Mother has been experiencing frequent UTIs & her only symptom is extreme confusion. I have to battle nurse manager & nurse practitioner of the nursing home when I recognize increased confusion in my mother. Each time I have finally gotten her urine tested she has been positive for UTI. She never has a fever and she does not complain with pain. When she is successfully treated with antibiotics her confusion goes away. When I initiate concern I am almost always told it is just that her dementia is getting worse. I must raise my concern repeatedly and typically have to wait until her symptom: confusion becomes extremely problematic & reach a Backshift supervisor that will listen to me. I cannot simply discuss with floor nurse because they are not suppose to talk with me; rather they have been directed to tell me I must speak with supervisor or manager. As I am my mother's medical power of attorney and the doctor activated it they have to talk with me but I am tired of being dismissed even when correct. Now they give her half doses and least powerful/effective antibiotic stating they fear "superbugs" and don't want to overtreat. Her recent bout was not cleared with the course of "treatment" & second lab test confirmed but because she is incontinent requiring catheterization to take proper lab sample they will not repeat the test nor treat further unless she has a fever. I feel I am at my wits end & don't know what else to do. Over a year ago I entered her into hospice program because she was sent to emergency room and they could not find a specific reason why she was in respiratory distress so the doctor said it might be "end of life". I explained to him that her history with bronchitis was rapid onset so he sent her back to NH with order for antibiotic that was good for bronchitis saying "it could not hurt". Because he documented his thoughts of "end of life" the NH wanted me to consider hospice. Since I was told the hospice had nurses and doctors that would provide additional help I agreed. The next morning Mom's fever went up and lots of congestion that was not present during ER visit occurred. The antibiotics took hold and eventually resolved with Mom getting back to participating in activities. The respiratory infections and the UTIs have had deteriorated her health such that she continues to meet continuing hospice criteria. I have not seen any support from the hospice group other than the aide that visits during the week has been good companion to my mother. So between battling the excuses of dementia and she is on hospice, I am not sure what else to do. I want her quality of life to be maintained and in my mind, confusion brought on by untreated UTI does not meet quality of life. The NH management obviously does not agree with me. At this point the NP and nurse manager will only "prescribe" cranberry pill supplements. I have also asked about more frequent changing of mom's diapers but was told that her inability to completely empty her bladder is more problematic with UTI than dry diaper. All this screams BS to me and I have considered contacting the ombudsman office. Am I off base and being too intrusive?