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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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Although OP's mom's ordeal may be past by now (I'm a little late coming to the party), there are many issues to be considered. Even if original poster cannot benefit from this, others might.

1. Symptoms for UTI in patients who have any dementia are varied. Our mother had one, but rather than complaining of pain, she went off the rails, generally later afternoon or early evening. Often this would happen at night and even worse on a weekend, when the doctor was not available. Lorazipam was used to calm her until we could get it tested and treated (symptoms/lorazipam did continue for a while after starting antibiotics.) Also note, many many years ago the only sign of a UTI for me was the result of a regular urine test for a physical. I had NO symptoms whatsoever!

2. Keeping hydrated IS important, however beware that being OVER-hydrated is an issue as well. The old standby of 64oz (morphed into 8 8oz glasses/day) INCLUDES fluids from ANY source (foods have fluids, as well as coffee, tea, other beverages.) SO, please do not encourage TOO many fluids - this washes electrolytes out of your system, and can lead to confusion or even more serious issues. If the person is eating a normal, healthy diet, 8 8oz glasses is really way too much!

3. Any doctor saying they want to avoid resistance by not giving long term antibiotics has no idea what they are doing! One should consult with a specialist, a urologist or the like. When I had a repeat UTI, that doctor told me if I had another, he WOULD put me on long term antibiotics. Resistance occurs when the current course does not treat ALL the bacteria, which results in the strongest of the critters surviving and reproducing (same result as not completing the full course of antibiotics, which many people have done, which leads to things like MRSA.) Culturing the urine sample is also VERY important, especially when the antibiotics didn't treat it completely. Some antibiotics are broad spectrum and may not be the best choice for the current infection (certainly not this case, when they finally determined it was MRSA!) Fine tuning treatment by culturing is the best, so they use the most appropriate antibiotic for the bacteria causing the infection. If need be, long term treatment should be the option used as well, to ensure the infection is treated fully.

Hopefully OP's mom is feeling better and maybe back to some semblance of her old self. Hospital (and probably any other care facility) stays are likely to throw anyone with dementia for a loop. Certainly surgery can do this, but being "moved" about leads to more confusion and possible setbacks. This poor woman has been moved multiple times (ER trips, scans, hospital, care facility), so it likely resulted in a setback, just like surgery might. MRSA doesn't help either. Hopefully she will be well monitored after she is declared "cured".
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D Mannose with Hibiscus flower fixed my 86 year old Mother. It has been years of fighting these UTI's, found the HARMONY BRAND DMannose with Hibiscus worked in two days!!! I use it also. Keeps your bladder flushed and clean..it's worth a try. Amazon, read the reviews, its amazing!! 🙏🙏🙏🙏🙏
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What I read at the link I will provide seems to me to be advice I could have used for 3 elderly relatives. Basically, be sure that the UTI is diagnosed professionally. Then be sure f
that the UTI has cleared after treatment, by having another professionally conducted, wherein the urine is collected carefully and if the patient has dementia, that may mean 2 people assist so as to ensure the urine sample is clean, not polluted by inadequately-wiped bottom, etc. Then be sure the person is getting hydrated, ideally by drinking about half her weight (say 120 lbs) in ounces of water daily (60 oz or about 5 12-oz bottles ). SEE THE UROLOGIST to rule out pelvic floor issues and other potential physiological problems that might contribute. Then CONSIDER TOPICAL ESTROGEN because post menopausal women experience drying and cracking that can lead to infection, and the hormone works for many to minimize that as a cause. My parents' doctor finally put both of them on prophylactic antibiotics and they've not had another UTI in a year. This is supposedly normal in Europe. It sure beats constant craziness and hospitalization and all the resultant disorientation and struggle and further mental decline. Once we got a handle on it with water and prophylactic antibiotics, the mental decline stopped and they have enjoyed many hours. Here is the link https://www.clinicaladvisor.com/home/consultations/treatments-for-recurrent-uti-in-elderly-patients/
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Colloidal Silver! First you need to get rid of the infection. This can be done by taking 4oz of colloidal silver three times a day for 7-10 days.
Once the infection is cleared up, you can resume by taking 1-2 oz of colloidal silver daily to ward off any recurrence.
No you will not turn blue. My family takes 1-2 oz daily, which keeps us out of the dr.s office. I use in for all my pets and in my Berkeley water filters. The uses are endless. NASA even adds it to their water supply, that’s how good it is.
I have a generator and make my own, if you buy it it can get pricey.
Colloidal silver is nature’s antibotic and with any antibiotics you will need to replenish your gut bacteria by using a daily probiotic. Good gut health is the key to a healthy immune system.
Also you can put colloidal silver in a spray bottle and keep germs at bay with a few sprays, especially the genital areas.
Hope this helps?
FYI your doctors will poo poo this remedy because Big Harma can’t make money off of it.
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Now that I have read through and see I am NOT alone, that D Mannose has helped others, again, I say, I am an RN and honestly I do not believe in supplements and naturals and all that other stuff. I am a real Western Medicine girl. BUT I SWEAR by D Mannose. Please try it if bladder infections are an issue. You have only 30 dollars for 100 days worth to lose. And for me it has been a miracle.
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She needs incontinence briefs changed frequently. And perhaps she could be seen by a urologist.
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First of all she obviously needs her briefs changed more often and or needs to be reminded or toileted more often, on a regular schedule. Seems to me the facility needs to take more responsibility for this problem, that is what they are paid for. Then there might be a happier medium between long term antibiotics and hospital visits. Part of the key is to find those subtly indications that so often exist when the first get a UTI but before it's that bad, with my mom it's a change in her mental status her aphasia gets worse and she just doesn't act right, we know something is off and as soon as we suspect UTI we call the doctor and they call in an antibiotic. They like to have us get a sample before she starts it but they are always willing to call it in pre-test result. Are you able to get a sample normally, I mean before her infection gets so bad she needs a cath or does she not toilet at all? If she does use it or can and it's too hard to pick up on early Q's with her maybe if you resorted to getting a sample a day, not testing it but then once you do suspect UTI but aren't able to get a sample you have one. If she doesn't ever use the toilet, can't use it anymore I'm not sure how to get around that but the facility must have methods other than sending her to the hospital. If not maybe the doctor needs to be ok with putting her on the antibiotic when a UTI is suspected and not requiring a sample unless that doesn't help and she continues to decline, then she goes to the hospital or they send in a nurse to cath her for one. But I think you are more than right to insist something else be worked out on both ends, so to speak, with her caregivers to keep her cleaner and dryer and her doctor to treat a UTI earlier and easier. Your right seems like this back and forth to the hospital is likely doing it's own harm to her mental and physical health.
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My mother also kept getting them. She gets less now that we changed her inhaler. If your mom uses an inhaler, read about the side effects. One was it could retain urine in the bladder and cause leakage. If that’s the case, get a different kind. Ask your doctor. We had to bring it to his attention.

Also, bathroom habits are of course important. Mom may have been wiping badly. Always have her wipe front to back after a BM, and don’t bring paper back “to look”. Do a few times. “Wipe back and drop” we remind her.
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Yes!!! So it’s not just me dealing with this!! We just had similar issues!! My mom is ALF also and gets UTIs very often. Has been totally incontinent for years and has Alzheimer’s. I get weary of them saying oh she is fine or she hasn’t been complaining of anything thing. Finally yesterday I had to get firm and say either you do something or I’m taking her somewhere and it was amazing how fast we got something going. And guess what all the sudden her urine has odor!! Keep pushing them!! We have to be their advocate!
The doctor can order a home health nurse to come and do an in and out catheter to get a sample. They did that for us one time. Also they did put my mom on a probiotic which has helped slow them down as well.
So sorry for your stress!! I totally understand!
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Lymie61 Mar 2019
Probiotic is a great tip!
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I was starting to have chronic UTI’s and my doctor sent me to a urologist. She said as we age, that our urethra gets more brittle and friction causes little tears that lead to infections. She has me taking D-Mannose with probiotics every day, and 1000mg of vitamin C. I also push water to stay hydrated. I use a peribottle to cleanse that area regularly too. I have not had one since I started this regimen 18 mos ago! My MIL started having them regularly and we started her on the D-Mannose and Vitamin C and it seems to be helping. I get my D-Mannose powder from Amazon.com and my Vit C from Sam’s. We didn’t think MIL would drink the powder/water-though it has a pleasant taste-so we give it to her in capsule form.
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AlvaDeer Mar 2019
So glad to hear someone ELSE with some success with D Mannose. I would take a little care with the Vitamin C dosages as Vit C in big doses is a bladder irritant and can even cause stone formation.
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The question should be why is she getting the UTI and what can be done to stop the illness. Something is going on in her system for this to keep showing up, I feel that people depend to much on drugs and not enough on change.
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truthbetold Mar 2019
It is a permanent condition of thinning tissue and collagen and all that is involved in what makes our organs. The bowels are right next to the bladder so there is the spread of ecoli and other pathogens from organ to organ right through the tissue. As soon as the antibiotic clears out the bacterias, they just come right back because the colon is populated with ecoli. That is why garlic and tumeric and probiotics are essential as they populate the digestive tract with good bacteria which is suppose to manage the bad bacteria and keep it under control. So that is the most hardest thing to do because doctors do not know how to advise an elder on how to populate the microbiome to prevent UTI's. THere is no standard for anyone to follow on how to populate the bladder with good bacteria or how to make the bladder inhospitable to bad bacteria. So it is infact a life long maintenance on keeping the bad bacteria under control with what ever means you can get. Be in drugs or natural remedies, Oh, also, UTI's are caused by sluggish bowels. THe faster the stool keeps moving, the less the bad bacteria can keep growing. Something like that. Wholewoman has alot of knowledge and research on this topic
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Change doctors... Obtain a second opinion. There are other meds out there that can help eliviate getting UTI's. Husband hasn't had one for over a year now. Last time (it was so bad) he was in the hospital for four days on IV antibiotics. He never has any pain. However, I'm now aware of a lot of the other symptoms.
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Sorry you are going through this. It’s one of the many hard roads we have to travel as we watch our LOs age.
Mom was in the same boat. Recurrent UTIs and moderate incontinence. (UTI averaged one every 4-6 weeks). Primary sent her to urologist.
After cystoscopy determined bladder spasms, which was causing the incontinence, which in turn along with dehydration (man it’s tough to get her to drink water) and improper cleaning (she is determined to do it herself) were causing her UTIs.
She has now been on a low dose macrobid that she takes once at night. That with pushing water (I try to make it into a game for her) and giving her some extra tips on “keeping extra clean” as I tell her, she hasn’t had a UTI in 4 months now. I know it’s not that long..but it’s a start!
UTIs in the older folks are no joke. My mom presents with no other symptoms than dementia.
We are in the process of neuropsych testing to determine exactly what brain disease she has... so there always is some delirium and hallucination with the disease.
But when that ramps up, I know it’s time to call the doctor to get a sample cup.
Thanks to everyone for the suggestion...I’m definitely going to look into D – mannose as I would like to get her off the antibiotic sooner than later but for now it seems to be the only thing that’s helping.
Good luck to you and I hope you find your answers and mom gets some relief.
All I can say is thank God for this group. You guys are invaluable with your plethora of knowledge, insight and experience.
I have lurked for months now...Learning so much as I take on this new role and chapter of my life.
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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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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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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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Take her to a urologist.
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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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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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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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The Doctor is right. Have you tried probiotics or yogurt? Constipation also contributes to 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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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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Urogynecologist , just remembered what they are called. A urologist that specializes in female issues.
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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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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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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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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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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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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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