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My mother, age 87, has live with us for 7 years. She has had back-to-back UTIs for seven months, despite multiple antibiotics, including two courses of IV antibiotics, which left her extremely weak for a week or so. Two urologists and the infectious disease doctor have all indicated that she will not ever be infection free. Yesterday, the second opinion urologist suggested discontinuing treatment under AND/DNR provisions. We agreed to a referral to hospice and will have a consultation with them on Tuesday. Mother has lots of limitations and has no problem with the idea of death. However, her mind is still good. Are we being premature in this decision? How long before the UTI turns into sepsis/ septic shock? She does not want any more IV antibiotics. These are questions we will discuss with hospice (dr. said it could weeks to months), but I'm interested in other input/experience. Thanks.

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If would would feel better, get a second opinion. I was told by a pulmonoligst in 2003 that my father would not live, never walk and never eat again. I refused to let his doom and gloom prophecy guide my decisions.

Right now, my 95 year old father is outdoors working in his shed.

Don't take just one doctor's dire prophecy but get advice from other doctors as you feel appropriate.

UTIs can cause confusion and certainly wear your mother down, but the issue in my mind would be whether the UTIs and her fatigue are sufficient to make a terminal decision.

Best wishes for this difficult time. And do, do do, try natural remedies! If Mom can drink cranberry juice, try it. The repeated antibiotics may have created a resistance in her body that can't overcome the UTIs.

We also found that a infectious disease specialist accurately diagnosed a repeated infection that at least 2 others doctors misdiagnosed. Why? Because they diagnosed by sight without bothering to do a culture.
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Thank you all. I think we might first try an immunologist, who my grandson and husband have found helpful, while at the same time trying natural alternate supplements (don't laugh). Mom is interested. It will either work or not. Thanks for your valuable input.
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If there was a referral from the doctor, then she is ready hospice and palliative care. This is part of medicare coverage and paid by our taxes. Take all the assistance to relieve your stress so that you can care for your dear mother.
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If your mother has the capacity to speak on her own behalf, allow her the dignity of the decision about her end of life care. I am experiencing right now the decision to let my mother go based on her health care directive and what she wanted. Her condition makes it impossible for her to make her wishes known, so as her health care proxy, I am her voice for her. It would be so much easier if my mother could voice her own wishes, but she is unconscience and I must do it for her and it is so difficult and emotionally agonizing.
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There's no telling how long a UTI will take over, if it even does. Your mom may just become symptomatic and that's where hospice will come in. The infection may cause her to become confused and disoriented and hospice will treat these symptoms. If your mom experiences pain related to the infection hospice can treat this as well.

I think hospice is always a good idea when the time is right and from what you wrote it sounds like hospice is a good way to go but hiring a hospice company isn't like pulling a trigger. Your mom may spend months with hospice. There's no gauging how long you'll need hospice. But if you've made the decision to not continue antibiotic therapy having hospice will help ease your mind that your mom's symptoms will be treated and she'll be as comfortable as possible for the rest of her life. It's a good decision.
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