How often should an elderly person who is prone to UTI infections be tested for a UTI?

Key word a few posters up...."good" urologist...I get uti's and kidney stones every time i turn around...I am not 50. My first encounter with a urologist...he did a closer examination of my insurance cards than he did of my urine culture, and he made a bigger issue of the fact that I was late to the appointment because of a death in the family than the fact that I had stinky pee and a barely visible stone on a CT scan, but was in extreme pain. Chalked it up to emotions. ! I did the cranberry thing and eventually passed a small stone at home. Scooped it out of the potty and walked it into his office. Made appointment with one of his competitors for follow up. SMH. Meanwhile, had an abdominal CT for some other issues, the original stone was still there, clearly more visible, and i have had five more UTIs. took home test kits to the PCP who did antibiotics. I agree with the mood changes, and increased confusion. One thing that seems to help...long nightgowns as the single item of clothing.....hee! .....estrogen cream.....(keeps things not dried out, according to the gyno) and yes to the more natural soaps and the bidet. There is even a portable one! I got so frustrated with the urologist I made an appointment with the gynecologist who was more than happy to advocate on my behalf, and learned a lot, btw, about women's sexuality through the aging process...yes, even in the 80's, 90's and 100's.....even in care homes. fascinating. But back to the UTI. thing...a GOOD urologist...indispensable.

Omg sorry bout the typos, on my small cell.what i meant was why would people be so concerned with keeping a person overly clean , healthy and protected for getting a uti or a cold if this could ultimately end their suffering from disease? A lot of people here, any thoughts, anyone else not using antibiotics ?

Nojoy. My.mother does have an advanced directive but its for no artificial means of support such as life support or feeding tubes. I should look again at it. My moms been here 8 years and hasnt walked or talked for 4 or 5 years. She us however now waking up laughing like hell in her bed at 6am lol.i do understsnd what you are saying but what i dont understand is if this were the norm. Ehy epuldnt people not be so upset ober utis, ehy keep them clean etc. Doesn't mske sense in some ways. I just know i couldnt not treat, well i think? My mkm told me 15 years ago not to ket her live if she couldnt take care of herself. Anyone else chiming in here on this subject? Anyone else choosing to not treat with antibiotics?

Reversroles: A POLST form is Physicians Orders for Life - Sustaining Treatment.
It is called other things in other states but the principle is the same. It is as important to have as an Advanced Directive, in many ways more important. The doctor, working with the pt(if able) or the pts representatives fills out a form addressing what care the pt is to recieve. It addresses: CPR; Medical Interventions, do you want comfort measures only or full treatment; Antibiotic use,
Medically Assisted Nutrition. Once signed by the doctor it becomes a physicians order and is to be honored by all medical personnel. It can be changed by the pt (if able) or the pts rep. This is the form you would want to give the EMTs if you had to call them for your Mom.
Regarding doctors: Remember they are humans too and they bring their own values and ethics to their practice. Sometimes their beliefs agree with those of the pts and sometimes they don't. It is not wrong to leave a doctor if the plan of care cannot be agreed upon. The important thing is to make sure it's an educated decision.
I do not want my Mom to die. I am going to do the best I can to keep her from getting sick. But I also realize Mom is 91, she's tired and I know she really wouldn't want to live like this. Deciding not to treat a medical condition in a terminally ill pt is not the same as trying to kill them! I'd encourage you read up on Pallitive and Hospice Care. I know I had to. You are right this is all so complicated. After years of caring for Mom two weeks ago I admitted her to a Memory Care facility. Mom can still walk with a walker, can still eat and talk but she can't really carry on a conversation. Most of the time Mom is not there. She's off in her own world, living in the past waiting for her Mom or one of her brothers(all deceased) to come take her home.

Noyjoy3, thank you for writing. I got a DNR for my mother and she signed for no artficial means of support or feeding tubes years ago when she had her mind.(What is a POLST?) My Mom also has late stage dementia, hasnt walked ot talked for 5 years. I need to puree her foods and do everything for her. She can however laugh, and thats all that makes my day. I can ask for a kiss and get one, she is happy. But, she never would want to live like this, she sits and stares most of the day, laughs, then stares again. It takes me 3 hours to get breakfast in her and 2 hours for supper, 1 hour for lifting her on the toilet to bathe her, etc.
I had asked my doctor is she got pneumonia if we would treat it, as I read hospice doesnt always. and he said yes, you treat until the antibiotics dont work. I dont know if I could "not" treat a uti or pneumonia? I do agree with you, why live like this? But on the other hand, why would everyone be careful about bathing, feeding, etc, if they wanted their parent to die. Do you know what I mean? this is so complicated. My moms on bp meds and antidepressant. I am so on the verge of throwing in the towel with no life here. She moved in 8 years ago and I have had hardly a life since. I am married with kids, grandkids, and cannot enjoy my life as I would like to. I would like to hear more, and from others to, is this something to really consider, hummm, it seems like a crime to not treat a medical condition. Thanks again, please write again. Is your mother in your home? Whats her condition?

Reverseroles: I guess the way to sort of explain my previous entry here is like this. If a terminally ill pts heart stopped (cardiovascular failure) you might choose not to do cardiac compressions to try and save them. If a terminally ill person quit breathing (respiratory failure) you might choose not to give them artificial respirations and put them on a ventilator to try and save them. If a terminally ill person developed a infection that the body could not fight (immune system failure) you might choose not to give them antibiotics to try and save them.
Most people don't have a hard time deciding not to do chest compressions or artificial respirations and ventilator care for a terminally ill person. But, antibiotic therapy is another thing. We've become so accustomed to the use of antibiotics that we just sort of take them for granted. We forget that these are very powerful medicines that can save and prolong lives. And, the question is, is that always appropriate?
My Mom has a POLST form and my brother and I had no difficulty deciding no CPR. It is also marked no antibiotic therapy. My brother and I had a much, much harder time deciding on this and there are times when we question if we did the right thing. Mom has late stage dementia (terminally ill) and her future does not look bright. We have chosen not to prolong Moms' life using any means, but to do whatever we and modern medicine can do to keep her comfortable during the end stage of this horrible disease.
I hope this explains better what my thought is. It is a tough, tough decision.

Sherry1anne, Again, so sorry for your loss, hope you are hanging in there :0(

What? I never heard of such a thing. My Doctor said treat until the antibiotics do not work any longer on them, for pneumonia also. Everytime my Moms urine is very strong smelling I give her antibiotics for a week, then stop. I shouldnt be? If this were the case, people would be making sure they got a uti or pneumonia wouldnt they???!!!!!! Trying to understand?

Just a question: Why would you want to treat a UTI in a person with late stage dementia? I know this question may sound cruel but in a case like this treating a UTI with antibiotics may just be prolonging the inevitable. In the elderly many of them do not have the pain associated with UTIs like younger people do and the mental changes can be helped with meds other than antibiotics. These people with end stage dementia are terminal, they are going to die, what difference does it make what the cause is. Shouldn't we be more interested in keeping them comfortable rather than prolonging their lives with the use of antibiotics?

Mother just passed away this week. She was plagued with UTIs. Consult a good urologist, a GP is no good on this. Mother had a bladder flush weekly with an antibiotic solution. She died in her sleep probably heart failure.

good tip on the incontinence pads/pants. Anything that traps urine and if not changed immediately can aggravate a UTI. also there are pills that you can get that have concentrated cranberry in them and they can help with the UTI. I once read an article that said that you would have to drive large amounts of cranberry juice to actually have an impact on a UTI. I would check with her/his health care provider before starting any pills. I believe they are over the counter but still check first.

mom on invanz for 19 days, didn't cure the uti, what next

Adult pull up type pants can cause these also if these are not changed EVERY time they are damp and they hold the dampness in. I went through this with my mother repeated hospitalizations, antibiotics, night terrors and craziness - Here's what I did - Forget the tests, sometimes they give a false positive, especially when in the presence of antibiotics. Cranberry juice concentrate - the real stuff not the sweetened stuff from the juice aisle in the grocery. Mix it with water to taste and I added Sweet-N-Low because sugar can feed the infection. Give 6 oz of the mix 2X daily + lots of water. I also gave her a health food store product for UTIs. It contained horse tail herb, dandelion and other herbs. D-Manos also from the health food store. I think the other thing is called DMO at any rate it's for UTI and it's over the counter in the pharmacy section. I makes the pee turn orange. I gave her pro-biotics as well. Changed pants AM & PM plus any time during the day that dampness occurred. Shower in the AM and wash with soap & water in the PM. It's a lot, but she seems to have been UTI free now for over a month.

A patient in a nursing home should be tested for a UTI once per month. You should get a doctor order for the monthly testing.

concentrated cranberry capsules and chemical free (baby) wipes can be found at vitacost.com....also check swanson.com

My mom had frequent UTIs One of the things she was doing was using an incontnence pad to catch any leaks. Her VNA nurse told her to stop as that traps bacteria, etc. Once she did her infections became less frequent. She sometimes has to change her underwear 2 or 3 times a day but it has made a difference. Also recommended was a concentrated cranberry pill that she takes (got the name from the nurse and found it at the health food store).

It's not so much about testing but to know what symptoms to look for. Sudden confusion is a telltale sign. Agitation? Balance problems? Are they exhibiting behavior that is suddenly out of the norm? Also, look at the urine. Aside from an odor, the color can be anywhere from cloudy & foamy to being pinkish/orangish. Are they experiencing more frequent urination then normal? Is there pain in the pelvis area? Also, your loved one may not be able to convey any pain/ burning sensation. Look for facial expressions.

Most importantly, don't assume your loved one will have a fever. The elderly don't exhibit the hallmark sign of fever because their immune system is unable to mount a response to infection due to the effects of aging. A UTI is not going to go away on its own. If left untreated, it will damage the kidneys. Basically, one will develop sepsis, it will enter the bloodstream & ultimately cause death. A UTI is a minor infection that is easily treated. In the elderly, it's major. It really takes its toll & drains them of their strength.

As far as testing goes, you collect a urine sample. The doctor's office will exam the specimen for crystals. If it's bad, they will usually start antibiotics right away. They will probably also order a culture to be done in a lab which will take 24-48 hours. That just confirms the right antibiotic.

It's easy to preach about hygiene. You are probably keeping your loved one way more cleaner than in a nursing home & hospital. Incontinence, especially in females, pretty much makes the person susceptible to this infection. As far as prevention goes & magically stopping any fecal matter from entering the urethra, make sure they drink lots of water to flush their system out. Also, try cranberry juice which makes the urine acidic. To me, I would never drink juice that has "cocktail" in the name. It's basically glorified apple juice with other flavors added. How much cranberries are actually in 8 oz? I just wouldn't subject my loved one to standards that I wouldn't keep for myself. However, cranberries are very tart. You could try to water down the juice or making your own blend. That way you know how much cranberries are in it & add apple juice to just sweeten the taste. There are capsules to take which may be easier. Also 100% cranberry juice for 32 oz can run out about $10.99.

Some people get UTIs & that's it. In others, it becomes chronic. One can only take antibiotics for so long until they build a tolerance to them. You can keep them clean as humanly possible. It is just going to happen. Just don't let a doctor tell you "we can let it (UTI) run its course." Ask questions & don't back down. Ever. You, as the caregiver, will be the greatest advocate for your loved one. Just as long as you know their wishes, you may be their only voice.

huggies natural is good. Now I am SO interested in an external catheter for a woman, for men it looks simple!! Got to research as it would make for a nice dry night!!

Reverseroles, it's not too much information.... good to know I am not alone when it comes to soaps. I am going to start looking for more organic soaps, nothing with any dyes. As for the wipes, I also use them, I haven't tried the Huggies but will give them a try :)

freqflyer, I too grew up on Ivory and switched to dove after my UTI. Well the dove didnt do squat for cleaning. It might have made my skin soft but it didnt erase odors, even under my armpits. It took me a week or so to realize that and I went right back to the ivory soap. I also use vagisil and natural huggies wipes, always have. sorry way TMI !

Mleigh- I 'hear you' about abbreviations. C&S is short for culture and sensitivity, which is a test done to determine what bacteria is present and which antibiotics are most likely to kill that bacteria. In 'olden times' there would be a specimen of body fluid or tissue (whatever was thought to be 'infected', in this case, urine). Then drops of it were placed in a lab dish with something like gelatin to 'grow on' or 'culture'. Tiny samples of various antibiotics were placed in the same dish, and then the lab would see- with a microscope- which antibiotics would "eat" those germs. C&S is not commonly done anymore, because Drs have fallen into the habit of prescribing certain antibiotics for certain types of infections. This is part of why so many don't work anymore, because they've been over-used and many bacteria have actually developed resistance to them and gotten harder to 'kill'. On top of that, people who don't finish ALL their antibiotic, kill off the weaker germs, and the stronger ones multiply and spread. Even if someone starts to feel better, they should finish the antibiotic, if it's the proper one. It's not like a pain pill, which you of course should stop taking, if you no longer have pain. ALWAYS finish the antibiotics. It's such a simple concept, it should be printed on every bottle of antibiotics.... but, that would make too much sense and the drug companies wouldn't make as much money.... but I digress... Thanks for asking.

I was thinking about UTI's this morning because I had my very first one after having kidney surgery a couple of weeks ago.... then I was thinking about my sig other's grown daughter, both she and her grade school daughters are dealing with UTI's on a regular basis....

As a child growing up in the 1950's and 1960's, all we had were bar soaps, such as Ivory.... now a days there are all these scented soaps and body washes. I picked up the body wash that I've been using and was surprised there was about 30 different ingredients including dyes.... hello, shouldn't this be just soap? Now I am wondering if all these unnecessary ingredients might be adding to the UTI's? Just a thought.

PS just a tidbit of info I wanted to add. I had a dog who had uti signs in the hospital and was put on an antiobiotic, Her urine test was negative, yet the neurologist said there is a part of the tract that cant always show an infection when there is one. In dogs you can get a false negative, why not humans? Humm interesting, he treated her and her signs were gone. So, when I took my Mom (who was off the wall acting crazy), and had strong urine, she got a test and culture and it was negative. I told the doctor about my dog and said "could you just please please treat her just in case because she is not herself?" He said he was okay with that, and she was treated, and a new woman in about 24 hours. Something to think about...

Maybe just go with the odor or her actions. I just had my first uti and I am in my late 50's. I peed blood and was shocked. Dr gave me cipro and told me to flood myself with water and cranberry juice for a few days and it worked great. My dil (daughter in law) gets them often and also gets cipro. My Mom however, takes amoxicillin. If she gets a strong odor I give it for a week and can give on daily to prevent, but I do give her breaks. Dr isnt concerned about her at all being on one a day and told me he is schocked how she hasnt ended up with a bad uti in 7 years with me. After all she is 93 and if she ever became resistant, we could change or so be it. He said whatever I am doing, keep it up with her. I myself had no signs before the blood. Doc said not to hold my urine, which I do all the time. I am fanatic about cleanliness on myself and on Mom. I wash and dry after every pee and go thru a few pair of underwear a day to feel fresh and clean, tmo ! (too much info)
I would like to get those cranberry supplements, how much do you take, one a day? Can you crush them? I always give 2-3 yogurts a day to Mom, more when on antibiotics and puree them with a muffin.
Doctorno... isnt that bidet water cold? I use hair dye bottles on mom and always wanted an actually hose with warm water too. good luck, they say sometimes you just cant cure a uti in the elderly, so stay right on top of it if you even suspect one.

probiotics and antibiotics together are not good. the doses have to be staggered to be effective, yes Cipro does kill all the good gut bacteria, and can lead to C-diff bacteria taking over and causing a terrible smelly diarreah. and can be life threatening. Cranberry juice itself can be too strong of a flavor, water it down to get it into their system. yogurt is good - if they will tolerate the flavor. they can be stubborn old children and won't always do what is best for them.

Great comments. My mom had been having chronic UTI infections. I purchased a commode attachable Bidet unit from Home Depot. I believe the cost was about $120. Voila. It works great. It's the next best thing to taking a garden hose to her after a pee or BM. She loves it and says she feels very clean afterwards.

This has been a problem for us for some time now and as FIL also has serious kidney problems controlling (eliminating) UTI's is important. We have used just about every suggestion in this thread so far. The other suggestion I would have is to start probiotics on a daily basis. It really helps and especially when antibiotics are used. Additionally when the person dresses themselves making sure they change their underclothes DAILY is very helpful.

Also once you start a course of antibiotics always, ALWAYS, finish the whole course even if you are feeling better,don't stop taking the dose until all the pills are taken no matter if you are feeling better.

C&Smeans culture and sensitivity. The urine sample is collected and then the lab tries to grow any organisms that may be in it and then treat with the antibiotic that the organism is senisitive to.

Unsanitary bathroom habits affects all. Doing over the counter testing can be a problem. Change of behavior can be the number one sign.
I agree with you comment, but many UTI's are being treated with the wrong antibiotic and way to strong of ones. Antibiotic are way over used and causing major issues. Water as I stated is super important and can be the major cause, Cranberry juice and pills (many can't take) helps, go to the health food stores they also have other natural treatments.