A still-present infection is causing further confusion in my 93-year old mom resulting in refusing to take meds or fluids or food. Trip to ER or hospital is not an option. Any suggestions?

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Thank you all for sharing your collective insights. My mother's abysmal experience at hospital in 2016 was the impetus for my promising her NEVER to bring her back there. At the urging of our geriatric manager, I did end up driving my mom to ER yesterday where, thankfully, a GEM (Geriatric Emergency Medical) rep helped us through the intake and assisted in getting my mom the IV fluids/labs she needed. By the end of the visit (a few hours later), the results from her urine culture came & she was prescribed (yet another) antibiotic to treat a pernicious UTI. I will look into hospice care because my mom, being wheelchair-bound, mostly incontinent, experiencing dementia, will never fully get off the the merry-go-round of dealing with the symptoms of the UTI. Thank you all again. The antibiotics already are working and my mom is willing drinking cranberry juice & water. I also picked up a Mio.
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I have similar problems with my wife taking her meds. At first I used a pedistal aand mortor to crush her pills into a powder and mix them with ice cream. That worked. Now I give her the meds with a small glass of diet soda. She will swallow the soda but if I give her water she holds it in her mouth a long time and may just spit it out. I still have difficulty getting her to put the meds into her mouth and when she does she will put the meds under her tongue until they dissolve. I do this three times a day. Frustrating.
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When a person doesn’t feel well, whether they are young or elderly, they don’t want to eat nor drink and they can become confused if they are dehydrated. Monateru’s suggestion of adding water flavors is great. You might try popsicles--however, they can be rather messy and stain clothing. Maybe freeze some flavored water in Dixie cups (I suggest 1/3-1/2 full). A cold wet washcloth that the person can suck on can help relieve some of the dry mouth feeling. Is the antibiotic a pill or capsule or is it a liquid? Crushed pills taste terrible :( even when put in pudding or applesauce.

I too have questions about the ER and Hospital—why are they not options? Is your Mom receiving Hospice care? If so, then you really need to contact the Hospice Nurse. If your Mom is not under Hospice care, then she probably needs to be.

As mentioned previously, there comes a time when our bodies decide that they have lived long enough. At age 93, your Mom has lived a full, long life. If your Mom is actively dying, there is not much you can do, except to be by her side and to comfort her. Tell her that you love her and that she has helped you to be the person you are today. I am sorry that you and your Mom are experiencing this situation. Please keep us informed of your situation.
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From Social Care Institute for Excellence website;

People with dementia can develop problems with swallowing food or fluids in any stage of their illness, although it is most common to see this at the advanced stage.

When a person with advanced dementia takes in only a very limited amount of food and fluids or can no longer swallow safely, it may seem that they are starving to death. In fact, they are not. Even so, medical professionals may consider using tube feeding at this time. This can be an extremely difficult and emotional time for family and care staff as they try to work out how to best respond and care for the person with dementia.
As dementia progresses it affects the area of the brain that controls swallowing. In advanced dementia the person may have a weak swallow or lose the ability to swallow safely, for example they may cough or choke after swallowing food or drinks.

Swallowing problems can also be caused by general weakness and frailty of the person, that is, their swallowing muscles become very weak.

Other problems – such as having a sore mouth or sensitive teeth – can cause a person to take in less food or develop swallowing problems.

It may seem that the person is being starved or dehydrated to death when, in fact, they are not. In the end stages of dementia (that is, in the last few months or weeks of life), the person’s food and fluid intake tends to decrease slowly over time. The body adjusts to this slowing down process and the reduced intake. It is thought that by this stage the hunger and thirst part of the brain has now stopped functioning for most people.

The person may be immobile and so not need the same amount of calories to sustain their energy levels. Having reduced food and fluid intake and decreased interest in this can be thought of as a ‘natural part’ of end of life and dying.

Giving increased food and fluids artificially to a person who has been having a reduced intake can be harmful.
Health professionals now feel that a person with advanced dementia and in the end stage of their illness should not be fed by tubes or drips. Why? Inserting tubes or IV drips requires hospital admission and this can be very distressing for the person. They may then pull out the tubes and drips, and the site of the tubes and drips can become infected and sore.
We also know that giving food and fluids in this way does not benefit the person and in fact may cause them harm. For example, giving a person food or fluids via a nose or stomach tube does not stop the person from coughing or fluids going down into their wind pipe.
In fact, we now know that a third of people with advanced dementia, who have a tube inserted for feeding, die within one month. So the case against inserting a feeding tube is a strong one.

Usually though, at this time, the most important part of maintaining comfort is with regular mouth care.

But is the person suffering?
This is the most common concern for both family and carers, who are often unaware of why the person is having difficulty swallowing or does not want to eat or drink anymore. Most people now think that a person with advanced dementia takes less and less food and fluid towards the end of life and their body adjusts so that they do not feel hungry or thirsty, and therefore they are not suffering.
Remember when the person is dying it is natural that they will become unable to eat.

I'm sorry that she's having this difficulty. Hope this information helps.
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You say that confusion is the reason she is not taking fluids and meds. Is the confusion new, or part of a long-term illness, such as dementia? What is the nature of the confusion? For example, does she think she is being poisoned? Is she sure that she just took the medicines?

Is she on hospice care? What does the nurse advice?

If she is refusing fluids because she is actively dying, I think you need to accept it, and keep her comfortable. I'm so sorry.
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Is she refusing the antibiotics? Have you spoken to the Hospice nurse line about this?
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TooFrazzled, since you mentioned that a trip to the ER isn't an option, that tells me that your Mom is on Hospice care. Correct?

Sadly there does come a time when drinking water or eating even a little bit of food is very uncomfortable, as the stomach isn't digesting the food correctly and the kidney are holding water much too long.

What does your Mom's doctor or Hospice Nurse have to say?
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Try putting water flavorers in the water. This will color the water so she can see it and it will make it taste good! My favorite is the little Mio water flavors. They have a lot of dye in them so it makes the water not so clear, which can be scary for older people especially if they have dementia. May I ask why the ER is not an option?
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