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She has dementia. Early morning she had clots the size of grapes. I went there and she seemed to be very sensitive and winced when touched. I said I wanted to her to be taken to the hospital. She didn't eat very much. She is booked for an ultrasound on Thursday, this week. She is in much better spirits today, eating a bit and up. They did blood work this morning. Also finally got a urine sample from her this morning, which was red. Sending that out for a full culture which could take several days. Should I push that she be admitted to the hospital ??? Thanks - Kathy

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The dr called me yesterday. He did an examination and feels the worse but we will wait and see what the ultra sound finds tomorrow and our plan of attack. There's not as much of blood as prior, however still some occurring. No Temp / blood work should be back. All of this is speculation until we get answers. She's up and moving about, eating yesterday and today.
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I have had a number of UTIs over my life time. Several in about a four year period because I was putting off a surgery needed for a shift in my baby making organs that had a tendency to crimp the internal tube that carries urine from the bladder to the exit - hence, preventing me from completely emptying my bladder.

Anyhoo - one UTI came on seemingly over night and went from zero to 60 in just a couple of hours. My urine was the color of cranberry juice.

I was mightily freaked out and in quite a bit of pain so I drove myself to the ER.

As soon as they saw the color of my urine, they immediately hooked me up to antibiotics by way of an I.V. I felt relief from the pain almost immediately, it seemed.  After about an hour they confirmed a UTI by way of a lab test and sent me home with a specific bacteria antibiotic. It all was relatively hassle free considering most ER visits - in my opinion- is like visiting hell where every one minute seems like 100. But then again, I’m not an elderly woman with dementia. 

So - as it relates to your mother - based in what you said, I’m assuming the blood is
in her urine and not her stool, yes?

Can the NH prescribe an antibiotic? Is your mother in any pain? Is her behavior of the odd variety that goes hand in hand with dementia and a UTI?

If it’s simply a UTI, I would think you’d want to treat it. When I think of DNR’s and Advanced Directives - I tend to not consider treating a UTI as an “extreme measure”, although others may differ with that opinion. Do you?

If the blood is in her stool - and
is not likely from hemmeroids you’re gonna have a bit of thinking to do about end of life possibilities and the care involved.

For me - I think an ER visit would largely depend on how much pain is still occurring - along with knowing what my mothers own Advanced Directive instructions were. Again - ruling out an UTI, which I would attempt to get antibiotics for from either the NH or my mothers own doctor - by phone and preferably not by way of a hospital visit.
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Don't wait a nursing home is the wrong place for her, she should be in an ICU being carefully monitored. She is in great danger of passing away in her condition. Don't let indifference kill your Mom unless the dementia is so advanced that it would be a kindness.
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She could bleed to death if you wait for her ultrasound. Worse if there is an internal perforation then she will get sepsis. Sometimes on arrival to ultrasound the staff may call 911. Assuming she is not yet on hospice care,take her to the ER. She will get an ultrasond even sooner.
If she has a DNR and they find some terrible condition that you do not want to treat then at least she is in a place that can make her more comfortable.
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Blood clots could mean several things. My Mom suffered from fibroid tumors which show the same way. What u need to do is talk to the doctor who cares for Mom. Would u operate if you found it was cancer? Like said, hospital stay may not be good for her.
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How old is mom and what stage of dementia is she in? Those are the first things I'd want to know. Also, if something is found, would mom want it treated? My mom reached a point (in her 90s) where she didn't want anything done whatever was wrong because she was ready to go. Where is your mom in that continuum? Is it possibly time for a hospice evaluation?
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Hard decision. A hospital admission (or even ER stay) could send her dementia symptoms skyrocketing.
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I would take my mom to the hospital. She could be hemmorraging, maybe she is suffering internal bleeding. It could have been caused by abuse at the nursing home. I would take to hospital or urgent care facility. Most nursing homes don't have a lab or doctor on site. The doctor is usually on call.
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I don't know much about these symptoms. What did they say after the examination? What would the hospital provide that they can't in the NH? I know that my LO does not do well in the hospital, as the staff don't seem to get it. It's like they don't know much about people with dementia.  They just assume that she's able to understand and cooperate like an average person.  Nothing could be further from the truth, though.  So, it can be confusing and scary for her.  

Plus, a hospital exposes the patient to the risks of infections and getting the flu or other illnesses. It's just not a place I want my LO, unless it's necessary. I'd ask some questions to see what your mom's situation is. 
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