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Mom in ALF with Alzheimer’s. Has been in pull-up incontinence briefs now all the time last 7-8 months. Constant problem with UTIs like every 4-6 weeks. Impossible to get a sample, so every time caregiver calls me it’s back to ER again for catheter. She ends up in hospital 2-5 days each time and gets better, but keeps coming back!


I have talked to her primary several times about a long term low dose antibiotic but they are afraid of resistance. Cranberry capsules and juice has not helped. This last one was bad; Mom couldn’t even stand up and was very lethargic and out of it. Anyone else have to fight with doctors about this? I think more stressful back and forth to ER and having them running catscans, xrays, catheters, and not eating well in hospital worse than risking restistance?!

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Ask the doctor what their recommendation is for long-term treatment of chronic UTIs. Ask the doctor if they will not prescribe low dose of antibiotics, if they will just prescribe antibiotics when she shows signs of UTI instead of sending to hospital for catheter. The hospital is to be avoided when not necessary, especially with people with dementia.

If the doctor's only answer is to send her to ER each time and then prescribe antibiotics, when clearly this is a chronic issue, find a new doctor.
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Has your mom been seen by a gynecologist/urologist who specializes in urinary issues?

Fit my mom with chronic it is, the solution was a probiotic called rePhresh and a vaginal cream. These docs are called genitourologists, I believe.
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These suggestions have been mentioned by others on the forum:

First, don't use cranberry juice it has sugar. I would continue the cranberry tablet and maybe a probiotic. Probiotics are used with antibiotics to prevent yeast infections. Mom used both even after antibiotics were done.

The elderly have a hard time completely voiding. Let Mom sit on toilet a little longer. Have AL change her as soon as possible or ask that she still be taken to the bathroom every two hours.

When in the hospital, make sure a culture is done to make sure what bacteria is causing the problem. Hospitals tend to start with a broad spectrum antibiotic. This was not good for my Mom. She was given one with penicillin and she was sensitive to it. She did a 180. They changed her antibiotic and she perked back up.

Your Mom may be allergic to the brand of pull up you are using. Change brands and see what happens. I personally can't use Kotex products.

And water, make sure she is drinking water.
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My Mom had chronic UTIs, it was driving her crazy (literally) as well as me.

I found that she was wearing the Depends too long as she stated that it was very difficult for her to get them on and off. Also, she would "see" that they depends was not used and she would reuse them (gross). She also would not drink enough water.

I finally got her to a Urologist. He was able to culture the bacteria causing the issue and prescribe a specific antibiotic to resolve. He also prescribed a preventative low dose antibiotic. The Urologist resolve the UTI and she's only had one recurrence since.

If the Dr won't prescribe the low dose, I'd seek another opinion. I'd also suggest a Urologist.
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Thanks everyone for helpful advice. She is still in hospital 3rd day. Today they told me it is MRSA UTI! She is still very out of it, but is not septic. Hopefully the meds will start turning her around soon. I’m sure between the incontinence briefs, hospital visits, and urine catheters didn’t help.
She never has any symptoms except once her Urine had a stronger odor. 2 days before this crash we were at her primary for bloodwork and she was walking fine and eating well. It is scary how sudden she went from generally ok to totally out of it from Wed afternoon to Friday night.
So stressful to bring her to hospital, but primary doesn’t do catheters, nor the assisted living facility. I just need to switch her primary to different doctor. Read something somewhere about low dose of trimethiprimsulfa (TMS) I know spelling is off. I will try 1 last time with this doctor, but if not helpful need to go to urologist or elsewhere...
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AlvaDeer Mar 2019
Please do try to D Mannose. I suggested and didn't realize how many OTHERS have luck with it. It is cheap and easy to try and so well worth the try. I use Source Naturals, from Amazon at about 30.00 for 100 capsules and take one daily. Honestly I would not be without this as I had so many bladder infections, serious ones that went into the kidney, and not one since on it.
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Bypass, the primary doc if you can and go to a urologist. That is their specialty.

UTI’s happen to all ages but very bad with the elderly as you know.

Bad with small children too because they don’t understand. Poor kids. When my daughter was two years old she started screaming on the toilet. Scared me so I took her to pediatrician that told me it was normal. Yeah right, normal to scream on the toilet?

Last time I ever took her to that pediatrician. I bypassed him and went directly to a urologist that detected the UTI. Antibiotics were given and in a week’s time it was completely gone and she no longer screamed on the toilet. He said she needed to drink more water and not keep on her wet bathing suit too long.
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JoAnn29 Mar 2019
Remember colored toilet tissue. Thought it would be nice to put yellow in my bathroom. Then my daughter started having UTIs. Changed her to cotton panties. Still uti. Tried to think what I had done new, Toilet Tissue! Went back to white, no more UTIs. Have u noticed, colored tissue is no longer sold.
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I've never heard of that, but, it sounds serious. I hope she's feeling better.

I do get how you are trying to avoid having your mother taken to the ER, catheter, strange people, pain, etc. My LO would get so scared when take there from her MC. She didn't understand and would cry aloud and keep repeating, I'm scared! I'm scared! It was like torture to her. After several of these visits for this and a couple other things, her doctor suggested that she be evaluated for Hospice. She was and they now treat her with antibiotics when she has symptoms. The hospice nurse sees her once a week. (She can do the test, if necessar). Plus, she has a Hospice aid several days a week, so, with this additional attention, she hasn't had any more UTIs. But, if she does, she won't have to go anywhere for tests, but, she will be treated.

There is supposed to be a way to test the urine from the patient by using their diaper, but, I'm not sure how that works.

Also, my mom has a terrible time with recurring UTIs. She finally saw a Urologist who said that he would put her on a daily antibiotic, but, you have to accept the risks. If you accept the risks, it might be something to consider, considering that she has this terminal illness (dementia).
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Annie48 Mar 2019
Thanks Sunnygirl; didn’t think of hospice evaluation cause she is normally pretty mobile. Hoping this will turn around once meds kick in. She was only diagnosed 6 years ago and is only 75. Doctors tell me she is in pretty good health save for the brain. This disease is so horrible; hoping she will bounce back soon and we can get out of this recurring cycle. Lots of great advice on this site; invaluable and so comforting to hear others experiences. Especially when your family/friends don’t know how or want to deal with the daily struggles.
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My mom had a MRSA UTI once. I asked her doctor if I should tell her that. " Good lord, no!" he said. It cleared up fairly easily.
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Have or would you consider other natural remedies? After 9 courses of antibiotics including cipro, cefpodoxime and fosfomycin, delirium and severe constipation ensued and I knew this absolutely could not continue without severe consequences. I searched and prayed and finally found and decided to give natural remedies such as herbs and essential oils including sage and thyme a chance. Along with drinking at least 64 oz of water daily, so far the sage capsules and castor oil packs with sage essential oil seems to be very effective at keeping at bay and eliminating the UTI, based on more normal behavior, regular urination after drinking 16 oz of water and based on urine dipstick test negative for nitrites and leukocytes. This has been nothing short of a miracle as I'm sure you can imagine.
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I read that an increase in orange juice consumption and water would help prevent uti. The acid in the OJ if supposed to kill the bad bacteria and the water flushes stuff out.
Sadly I never got a chance to try it on the wife.
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Hygiene and hydration are both important- how often does mom receive help in changing her brief ?

my mom had many recurring UTIs at her memory care and was hospitalized with sepsis- she made a slow recovery and is now immobile- since then, we use a lanolin based protectant and she takes an OTC cranberry, d-mannose and probiotic supplement daily
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Partner went through that last spring through summer, multiple infections, superbug uti's, sepsis, revolving door hospital stays, where he PICKED UP the super bug. So many antibiotics it was scary. Cathed etc.

The upside ...we won the battle. The culprit in my book-DIAPERS-they are just EVIL and are collectors of kooties esp with the elder doesn't shower every day or two. GET RID OF THEM and have the accidents without the bugs being given a nice dark moist environment to grow in.

Push the water, push the cranberry juice and Orange juice. Also garlic and honey are natural antibiotics, try to get some of both into her diet daily. CLEANLINESS, ditch the diapers, maybe try a panty pad/thick kotex instead. Or even a puppy piddle pad on the bed that can be more easily changed with COTTON undies. DO NOT do the low dose or any dose antibiotic because of resistance. Your doc is right on that one.
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Get an appointment with a urologist that specializes in female issues.

My mom had this issue and the urologist was able to manage and stop the infections.
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My mom also has had chronic UTIs , I started her on d-mannose supplement and that has helped. Drinking enough water is a daily battle, I purchased a Hydr-8 bottle (Google it) and that has helped me to show her how much water she should drink daily. It's still a daily battle, but getting better. Definitely need to make sure that her depends are changed every 2 hours! Good luck!
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A supplement callded D-Mannose in health food store or Amazon. My mom hasnt had one in 2 years since we started ber on it. No side effects. And no bladder infections since. We gef the one by Pure. Has Cranberry in it also. Before this, she lived on antibiotics whi h is terrible. They just become resistant to them. Also, make sure stays dry and drinks more water.
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When this happened to my mom she was found to have sepsis. The infection had spread to her blood and she ended up in hospital on IV meds.
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Annie48 Mar 2019
Yes turns out she was septic. Went in Sat. Monday they said she wasn’t septic, but Wed they said she was . By Thursday they said the uti had cleared and they told me she was ready to be discharged back to her ALF.
Mind you she has always been mobile up to Sat. morning when she went in hospital; no walkers etc. She still can’t standup or walk! Now they are keeping her until can decide on skilled nursing facility for rehab. I hope she can get her mobility back soon. I have read other posts on here about sepsis and some said mobility never returned!?
Scary stuff; hoping in time will improve back to where she was. I will look into the D-mannose.
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I had a terrible battle with mom's GP. She was having UTI's so bad that they caused delirium and was hospitalized. She was bedridden and he wanted her to go to a urologist....he wouldn't prescribe any more antibiotic and she had delirium that came on quickly and was rushed to the hospital yet again. I finally used d-mannose and when I took her home from the NH on hospice, I was able to keep her cleaner and better hydrated and this helped. I think a lot of doctors don't understand the problems UTIs can cause in the elderly leading to hospital stays and catheters, which in turn make UTI's more prevalent. Keep hydrating and use d-mannose supplement if you can. I know the dismay of doctors not helping.
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Hospice has a palliative care program. This is to keep the patient comfortable. Frequent UTIs with Alzheimer’s was a criteria for admission for my mom. My mom too is healthy other than the brain. She was 67 when we really couldn’t deny the symptoms. She is now 81. She went off hospice because 2 times, because with their care she would improve. She was not on palliative care, not all hospices provide a palliative care program. It was around the age of 77 when she had her bout with UTIs. Not only the cathing was upsetting to my mom, but the loose stool s and stomach upset of the antibiotics. I wish you well.
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Mamamia56 Mar 2019
Hi I'm sorry your mom went thru that, my mom started with dementia since she became blind 6/7 mos ago. The hospice nurse from VNA wont put her in altho it would help me tremendously. Aides, a good RN or NP. She Told me dementia isn't a hospice diagnosis. Can I go to a different Hospice?
Also does UTI have urine odor, I did test but showed only a trace. Not sure if palliative care would help either, then the assessment investigations gets mom all upset too. She won't drink enough water says I drank alot! I take her to bathroom so not to leave wet diaper, only it's soaked in morning. The dementia started since Dr put her on xarelto in Sept, hair loss, muscle aches, dementia but now on baby aspirin. Thank God but still has issues. Constant talking to me, questions, very scared, can't leave her alone. Nasty at night, talks in sleep, or pulls diaper off, I get no sleep am very cranky and disgusted. Thx for listening, I kno I complain alot but its so hard, don't think I can do it anymore but have no choice.
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Long term antibiotics are not the answer. Antibiotics kill off the good, natural gut probiotics which improve our mood, digestion, ability to fight infection, etc. etc. Scientists are just learning how much healthy gut bacteria affects our brain.
The answer is to get to the root cause of the UTIs and solve that problem and/or provide nutritional supplements that help address the issue.
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Urogynecologist , just remembered what they are called. A urologist that specializes in female issues.
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We had same issue but not the trips to ER thank goodness. Urologist did prescribe long term low dose 3x a week as prevention. But when I caught caregiver wiping back to front with a full fecal load (swearing the first time) caregiver was let go, antibiotics discontinued and now only an occasional UTI.
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Has your Mom been drinking enough water? My mom keeps a large glass by her bedside at all times and drinks from it every day. Hope this helps.
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The Doctor is right. Have you tried probiotics or yogurt? Constipation also contributes to UTI.
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As we age, the body breaks down. Chronic UTIs are not uncommon.
My dad has been living with UTI for over 2 years...and no antibiotics (due to allergies and diarrhea from it).
We let go, and he's still here regardless...it's part of the aging process.
Eventually the drugs don't work, there's nothing to do, except enjoy the time we have left.
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fantasmagorical Mar 2019
I had the same experience with my FIL. He lived with no real issues with a UTI. He had refused antibiotics because he would have issues with diarrhea for a month or more after taking antibiotics.
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I spent my entire career as an RN so you might guess I do not believe in or do vitamins or supplements. HOWEVER, when I began to get constant bladder infections that went up into kidneys about 8 years ago, over four a year, I got threatened with low dose antibiotic and in desperation I tried D-Mannose. It is a simple 30.00 for 100.00 on Amazon and I take one 500 mg capsule a day. The brand I have taken is made by Source Naturals. I have to tell you I have not had a single infection since I started it. It works in much the same way cranberries do, in that it stops bacteria from adhering to the bladder wall, supposedly. Is a simple hexose sugar, but can be taken by diabetics in so far as I can read. Since I have taken it I have recommended to one Facebook friend and one "dog park" friend, and both have had the same experience, so I am just saying it is worth a "try" for you.
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Mom1928 Mar 2019
As I've commented on the others, DMannose is the best!!!!! My 91 year old mom was getting UTI s regularly. Got her on th DMannose and not one for a year now. She wears depends too and no problems. Wish of knee this when my dad was.alive. He got real sick after a uti turned staff. Levoquin antibiotic fried his brain and he never recovered. He was on the long term antibiotic which he became resistant to.
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I have had a ...cele for years and wonder if that might not be what your mom has.

its been diagnosed as an enterocele, a cystocele, and a rectocele depending on what doc i see.

No to be gross but im sure i feel my bowel when i wash because i can feel poop.

I am, quite honestly, too lazy to use a pessary even if it would work and am fortunate still able to keep track of things so change pads as necessary. So far ive been able to avoid a uti even with slight bowel discharge.

I think what happens is that all our insides get pushed around together outside and we end up with utis and have to be able to keep track with what goes on. If we cant keep track we’re “done for”.

it seems that most docs are trained to look for cures not for causes and problems return over and over.

im certainly not saying that we shouldnt keep hydrated and eat things that help us, tho, too.
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truthbetold Mar 2019
Check out wholewoman website by Christine Kent because some woman can get their prolapse back in place by tilting their pelvis forward. Think twerking lol It works. A pessary creates more stress so you did the right thing to not use it.
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Take her to a urologist.
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Urologist comment is good.

It's a lot of work, made me very unpopular with the staff, (is it private CGs or a facility? Facility may not cooperate; I had private CGs). This is what I wound up doing:

Regulate having her changed every two hours. Some caregivers will be lazy and say, "I checked and she was dry" - when in fact, they didn't check properly and she was wet. So, make it a rule & stick with it. Second, when she's changed, the brief will be the evidence if she was wet or not. If not, use wipees to clean and re-brief. If wet, have her WASHED, dried, and re-briefed. Balmex too, if there's any red spots. This will not be welcomed by the staff but until they start taking regular good care of her, this will be the rule. Once they get it through their heads that you mean business, they'll be better about her care. Then & only then, may you relax - a little bit.

I have gotten rid of my own UTI's by doing this, but not its recommended. It was "in a pinch" and I was young. But now, if I get a little inkling that I might be starting to have one, it has prevented the full blown problem. Every time you pee, you must do this. Doesn't take long to correct the problem.

And of of course, antibiotics when needed. God bless & hugs.
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I was told by a friend that lemons are high in alkaline , so there for nothing survives in alkaline. So try giving her more lemon in her water, cranberry juice and make sure her diaper is changed more often. Check when you see her. Is the diaper wet at all? change it. Remind them to wipe from front to back.

a doctor told me, the more times my aunt enters the hospital, the weaker she will be. Otherwords, it does take a toll on the elders. Do try to keep them out of hospital. Ask about PALLIATIVE CARE. Palliative care, they will have a nurse check her vitals at home, and perhaps they can catch the UTIs sooner and help her in her own room rather than dragging her to ER FOR ANOTHER UTI. You want tokeep mom out of hospital as much as possible, it does take a mental and physical toll. It's stressful
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A supplement called D-Mannous that can be purchased at most drugstores has worked wonders for our 93y Mom. It was recommended by an Urgent Care physician and has solved the problem! Sea
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Mom1928 Mar 2019
That's what we have mom on. No UTIs since. Great stuff!!! She was also on antibiotic every fee months for a couome years.
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