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Antibiotics have cleared infection but confusion and extreme weakness have persisted. Diagnosis was 11 days ago and there's been no improvement.

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My mother has an internal catheter and was STILL getting UTIs almost every month. YB finally figured out the problem: she was using the same washcloth to clean the port over and over. Nasty bugs lived in those washcloths, even dry and she was re-infecting herself. Cleanliness is a MUST!

YB bought a pile of cheap washcloths and instructed her to use a clean one ONCE and only ONCE and she has not had a UTI in months. (He has her put them in a separate bin and he washes and bleaches them and dries them on HOT, to kill any nasties) BTW, mom never got 'crazy' with a UTI, she just kind of slumped over and her urine smelled horrible.

And yes, it is common knowledge, though the medical community seems to disagree--a UTI can change a person's behavior and personality for long periods of time, if not forever. MY MIL is 4 months out from her UTI and she is still an anxious mess. They do not hold out much hope that this is going to 'fix' itself.
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My grandmother had this occur about 2 months ago. I was worried about the same thing. When she was first taken to the hospital, she didn't recognize me, where she was or understand anything. After several days in the hospital, she was transferred to a nursing facility for rehab because of the extreme weakness. After a few days, she did improve cognitively some, but was still not anywhere close to her normal self. It also took her longer than we expected to physically regain the strength that she had. However, she's back in her assisted living apartment now and is doing much better. It did take WEEKS for her mental and physical function to get back to normal.
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U.T.I.s are nothing to fool with. Elder needs to be seen again by physician. I, myself, believe I have a U.T.I. & will see the doctor tomorrow, which is my birthday.
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You need to go back to the doctor. My Mother had this and she was hearing music and voices. I didn't know it was from the UTI. The first dose of medication wasn't strong enough. After a stronger medication was given within two days all is back to normal. I thought this was going to be a new way of life and was not sure how to deal with it. That is why we went back to the doctor.
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My husband had 2 infections within a month. The second time he was sent home with a longer dosage of antibiotics and probiotics, as well as a prescription for Flomax because of an enlarged prostate. It took about another month for him to get back to his “new normal” of short term memory problems. But he’s now more social and able to socialize with others. Although he doesn’t remember it the next day. However, I know the hospitalization completely changed him for awhile.
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Yes, confusion and extreme irritability can accompany UTIs in the elderly. UTIs can also result in high fever, and sepsis. It is an emergency. It can be fatal.
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After my dads first UTI, a friend advised giving him Ester-C, 1000 mg daily. He hasn't had a UTI since! You can find it at Walmart or any drug store. I have to say, my dads memory was never the same and has declined rapidly since.
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My dad took about 1 full year to get better from a hospital stay. I have read that recovery takes longer as someone ages and has other things going on.

I hope you see improvement soon.
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Has a follow up urinalysis and urine culture been ordered by her physician to make sure the infection has been resolved? Has she been examined by her physician to rule out any other issues that may be causing a problem? It could be that she needs another course of antibiotics or some other intervention depending on the physician's findings.
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My stepmom developed a UTI which caused delirium. She thought my dad was trying to kill her and refused to stay in the apartment in assisted living with him which in turn made my dad extremely upset to the point he was in tears (they both suffer from Alzheimer's). It took two different antibiotics to get rid of the UTI but she also developed a yeast infection from the antibiotics. Called her doctor and got her medication for that but it took a couple more weeks before she was completely out of her delirium.
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Yes it happened to my Mother, everyone said she would get back to normal but she never did! She woke up one day 3 years ago living in the 1930’s. I became her sister and it hasn’t changed. She calls me by my right name but I am her sister not daughter. That was only the beginning!
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I thought this was permanent with my mother, she had a chronic UTI and E.coli in her urine. After many years and many antibiotics nothing would kill that e.coli in her urine permanently, as after the antibiotics she would be 100% clarity, probably more with it than I was, until UTI infection came again. Biocence is the ONLY thing that killed that e.coli. After Biocence no more dementia-like symptoms.
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What is Biocence ? I found it on amazon,, but is it for cleaning, or take by mouth?
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Any illness can cause permanent damage in the elderly. My DH got pneumonia in November and even with medicines, he still had it in December. The 2 months of pneumonia took his memory.

I finally cleared the pneumonia with Colloidal Silver Nasal Spray 500ppm and Iodine brought back some of his memory but the damage was already done and he never fully recovered his memories.
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Then have the UTI test run again. Sometimes you will need another type of antibiotic
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Does anyone else have good results with cranberry juice to prevent or help UTI's? Back in my days of no insurance and no medical help, "Drink cranberry juice" was the "go to" routine. I don't know if that works as effectively in older adults as it did for hippies with no medical insurance, but it might help some.
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Manson Jan 2020
cranberry juice is supposed to help. something with the PH in it I think I read.
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If her infection has cleared - get the results from a culture to make sure - she may have some slight kidney damage. Her injured kidneys don't function as well as they usually do to clear her blood of waste products. This could make her weak and a little confused. Usually, confusion clears when UTIs are treated correctly.
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When my mother was in the nursing home, she had a UTI. I was following up with them. They are suppose to put the patient on an antibiotic and wait for the 3-day culture to see if the patient is on the right antibiotic for that specific UTI. However, my mother wasn't getting better but she just happened to fall out of her wheelchair and hit her head and made them call EMS & take her to the Emergency Room at the hospital. They said she still had a UTI and the nursing facility had put her on the wrong antibiotic and did not follow up after the 3-day culture!!! So beware and always ask about the "cultured test". My poor mother suffered with that for 3 whole months because I believed they had treated her properly and they had not.
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my2cents Jan 2020
You are absolutely correct. They give initial antibiotic, check the culture a few days later to determine 1) if there really was an infection and 2) if they are using an antibiotic that will correct the infection she has. Additionally, some patients are prone to chronic UTI issues that will require very strong meds or longer periods of time to take them.
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Have the antibiotics cleared the infection? Unless you're happy that it definitely isn't still lurking, that's what I'd ask them to check first. Blood tests/proper cultures, not just dipsticks.

But assuming it is gone - diagnosis 11 days ago, five? days of antibiotics or say seven, then it's still early days. Did the antibiotics cause any gut upset, too? (they often do, it can't be helped). I should give it a while longer, these things are rough on frail older people.
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Anyone who takes any antibiotic tx should be on a probiotic/prebiotic. Also eat greek yogurt if possible. And they should be on it all the time, not just when they are on antibiotics. It will restore the natural flora in the gut and other organs that the antibiotics kill.
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I have found that a daily capsule of cranberry concentrate (4600 mg equivalent) has helped prevent more uti for my dad. He had three bad ones in the year before(hospitalization required) and his sudden delusions and fever were the symptoms. Yes it took longer to return to “normal” each time.
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I would suggest the confusion to which you refer is in fact delirium. Sorry to say it can last for days, weeks, even months. My mother has had a series of UTIs both before and after going into a memory care unit. Each attack is quickly knocked over with antibiotics, but the delirium is taking longer and longer to move on each time.
The problem with dementia patients is that it is difficult to know what is ''normal'' dementia confusion and what is ''normal'' delirium. If medical people find it difficult to work out the difference, no wonder we carers have difficulty understanding it.
About the only thing I can suggest is in future to closely monitor the patient, if there is a sudden downward trend in confusion then check for a UTI. On this forum you will have noticed a lot of posters' first suggestion is a UTI in any change of behaviour. While the causes for changed behaviour can be endless, it is a very good starting place for investigation. Likewise for constipation.
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It seems that some crises cause a step downwards, that never really recovers completely. An operation under anaesthetic is often reported that way. Could this be what is happening?
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I don’t know about UTI, but doctors thought the same with my mom. She had a ruptured ulcer and they thought maybe that was causing her confusion. It’s months now and she seems a little more clear but it also seems like her dementia was made worse. Not sure if that helps, but I thought it was similar.
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Ellen I did an internet search of "permanent personality change after UTI treatment" but nothing comes up...

As others posted below it is possible her symptoms will take longer to go away, but there is possibly something else going on with her. Does your sister (or anyone) have durable PoA for her? If not and if she is resistant/uncooperative someone may need to pursue guardianship over her or else call social services to report her as a vulnerable adult and they can eventually get guardianship and get her into a care facility where she will get medical attention and be safe. Good luck!
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My MIL had a UTI 4+ months ago and b/c she was so down, she developed pneumonia on top of the UTI.

I rarely see her, so when I DID finally see her, she'd been back home ( 6 weeks in rehab) I was SHOCKED to find that she had totally lost her 'filter' and is now just a screaming, angry old woman. She doesn't even try ( and it may not be possible) to be even remotely nice. Like, 'barely nice'. I was only at her home for 1/2 hour, at the most and had to leave. DH had seen her this way and didn't think much of it, she's never been a nice person to spend time with.

Anyhow, I talked to DH after this failed visit and asked him if the drs had weighed in on her incredible fall from 'norm'. He didn't know, but asked his sis, and she said that they felt that the UTI did permanent damage. I've seen my own mom with UTI's and she's miserable, but NOT nasty and mean.

She lives alone and won't allow anyone but SIL into her home. SIL is burned up, and insists on MIL accepting one day a week care for a bath and some light housework.

That's the 'new norm'. It's truly awful. I can't imagine how horrible she feels everyday when she cannot feel joy or laugh or talk about anything but how miserable her life is.
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It can take a person with Dementia much longer to return to "normal" or what was "baseline" And they may never get back to that point but there should be some improvement.
Hydration is key also to help prevent the UTI from returning but to help keep all organs with the fluid they need.
Weakness can be helped with just trying to increase daily activity. A little bit each day, or several times a day getting up and moving about. Just like PT would do. This is not just walking but even playing catch, tossing a beanbag into a bucket, putting clothes pins or clips onto a curtain and taking them off.
But all of the declines are "expected" can not be prevented so we must be prepared for them. You learn to work with a New "normal".
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