he hears his old time gospel music and songs of his day, he
lights up, sings along and tears of gratitude run down his face.
I had an old audio tape recorder with an auto-reverse playback that
could run continuously so that every time he put on the earphone
headset, there was "his music."  Of course, the tape recorder broke
and cannot be fixed or replaced.

He is too far into dementia to work a CD player or even recognize that
there is music on those round things.  He cannot work a tape recorder,
flip over tapes or even remember that this is where the music comes
from.  He just remembers to put on the headset earphones and now. . .
. there is no music there.

Question:  How do I find something to put his music on - that I can
just load from CDs, something that once loaded, I can plug in his
earphone headset and just start his music playing, starting and the
beginning and playing, then replaying again and again.  Of course, I
would like this to plug into the wall. 

Are there any MP3 players that are extremely simple, have the
capability to plug in to the wall and just play over and over again
everything that is loaded, from start to finish and then starting over
again?  There is no need for any song selection feature.  Size does
not matter. . . in fact, the larger the better because it probably
will not be stolen from the nursing home.

If an MP3 player is not the answer. . . could any of you give me some
suggestions?  I would love to give him back "his music" since
everything else is downhill for him.  Thanks guys

Hi, Carolyn!

My recommendation is the Archos Jukebox Recorder 20, which not only
plays MP3 audio files, but (unlike most other devices) makes recording
the files very easy. You can record music from any audio source (such
as a CD player, radio, or cassette player) without using special
software. You don't even need a computer. The device operates on
batteries or (with an AC adapter) on house current.

From the Archos site:

"The ARCHOS Jukebox Recorder 20 is the first, portable MP3 recorder
with a 20GB Hard Disk that is also compatible with USB 2.0. It
provides the awesome capability of recording directly from any audio
source - real-time, on-the-fly recording of up to 300 hours (500 audio
CD's* - 5000 songs*) of top quality music in MP3 format. You can
record direct from a stereo, CD player radio, or microphone via the
stereo, line-in jack without needing to use a computer. It is also a
voice recorder with a built-in microphone. You can record from any
analog or digital sources at bit-rates up to 160 kbps and can port
your recordings back to the PC without any specialized software. This
exciting new Jukebox Recorder/Player is the first palm-sized,
real-time MP3 encoder, plus an MP3 Player and 20GB Hard Disk that
connects to the computer through an ultra-fast USB 2.0 interface.
There's no need for special software to download MP3 songs."

Archos: Jukebox Recorder 20
http://www.archos.com/products/prw_500277_specs.html

There are products which are capable of storing more songs, but I
doubt that you'll exhaust the capacity of the 20GB Archos. The ability
of the Archos product to record directly from a CD player makes it so
simple to use that you won't get bogged down learning how to make your
own MP3 files; you'll be able to get the music right to your dad
without first spending a ton of time figuring out a lot of technical
mumbo-jumbo.

A friend of mine bought one of these so that she could play music in
an endless loop in a small shop that she owns. She liked it so much
that she bought another one to play background music in her home. She
sets it on "Random Play," so that she never knows what song will come
next, and just leaves it going 24 hours a day, playing through a
stereo in the family's den.

Here you'll find a review of the Archos Jukebox Recorder 20:

CNET: Archos Jukebox Recorder 20
http://reviews.cnet.com/Archos_Jukebox_Recorder_20/4505-6490_7-8408812-2.html?tag=review

Google search strategy:

Google Web Search: "archos jukebox recorder 20"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=%22archos+jukebox+recorder+20

I hope this will meet your needs exactly! If not, please let me know,
and I'll try again. If you decide to purchase the device, I'll be glad
to do some price-comparison searches to help you find a good deal.

Best wishes to you and your dad. And bless you for caring enough to
provide him with some beautiful music to make his days brighter.

~Pink

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Clarification of Answer by pinkfreud-ga on 27 Oct 2003 13:30 PST

Carolyn,

I'm beginning to research your question about super pubic catheters
and their effect on urinary infections right now. Once I've gathered
some useful information for you, I'll post it as a clarification to
this question.

Having taken care of my elderly father in his latter years, my heart
is with you. To provide a few simple pleasures and lessen the pain and
distress of a parent can be immensely difficult, particularly when the
parent is not in his right mind. But the payoff of an old man's
beatific smile can sure make it worthwhile.

~Pink

---

Request for Answer Clarification by schmooz-ga on 27 Oct 2003 13:46 PST

Thanx Pink for taking the other question. . . one more thing. . . you
offered some price comparisons on that Archos. . don't spend a lot
more of your time but if you do know how to find a good price, I would
really appreciate it.
C

---

Clarification of Answer by pinkfreud-ga on 27 Oct 2003 15:00 PST

> Dad has been self catheterizing for years - many Urinary tract 
> infections which is putting him deeper in dementia every time.  
> I have heard about a super pubic catheter which is a day surgery.  
> I have tried and tried to find out about this procedure but have not
> been able to find anything out. My question:  Can you help me 
> find out about this procedure - what it is - opinions about 
> whether it lessons uti infections? 

There is evidence that men with suprapubic catheters have fewer
infections than men with urethral catheters. Here's an excerpt from an
excellent article published on a British medical site. I suggest that
you read the entire article. It's very informative.

"Two studies were identified in our search which compared catheter
options. The first focussed on the risk of Methicillin-resistant
Staphylococcus aureus (MRSA) colonisation and infection in nursing
home patients. This study concluded that indwelling catheters posed a
greater risk of infection than intermittent catheters. The second
studied men with prostatomegaly and reported a significantly lower
rate of infection in those with suprapubic rather than urethral
catheters, despite the former being used for two weeks longer. A
non-comparative study of patients with neuropathic bladder
demonstrated a low rate of infection (6 percent) associated with the
use of long-term suprapubic catheters. However, 30% of patients in
this study reported other catheter-related complaints. Economic
opinion suggests that if staff and resource use are the same,
suprapubic catheterisation is more cost effective."

Evidence Based Practice in Infection Control: Urinary Catheterisation
http://www.epic.tvu.ac.uk/PDFFiles/Section%203%20UCs%20June%202003.PDF

"In recent years, suprapubic catheterization has become popular
because it is easier technique for people with cervical spinal cord
injury and limited hand dexterity to do catheterization.  Suprapubic
cystostomy creates tunnel from the abdomenal wall to the bladder.  A
catheter can be inserted into the bladder through this tunnel.  The
catheter drains urine into a bag... Combined with oxybutinin,
long-term suprapubic catheterization markedly reduces recurrent
bladder infections and kidney damage, and is well-tolerated with
minimal complications when the catheters are regularly irrigated and
changed...

Mitsui, et al. (2000) compared 34 and 27 patients managed with
suprapubic cystotomy (SC) and intermittent catheterization (IC)
respectively for 8.6-9.9 years.  Neither group had any kidney problems
but only 12% of SC patients had urinary tract infection compared to
26% of IC patients.  However, kidney stones occurred in 9% of the SC
group compared to 4% of the IC group.  Bladder stones occurred in 65%
of the SC group compared to 30% of the IC group.  SC appears to be
associated higher incidence of kidney and bladder stones than IC...
Suprapubic catheterization appears to be associated with significantly
lower incidences of urinary tract infections than chronic indwelling
urethral catheters and even intermittent catheterization.  However, it
seems to increase the incidence bladder stones and possibly kidney
stones.  As much as a third of people with long-term suprapubic
catheterization will develop bladder stones over a 10-year period."

CareCure Community: Suprapubic Cystostomy vs. Urethral Catheterization
http://carecure.rutgers.edu/spinewire/Research/Suprapubic.htm

"Suprapubic catheterization is more comfortable and acceptable to the
patient and may be associated with a lower incidence of CAUTI
[Catheter-associated urinary tract infection]. For incontinent males
who do not have bladder outlet obstruction, condom drainage, while not
free from nosocomial urinary tract infections, appears to be
associated with a lower risk than indwelling urethral catheters."

Cache from Medscape: Guidelines for Preventing CAUTI
http://216.239.39.104/search?q=cache:OkkyPdfSH-EJ:www.medscape.com/viewarticle/414419_5++%22suprapubic+catheterization+is%22&hl=en&lr=lang_en&ie=UTF-8

"Chronic infection caused by the catheter may be secondary to
occlusion of natural ductal secretions in the urethra. In addition,
significant pain can occur when the catheter irritates the naturally
sensitive anatomy. In these cases, a suprapubic catheter may be more
comfortable. Suprapubic catheter placement is an outpatient procedure
that takes as little as 10 minutes under local anesthesia."

Postgraduate Medicine Online: Common urologic problems in the elderly
http://www.postgradmed.com/issues/2000/01_00/reznicek.htm

As is often the case when dealing with medical studies, there is also
evidence to the contrary:

"Transurethral catheterization is generally associated with a higher
incidence of urinary tract infections than suprapubic catheterization;
however, suprapubic catheterization is associated with other
disadvantages such as higher costs and a more difficult technique, and
at the moment there is no consensus about the use of both catheter
systems. Therefore, a prospective randomized study was performed to
investigate the effects of suprapubic catheterization and
transurethral catheterization in patients undergoing surgery on the
incidence of urinary tract infections and patient satisfaction... 75
patients were allocated to receive the suprapubic catheter and 71 the
transurethral catheter. There was no difference in the incidence of a
urinary tract infection between the suprapubic group (n = 9/75; 12%)
and the transurethral group (n = 8/71; 11%)... CONCLUSIONS: The
incidence of a urinary tract infection between a suprapubic catheter
and a transurethral catheter in patients undergoing major surgery was
not different."

PubMed Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12789024&dopt=Abstract

If your dad's physicians decide that suprapubic catheterization is not
appropriate, perhaps the use of a hydrophilic-coated catheter would
help to reduce the number of urinary infections:

"PVC hydrophilic-coated nelaton catheters - These are impregnated with
a coating that forms a slippery, pre-lubricated surface following
immersion in water for 30 seconds. Although there is some evidence
that these catheters reduce urethral inflammation when compared to PVC
nelaton catheters (Vaidyanathan et al 1994), there are no studies that
compare coated and non-coated catheters over the long term, and it is
not known whether coated catheters reduce urethral complications.
These catheters are potentially more advantageous to men for whom
lubrication is particularly important due to the resistance of the
prostate and the length and curvature of the urethra."

Nursing Standard: Intermittent Self-Catheterisation
http://www.nursing-standard.co.uk/archives/vol15-09/pdfs/p4752v15w9.pdf

"The concept of single-use intermittent catheters has benefits for
patients who are prone to urinary tract infection, in that the
catheter is discarded after a single use, and does not have to be
stored (often unsatisfactorily) to be used again.

In order to reduce the risk of infection still further, each Aquacath
single-use catheter comes singly wrapped in sterile, convenient
packaging. This has clear advantages for patients who are prone to
urinary tract infection, in light of the work of Wyndaele and Maes
(1990). These researchers found that:

'In most acute infections, improper clean intermittent
self-catheterization or misuse could often be found' and that: 'In
patients with recurrent urinary infection and urinary retention prior
to commencing clean intermittent catheterization, the incidence of
infection was found to decrease [once clean ISC was commenced].'

Clean intermittent catheterization is a major step forward in the
treatment of urinary or bladder emptying problems."

InterNurse: Aquacath
http://www.internurse.com/products/products/entries/aquacath.html

Here's a page with some good information on suprapubic
catheterization, with a cut-away drawing that shows the anatomy of the
arrangement, and a photograph that shows what the tube that enters the
abdomen looks like:

BioMed: Suprapublic Catheters
http://www.bio-medcen.com/suprapubic_catheters.htm

These search strings will provide access to a great deal of
information:

Google Web Search: "cauti" + "urinary"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=cauti+urinary

Google Web Search: "suprapubic catheterization"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=%22suprapubic+catheterization

Google Web Search: "suprapubic cystostomy"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=%22suprapubic+cystostomy

Google Web Search: "hydrophilic" + "catheter" + "urinary" +
"infection"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=hydrophilic+catheter+urinary+infection

A personal note: this doesn't prove anything, since it's strictly
"anecdotal information," but my brother suffered for many years with a
progressive neurological disease. He lost bladder control, and the
best arrangement by far proved to be the suprapubic catheter. He had
fewer infections, odor control was easier, and his caregiver was very
pleased. As far as we could tell, my brother was pleased, also, and
the overall result was a reduction in both pain and nuisance. What
sounded like a drastic thing (surgery!) turned out to be a half-hour
outpatient procedure in his case.

I hope this helps! Please keep in mind that Google Answers is not a
source of authoritative medical advice; the material I've posted is
for informational purposes, and should not be viewed as a diagnosis
nor a substitute for the services of a qualified medical professional.

Best always,
Pink

---

Clarification of Answer by pinkfreud-ga on 27 Oct 2003 15:01 PST

I've just started my quest for the best price on the Archos Jukebox
Recorder 20. Will post my findings soon.

~Pink

---

Clarification of Answer by pinkfreud-ga on 27 Oct 2003 15:45 PST

The best deal I've found on the Archos Jukebox Recorder 20 is at
Circuit City online. Their price used to be $269.99; it has been
reduced to $249.99, and free shipping is offered:

Circuit City
http://www.circuitcity.com/detail.jsp?oid=69229&WT.mc_n=87&c=1&b=g&WT.mc_t=U

Since many places are charging $15 to $20 for shipping, this is a very
good price. Circuit City is a very reliable merchant with an excellent
return policy.

Another good deal is a price of $234, at Harmony Computers:

Harmony Computers
http://www.shopharmony.com/product.asp?file=DEALTIME&i=ARCJR20FM

Harmony adds $14.95 in shipping charges, though, which makes this
essentially the same price as Circuit City's offer. Given the choice,
I'd go with Circuit City.

Comp-U-Plus has a slightly different version of the device for $234
(this one has a built-in FM radio, but otherwise seems to be the
same). Compu-U-Plus also charges $14.95 for shipping.

Comp-U-Plus
http://www.compuplus.com/insidepage.php3?refer=streetprices.com&id=1000489

Like most Internet retailers, these merchants charge sales tax, but
Harmony and Comp-U-Plus do so only when shipping to New York. Circuit
City charges sales tax when shipping to any state where there is a
Circuit City store, which is pretty much everywhere.

Another way to go is eBay, where you will find many choices:

eBay
http://search.ebay.com/search/search.dll?cgiurl=http%3A%2F%2Fcgi.ebay.com%2Fws%2F&krd=1&from=R8&MfcISAPICommand=GetResult&ht=1&SortProperty=MetaEndSort&query=archos+jukebox

Good luck! I hope this works well for you. Sounds great to me (my
friend who has two of 'em should be doing commercials for this
product!)

Best,
Pink

---

Request for Answer Clarification by schmooz-ga on 13 Nov 2003 18:43 PST

Pink
Have no way to know if this will reach you.  I purchased the Archos
Jukebox 20GB from Circuit City.  My husband installed 7 Christian old
time Gospel CDs.  He has been working and working with Archos because
the "shuffle" between CD/Album/Sub-Folder of 7-Gospel folder - simply
does not work.  They save as albums/cds.  The "shuffle" works within
one CD/Album/Sub-Folder but does not "shuffle" to pick up songs of all
CD/Album/Sub-folders.  Walt (husband) has talked to a number of techs
at Archos and finally Brian said that the "shuffle" software has some
problems. He was able to offer no solution but said he would contact
us tomorrow.
I am very disappointed because I thought that this would shuffle
between different CDs, picking up different songs.  Your friend who
has one in her store and one in her home. . . . did her Archos shuffle
between different CD/Album/sub-folders on her play list?  Did she
record the cd/album en-total or did she record each song individually
into a single play list folder in order to get it to shuffle?
The Archos techs seem to be unable to help with this but if it worked
with your friend, we either have a faulty Jukebox or. . . we are
setting it up incorrectly and would like to set it up the way she did.
We want to get this set up for my Dad the right way.
Sorry Pink, I will understand if you do not reply

---

Clarification of Answer by pinkfreud-ga on 13 Nov 2003 20:30 PST

Carolyn,

I've emailed my friend who has an Archos player in her shop and home.
I've asked her for assistance with the shuffle-play feature. I'll let
you know if I learn anything useful from her.

~Pink

---

Clarification of Answer by pinkfreud-ga on 15 Nov 2003 13:55 PST

Carolyn,

I have not yet received a reply to the email that I sent to my friend
who has the Archos Jukebox. I've sent out inquiries to two other
online acquaintances who have some expertise with MP3 players. If I
get any responses that could help, I'll post the info here.

~Pink

---

Clarification of Answer by pinkfreud-ga on 15 Nov 2003 16:18 PST

I've found some information that might help:

"The other main interface complaint is the weird method it uses for
random play. For some reason the unit can only random play within a
directory, making the feature useless for anyone who is actually
organized. Getting around this required some searching on the net.
After looking around and many tries, we discovered that it could use
playlists generated by MMJB. The end result was to copy the entire
folder of songs from MMJB, and then creating a random playlist in
MMJB. Just select all the songs you want in your play list, drag it to
the playlist in MMJB, and select random. You can then save the
playlist, and then copy it from the MMJB folder on the Archos. This is
a bit of a long process, but until Archos gets their act together, I
think it is the only way to go.

Having said all that, the price point is what really makes this device
worthwhile. I know of no other device that matches its price/space,
making it a terrific value.

As an update, some generous programmers on the Internet have created a
much improved firmware for this device. You can download it at
http://rockbox.haxx.se/ . Not only are there a lot of new features,
and a way to customize the currently playing display, but because they
don't depend as much on the "off" button, it is a LOT easier to
traverse directories. I highly recommend loading this firmware if you
have one of these units."

http://hardwarecentral.dealtime.com/xPR-Archos_Jukebox_Recorder_20GB~RD-90053381764

Here's an article about "Rockbox," the firmware for the Archos that is
mentioned above:

http://hardwarecentral.dealtime.com/xPR-Archos_Jukebox_Recorder_6GB~RD-100237872772

~Pink

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Request for Answer Clarification by schmooz-ga on 18 Nov 2003 08:37 PST

Thanx Pink - We eventually figured out the copy/paste of the
pre-shuffled.  The problem remained that the "shuffle" could not be
put on "repeat" and after playing all the cuts in the shuffle (copy
paste), the Archos shut off and you had to go through a number of
steps to bring up the the shuffle.  The option for continuous replay
was one complete cd after another, after another. . . never stopping. 
We wanted this same feature in the shuffle to mix up the Christian
songs dad would hear. . choir/piano/solo.  This was beyond the Archos
capability. . . so we had to spring for an Ipod, which does this just
fine.
Dad is in intensive care and when he is able - has told us how much
this music means to him.  Thanx for all your hard work. . . you are
the best.

---

Clarification of Answer by pinkfreud-ga on 18 Nov 2003 09:36 PST

I'm relieved to hear that the iPod did the trick for you. Sorry about
all the nuisance caused by the Archos. It sounds as if that device is
badly in need of redesigning.

I greatly admire your persistence of effort in making life more
pleasant for your father. Having been down that road, I know how
difficult it can be. May God bless those who take the time to make a
parent's sunset years a bit brighter.

~Pink

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Request for Answer Clarification by schmooz-ga on 24 Nov 2003 10:08 PST

My Dad met the Lord on Saturday the 22nd.  Thanx for all your help. 
No need for any response. . I just wanted you to know how much I
appreciated your comments on my requests and those in the responses
you gave to others.  C

---

Clarification of Answer by pinkfreud-ga on 24 Nov 2003 10:22 PST

Carolyn,

Thanks for letting me know.

Your father is now listening to gospel music without earthly impediments. 

~Pink

---

Request for Answer Clarification by schmooz-ga on 21 Aug 2005 16:53 PDT

Pink -
I have no idea if this will reach you - but - as you know, my father
died.  We ended up with an Ipod and put it into one of those fake
book-safe boxes, hooked up to an amplifier and earphones plugged in. 
At that time, we had to pay big $$$ to get one that would shuffle a
lot of "there day" type Christian music.  My reward was to see tears
in the eys of a man who- once was a youth pastor in LA - who wrote off
the Lord - I think, because he asked something that the Lord did not
answer in the way dad wanted.  In dad's last months of life, it seemed
that the music of his youth, touched and repaired something in him
that was beyond my knowing.  I saw the tears - and. . . .

As a result of this, as we have the money, we are trying to make this
available to those confined in resthomes.  I have found the Ipod
Shuffle - at less than $100 + the price of a "book safe" and
earphones, we can do this.  I just wanted you to know.  The Shuffle
keeps playing and an playing and playning, shuffling all the time,
just as we hoped for.  All you do is take the earphones off and
whenever you put them back on the person in the bed - the music is
waiting for them.  God is good to make this less expensive for us. 
Thanks Pink

---

Clarification of Answer by pinkfreud-ga on 21 Aug 2005 17:04 PDT

This is a great example of how a high-tech device that most people
associate with young folks can be a wonderful boon to the elderly and
infirm. Unlike books and television, music is something that can be
appreciated by anyone who is able to maintain consciousness. My
brother died slowly, over a period of several years, of a degenerative
brain disease. Up to the very end, we played music for him; it was one
of the last pleasures he had left.

~Pink

Answered 100% and more!!!!!!!  As always, you go beyond what is asked
for and do such a wonderful job.  Thanks Pink

Many thanks for the five-star rating and the generous tip! It's always
a pleasure to work for you, Carolyn.

~Pink

On the subject of REMOTE CONTROLS, if you're lucky/careful you can
prise open a remote control casing and stick Post-It note over the
printed circuit board pads corresponding to the buttons you want to
disable. (TV repair shops are often experienced at repairing remote
controls where the conductive rubber keypad has failed - this is the
reverse of repair).

Owain