Most of the elderly women in florida have been very open. I have not had one that has said "no". I always ask "Are you comfortable with me performing this?" and I'm professional 100% of the time. Presentation and salesmanship are 50% of the job.
One of my secrets is I have a surefire $60 flashlight on me instead of the dorky pen lights. When you depress the button and turn it on, it's in low power reading mode. Half press the button two more times and it provides 250 lumens of blinding white light. When performing a cath on a female. I turn the light on and set it right outside where I will setup my sterile field. You can see everything you need, even on the heavier set women that sometimes needs two people to lift the fat of their thighs out of the way. If you can cath 100% of the time, you'll be doing a lot of caths.
It also works as a make shift vein scanner in a dark room.