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When mom's regular aide went off duty after being with mom for a few weeks and our fill in aide checked on mom immediately after the regular aide left the house for the weekend, she found mom with extremely foul smelling & very cloudy/darkish urine. Mom had been put to bed by the regular aide about 5 hours earlier. The regular aide claims that she saw no signs of a UTI when mom was put to bed or earlier that day/week. I am wondering how likely or possible is it that a UTI would progress to such a degree without any signs prior? The regular aide has had some issues lately in her personal life and I am concerned about mom's care and now this...Would these symptoms typically come on slowly? Mom is now on antibiotics but I am concerned over this situation and what it may indicate....

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Confusion is a sign of a UTI. In my CNA classes there were 7 of us. 4 of us were dumb as boxes of rocks but instructor allowed them to change test answers UNTIL THEY GOT A PASSING GRADE. There are idiots out there caring for our elderly. I got my certification because I take care of my dad. I found more than half of the info was EVERYDAY COMMON SENSE. If aide had NO IDEA then she/he wasnt doing the job. She/he WILL miss other things as they come on. I would dismiss her immediately. In my professional opinion. Retired Law Enf/CNA
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busymom Feb 7, 2019
Wow! Would you want a surgeon operating on you if his/her instructors allowed that student to change answers on tests until they got a passing grade? Not I! Neither would I want that for CNA's and others who cared for my parents during their final days of aging. Thankfully, both my mom and dad had exceptionally caring staff (for the most part). They were blessed and so were we as a family.

It makes me sad when I see how some elderly are not cared for. I had an aunt and uncle in an assisted living facility (had to be placed somewhere by DSS) and it was so subpar that I can't believe it is still open. We managed to press until DSS worked to get them moved to a much, much better facility.

The common sense which you spoke of, may sometimes come with a little bit of age and living life. I noticed that the older care givers were more aware of things: such as possible UTI's than some of the younger ones. But I also know that most people can learn, if they are willing. I did a lot of research and reading books to teach me more about my mom's Parkinson's disease. When my dad was diagnosed with advanced prostate cancer, I read every test results, images, etc. If I didn't know a term or a unit of measure (since they're usually not given in inches), I learned what each one meant. I did the same when it came to legal matters, because I owed it to my parents to be as knowledgeable as possible to best meet their needs. Granted I had two wonderful parents (not perfect, but kind and loving). Caring for them was an honor and a gift of God—even in the most difficult decision-making times all the way through planning and executing their funerals.

Thanks for taking care of your dad. You certainly went much further than most of us by taking the CNA classes. I applaud you!
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My Dad has LBD and has a full time aide as well. I called him at 10:30 in the morning to ask if he would like to go to the movies. He stated yes and sounded pretty lucid (for someone with middle stage LBD) and I then told him I would be there in about noon. I go there and was practically unresponsive. Could not speak, he looked as though he was drunk out of his mind (he doesn't drink). I was so concerned I took him to the hospital where it was determined he had a very bad UTI. He was hospitalized for a few days. The aide stated that his urine was not dark, etc. We asked the doctor if this can come on this soon and he stated yes.
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caregivingstuff Feb 8, 2019
Thanks so much...
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The symptoms, in my experience, come on very suddenly. You get no advanced warning. Unless your mom complained of back or abdominal pain or had a sudden, drastic change in behavior, there is really no way an aide would know she had a UTI other than by observing her urine.
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caregivingstuff Feb 8, 2019
Thanks
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My first inclination is to say that typically there are warning signs prior to an UTI getting that advanced.

However - they would be things that your mother would be feeling physically such as pain in the very lower tummy area and pain/burning when urinating. Is your mother able to recognize these symptoms and communicate then to her caregiver?

As well, I had a UTI once myself that was unlike the other few I had over the years. I had no symptoms at all - then suddenly was in a great deal of lower tummy pain and when I went to pee - it looked like I was peeing straight blood. It literally went from zero to sixty in about ten minutes. It was bad enough that I went straight to the ER and when they saw - just saw - my urine sample in the little clear cup - hooked me up to IV antibiotics immediately. Fastest action I’ve experienced in an ER - ever!

So, yes. In my experience it can happen just that fast - but it also seems to be nontypical.
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caregivingstuff Feb 8, 2019
Thanks very much....what an experience
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Yes it's possible not to be detected. As we age particularly advance age, patient would not have any sensation or pain sadly until it has advance. On the other hand it can be detect it observing client moods: sleepy, drowsy, poor appetite, lethargic, weak. These are common signs and symptoms of UTI.
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My mom gets frequent UTIs despite all best efforts. Our caregiver is diligent about cleaning mom which helps. One earlier caregiver wiped from back to front so some really are not well trained. And yes got a UTI then. Moms first symptoms are always behavioral - she gets annoyed at everyone and everything. It then progresses to delusional if we don’t catch it and test her. Dark smelly urine comes later for her. The lab gave us a few urine cups to take home so we don’t have to bring mom to the doctor/lab for this. Makes life a bit easier. A doctor’s tip was If a mild-mannered elder is suddenly angry at everything get a urine test for UTI.
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caregivingstuff Feb 8, 2019
Yes we are lucky to get the lab to come to house, which is such a help.
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The symptoms seemed to come on pretty quickly with my mom, too. She had burning and would have to urinate frequently. She also showed Alzheimer's like symptoms, forgetting where she was and calling for her dead sister. It can be pretty scary.
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Two years ago my mother had a UTI that came out of nowhere. One evening I called my mother and she told me she had felt nauseous earlier in the day, but was feeling better--thought it was a stomach bug. She suddenly started talking out of her head and was making no sense at all. I had her put my dad on the phone, and I told him I would meet them at the ER. I thought she was having a stroke. The doctors concluded she had suffered a mild heart attack brought on by a UTI. When the nurses did a blood draw, her WBC was off the charts. She had no cramps, backache, blood or other issues with her urine, nothing. She spent nearly a week in the hospital, and then did a antibiotic IV at home for six-weeks. Until this experience, I had no idea that UTIs could become so dangerous while showing none of the usual symptoms.
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caregivingstuff Feb 8, 2019
Wow, I never would associate nauseousness or a heart attack with a UTI. That is good to know! I hope your mom is okay now. Thanks for sharing...
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Mother could be perfectly fine and in 6 hours, raging fever and urinating blood. It reminded me of the years of breastfeeding and how quickly a breast infection could come on--literally 2 hours from being "Fine" to a temp of 102 and complete misery.

I learned to keep antibiotics on hand and not"wait it out".

I imagine that when mother has yet another UTI. I have never had one and so I cannot relate, but I imagine it's similar to the BF infections. Awful.

Mother always has a 'low grade' UTI. She catheterized now, but cannot clean her own cath bags and so keeps getting infections. Frustrating is not even the word to use here.

(Don't tell me to get outside help, as much as 3xs a weeks in home care would be--brother will NOT allow it)
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caregivingstuff Feb 8, 2019
thanks and it sounds like you have your hands full..that must be tough.
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I can say as a nurse that the caregiver is not at fault for not noticing the foul smell. UTI symptoms can occur rather quickly. The issue is to have the aides make sure they give your mom more water and to cleanse her from front to back. She could still get the infection.
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caregivingstuff Feb 8, 2019
Thanks, very helpful to know this.
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