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My mom is in a nursing home had stroke left her incontinent has cath full time keeps getting bad uti's. What can I do to help prevent these from happening?

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My MIL had UTI's so often that her doctor gave her a standing prescription for antibiotics to take at her own discretion. Needless to say rather than trying to prevent them she used the antibiotics for several years. When she came to live with us and I found out all the stupid things she was doing we changed what we could. First and foremost I got her on a high dose cranberry pill regiment and she has not had a UTI in over a year and a half. She is like most elders and won't drink enough fluids, uses copious amounts of toilet paper, wipes the wrong direction and uses baby powder like it is water....some habits are impossible to change. That being said she is doing much better. We recently moved her into an assisted living facility where she gets wonderful care. She is a fall risk and could no longer stay with us with all the other health issues plus dementia.She loves it there and life here is better for all of us.
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Cranberry pills that very easy to purchase and take.
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Sometimes cranberry juice is difficult to swallow. Cranberry comes in tasty chewable forms and in capsules. The chewables work great for my mom.
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I've been using D-Mannose, a type of not-very-sweet sugar (safe for diabetics-- very low carbs) for bladder infection prevention. D-Mannose binds with certain bacteria so that they are flushed out when the person urinates. Here are the conclusions of one study:

http://clinicaltrials.gov/ct2/show/record/NCT01808755
"CONCLUSION In our pilot study oral D Mannose proved to be effective as a safe and effective treatment choice of recurrent UTIs in adult women. This was the first experience in the clinical setting, the previous data coming from animal studies. It was observed a statistically significant difference in the proportion of women remaining infection-free during an average course of 24 week treatment, both for resolution of acute episodes and as a safe, preventive therapy of UTI recurrences, in comparison to targeted antibiotic treatment. Future research is needed to establish and confirm D Mannose as a practical, safe, and effective therapy in a wider population. An appropriate dosage schedule and length of treatment will have to be identified and studied to further develop and fully exploit its promising therapeutic potential in UTIs."

and another:
http://www.ncbi.nlm.nih.gov/pubmed/23633128
"In our study, D-mannose powder had significantly reduced the risk of recurrent UTI which was no different than in Nitrofurantoin group. More studies will be needed to validate the results of this study, but initial findings show that D-mannose may be useful for UTI prevention."

I buy it online but you can get it at local health food stores as well. There is lots of information on the Web about this.
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My mother (as well as myself) were having recurring UTI's until I got
pro-active with drinking cranberry juice daily but also I
added a daily dietary supplement -- "Cranberry Soft Chews" 500 mg
put out by Sun Valley. I got it at Walmart for about $5.00. The
chews taste great and we take 1-2 each evening. Works like
like a charm.
Cadams
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I have no experience with Catheters and I am sure they make things much trickier.

But for regular older ones who are experiencing lots of UTI's - often it is not being careful enough when using the toilet and not showering often enough.

When my MIL had a bath lady twice a week - she did better. When Medicare cut her home health help and she was on her own (she cares for her own personal needs) she only took one shower a week and then the UTI's were happening more often.

It is hard to talk to someone about hygiene (they think they are doing ok) - but I finally had to 'suggest' that she try to get two showers a week 'minimum'. Of course she has to tell me 'how hard it is - you just don't know.' She has a huge walk in shower with a padded bath seat, everything right there handy and a nice hand held shower head and a 'heated shower lamp' - she just turns it on a few minutes before getting in and stays in there until she is nice a warm and dry before leaving the shower. I am talking about 6' x 6' shower with multiple hand rails, etc.

She just didn't want to bother :0(

But she is doing better. We even put a portable bidet on her toilet - but she refuses to use it. So, I kindly told her that with her lack of mobility - it is very easy to transfer bacteria to the wrong places and that is why it is so important to at least go in and rinse off every day or two. So, she is doing that now. And yes, there is a big difference between cranberry juice cocktail and cranberry fruit extract in capsule form. (no sugar in the latter).

But, there are times when antibiotics are needed. I am not anti medication. But, prefer to try and avoid them because invariably they lead to other problems like vag. infections requiring further treatment. Everyone who deals with this probably knows the routine.
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I am all for the use of supplements whenever you can, if they give the intended results. I don't know much about any of the other supplements listed above, but I do know that cranberry juice will not kill any bacteria and it will not keep bacteria from getting into the bladder. The only thing it will do is make the inside of the bladder slippery so the bacteria cannot stick as well, and gets washed out with the urine - and for this action, it is desirable to drink it. Even so, if there is an extraordinarily large amount of bacteria, that would probably not be able to keep up with it. Also, again, e-coli does not "form" in the bladder. It can only get there when traveling there from the bowels in some way, and is needed in the stool-making process, so there is no way of getting rid of it there. With men, it is a little bit easier to keep the stool away from where the urine comes out because with women, those 2 openings are right next to each other. In 'stressed out's' case, her mom already has a catheter in, so there is no urine back up in the bladder so this would not apply to her. However, that's not to say that supplements can't help. If kltowson has found those supplements to work, and your mom's doctor says it's OK to try them (ie: they are not contraindicated with any meds she is on), then that would be worth trying.
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Has she been on antibiotics to clear up the UTI, perhaps she needs a different antibiotic and you might ask her dr if say an internal exam and/or more blood tests are needed, what if it is some disease causing that UTI?

And cut back on any sugars, I read sugars are really bad when one is prone to UTIs. But I would take her to a really good urologist to see if there is something else going on and a good dr will know exactly how to get rid of and prevent any further UTI's that's your best bet.
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Researched Supplements was the key!! This kept happening to my dad and the doctors said "not really much to be done" since dad was incontinent -- I didn't accept that and did a little research. If somone is incontinent, the fluids tend to build up in the bladder because the person does not have the ability to release them as quickly as other people with normal flow and then E-coli builds up in the bladder which can cause the UTI. Enter supplements to keep the E-coli from forming: Cranberry juice or pills, Vitamin C, Grapeseed Extract, Calcium, Magnesium and Acidophilis Probiotic -- when I gave dad this combination of supplements, he went a year and 1/2 before getting another one when previously I had to take him to the ER every 3-4 months. Obviously, hygene is also an issue but with elders on incontinence equipment (diapers, caths etc.) that is obviously a challenge in and of itself -- we were really on top of that with dad but he got them anyway from the internal bodily challenge -- try this combo of supplements after checking with your mom's doctor -- I proved all the doctors wrong and dad's doctor even started giving that combination to other patients because it worked so well. UTIs can increase lack of cognition in the elderly with dementia or Alzheimers' and after each such episode, dad's mental acuity declined so UTIs are more serious than people realize -- do try this method -- it can't hurt in most cases.
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I agree with Carol Bursack above totally. As a nurse, I've seen this for many years. Like Appaloosa says, the catheter is a highway for bacteria to travel up to the bladder so UTI's with a catheter kind of go hand in hand. You can do things to cut down on the # or them, maybe, but you won't stop them altogether. They say cranberry juice, though it is not going to stop bacteria from getting to the bladder, it does coat the bladder somehow so the bacteria doesn't stick to it as easily - not sure if the pills would work the same. Lots of water helps too, but like it was said, it's sometimes hard to get older people to drink much. Is she incontinent of stool also? If so, that's a constant contamination, being that there is almost no way of keeping it from getting on and around the catheter. E-coli is a bacteria meant to be in the stool, but when it gets into the bladder, causes problems. Same thing if she is able to hold her stool until she gets to the bathroom, but wipes from the back to the front, bringing stool up to the catheter area. Sometimes no matter what you do, they keep getting them. Some doctors believe that catheter patients that keep having that problem frequently should be on a continuous low dose of antibiotics, but others don't like to do that because of the bacteria these days developing resistance to the antibiotics. You need to talk to her doctor to see what he suggests. It's not likely that you'll find a nursing home willing to put in a bidet in for her.
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Someone else suggested this but just to reiterate - cranberry capsules. They are much more concentrated than cranberry juice so are more effective.
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I am 80 and have found that if I wash with clear water and dry each time I urinate it helps and if I feel any sensation of irritation in the area I put some Sudocrem on immediately. This is working so far. Also I like to let the air get at the area as much as is feasible, sometimes wearing light cotton panties and a skirt.
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My Mom lives with me and has had constant UTIs also. She has a foley in as a way to help and I have a few tricks that may help. I give her 1000 mg. of vitamin C a day as this also helps with diabetes. She also takes Primadophilus Optima 90 billion active probiotics by Natures Way and Cranberry Mannose + Probiotics by NOW, it is a packet to mix in water, she may drink this as much as three times a day. This will not interfere with warfarin or blood sugar. I looked on line and found a product called Sensi Care for peri care. I use this spray many times a day and it has been helpful, it claims to help with prevention of E. coli. I spread the labia gently and spray then on a clean wipe I spray and clean the catheter tubing. In the evening she still uses briefs for bed so After cleaning the front I roll her and clean her bottom with the spray before I use the barrier cream. She also takes a medicine for bladder spasms. I monitor her fluids and keep track by the number of glasses she drinks. I know foleys can be a challenge but this helped so much. I also alcohol the tubing when changing the bags. Wear gloves and hand wash often and also clean the bags with bleach. You all take care and I sure hope this helps!
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My Mom lives with me and has had constant UTIs also. She has a foley in as a way to help and I have a few tricks that may help. I give her 1000 mg. of vitamin C a day as this also helps with diabetes. She also takes Primadophilus Optima 90 billion active probiotics by Natures Way and Cranberry Mannose + Probiotics by NOW, it is a packet to mix in water, she may drink this as much as three times a day. This will not interfere with warfarin or blood sugar. I looked on line and found a product called Sensi Care for peri care. I use this spray many times a day and it has been helpful, it claims to help with prevention of E. coli. I spread the labia gently and spray then on a clean wipe I spray and clean the catheter tubing. In the evening she still uses briefs for bed so After cleaning the front I roll her and clean her bottom with the spray before I use the barrier cream. She also takes a medicine for bladder spasms. I monitor her fluids and keep track by the number of glasses she drinks. I know foleys can be a challenge but this helped so much. I also alcohol the tubing when changing the bags. Wear gloves and hand wash often and also clean the bags with bleach. You all take care and I sure hope this helps!
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Here is a good one not that all these are bad ideas, but my problem with cath's brought on many symptoms of UTI because, I was allergic to the material it was made with. So it would burn my skin probably similar to a tear, and from there it "sounds" the same, but gets resolved differently.

Also antibiotics bring on UTI's which is how I got my last one.

Cranberry juice unsweetened, I chose the tablets, lemon water, etc.
Uristat or generic works wonders for the pain
Latex free stopped the burning that is often associated with UTI's because the cath was actually burning my skin.

I also have the same thing with tape and other adhesives like heart monitors, the tabs from the EKG machine, etc.
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I should have mentioned probiotics, too. Thanks Ferris!
Carol
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My mother has a similar problem. She is in rehab and her recovery has been difficult and prolonged due to recurring uti's. Rehab doctor has started her on cranberry pills 2x/day (as an alternative to a low dose of antibiotics, which is risky). She is doing so much better. We are hoping this will be a long-term solution.

Good hygiene is also crucial. If you keep on the NH about cleaning mom thoroughly, not just wiping, at least 2x/day, that should help. Have this added to her written care plan. Good luck. UTI's wreak havoc in some elderly.
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Your mother's immune system is compromised and therefore needs some probiotics to correct that. Urinary tract infections with catheters occur frequently because they are not changed frequently, sterilized when changing, and/or the nurse might insert catheter tearing some cells in the urethra. There could be other issues as well, and not knowing your mother's history I'll not comment further. As was mentioned, cranberry juice is acidic, and some studies have shown it to be effective with a healthy person, but if it is the regular one, it will have sugars in it. This will contribute to infections. Try talking to her doctor and get this infection under control or it could be serious.
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check out D-Mannose works for us
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She might do better with depends than with a catheter. A catheter is easier on the staff than cleaning up urine accidents, but it's also a highway into the bladder for all those bacteria on her skin down there. Talk to her doctor.
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Those UTI's are a royal bitch. When my mom was at home, I changed her every 3-4 hours like clockwork, I used a cloth with soap to clean her, followed by another cloth with just warm water, followed by a soft, dry towel, followed by a soothing cream. I figured I could prevent the UTI's. Nope. Wishful thinking. She'd still get the damn things somehow. I think, like Carol said, it's just something that's common with the elderly. I helped cut back on them, but nothing I did prevented them totally, unfortunately.
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con:t if she is a catheter
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Make sure she is kept clean if she has a catheter peri care very vital in a nh environment this really does not get done as much as we would like cont giving lots of fluids and also if she is constantly in a lying down position can cause the uti i was surprised when i learned that i am PCT, CNA and i see alot of this express concerns on her peri care and tube changing
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Mom, now 92, has a long history of UTI. I personally believe cranberry, yogurt, apple cider vinegar, etc cannot compare to an emerging new trend. That being the bidet. They are coming out with all kinds of models, ones you can attached to a conventional commode, a whole seat, hot, cold, warm air blowers.Even small wands. It's all about hygiene. Cranberry juice isn't going o stop bacteria from finding its way to places it doesn't belong. Keep all the cracks and crevices clean, less paper, worked for me. No UTI for a year now. Many available online or at your box hardware store. And ez to install.
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My MIL has type 2 diabetes and used to get UTI's a lot. She has been taking a cranberry extract capsule in the morning and in the evening for over 3 years now. She rarely has a UTI any more.

It is very hard to get them to drink enough liquids - most older ones equate drinking fluids with having to run to the toilet or if they are 'incontinent' - well, that's a whole other story. So, they hold back on the fluids which causes their urine to be concentrated - which can encourage bacterial growth as well.

Diet is important - especially if the person is diabetic. I tell her she is just too 'sweet' - and that is exactly the problem.

So, push fluids (but avoid sweet juices and sodas - give them the whole fruit instead) and cranberry fruit extract (can be purchased inexpensively at Wal Mart, Sam's or Costco) twice daily - AM and PM - these measures should help a lot. She also like cranberry juice (but most of these are really 'drinks' and are high in sugar. So we water them down 50/50 and that helps. Herbal teas are good and come in many flavors. Hope this helps.
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Cranberry juice is still considered a good preventative step to keep UTIs away. She need to drink it daily. Also, consider whether or not she is capable of wiping carefully after going to the bathroom. She could be contaminating herself. Lots of water and other fluids are important. I'm sure her doctor has other suggestions, but sometimes elders are simply prone to these miserable things. I hope you can find ways to cut down the frequency.
Carol
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