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My 83 Y.O grandmother has been having confusion for a couple of months, and it seems to be getting rapidly worse by leaps and bounds......she was diagnosed with a e-coli, UTI and given 5 days of cipro....how long should it take for her confusion to clear? Thanks

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My mom started having diagnosed UTIs at @ 85 while living at home. Likely she'd had it earlier contributing to her confusion & delusional behavior. She was hospitalized 3 times: given intravenous antibiotics and sent home with maintenance antibiotics, cranberry pills etc. Within 1-3 months it came back. She had been incontinent and wearing diapers which she was not changing regularly. Nor was she showering fighting the home health staff - all due to her UTI-accelerated dementia-like behavior.

At 89 yo (1.5 years ago) I put her in an ALF specializing in UTI prevention, daily Nitrofurantoin, a showering and diaper change schedule. There she had 6 diagnosed UTIs in 1 year and further became fecally incontinent.

Last week she was sent to the hospital with elevated heart rate, blood pressure through the roof, and fever, classic Urosepsis symptoms she'd had at previous hospitalizations. Next day she was released with no discernible symptoms but now believes she "does not live at the ALF and has to go home because her parents are worried about her". This bill for the ambulance/ER/Hospital day was $45,000.00

Each medical intervention and treatment has left her with more permanent confusion, delusion, incapacity to walk (for no reason other than doesn't care or want to).

Just last week I insisted no more hospitalization, realizing my mother is going to die of this ailment. Hospice accepted her and took her off Nitrofurantoin as it's warning is NOT FOR ELDERLY and causes confusion and weakness, and it is not to be taken for long periods. She'd been on it 2 years.

If your situation is like ours, what no one is telling you is that she isn't going to get better.

Now I have shifted our approach - with advice of Hospice doctors and nurses - to palliative care. Our goal is to make her comfortable not trying to treat her.

Factually all the treatments and interventions did not help but instead contributed to making her dementia worse. I've come to realize that at some point her diminished systems will be overcome by Urosepsis and will ultimately be the cause of organ failure and death.

I'm not trying to be a downer. This is my heartfelt struggle of over 8 years with my Mother. The medical system has literally churned my mother for at least $500,000.00 on a condition that was always made worse due to the side effects of the treatments. Today we believe that she should be allowed to pass peacefully without being a "guinea pig" in a medical system that fights to ignore the fact that sometimes it's best to face our mortality and embrace it with an emphasis on quality of life and peaceful passing.

My mother now has that with Hospice and a medical directive that I, as her POA, have established. It's pretty miserable to have to fight for your mother's right to pass. It has broken my heart, but I know it's right for her dignity and as the natural course of life.
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bigsun Feb 2020
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Test again. Even if the cipro worked on the ecoli, there may be another bacteria present, hiding behind the ecoli. It will show up on follow up test, and need a different antibiotic. This happened to Mom and took a few weeks to get over.
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I can only go with our recent experience with my 85 you mom, but she's been having confusion and emotional instability for the past few weeks and urine (and even blood tests) keep coming back negative. Unfortunately for us, we've had to accept that she's probably moved into the later stage of dementia much sooner than expected. We are seeing her neurologist today for confirmation. I'm hoping that isn't the case for your family and the confusion will resolve quickly.
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Cipro is a very strong antibiotic and I had problems with it (I'm 63 and it gave me a yeast infection). I test my Mom using AZO Test Strips (bought them at Amazon) and I give my Mom D-Mannose powder (also bought from Amazon) in either water or apple juice to prevent UTI's. My Mom has been less confused since taking the D-Mannose powder.

Jenna
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When my 90 year old Grandma got UTI's she was extra confused, after the Dr's prescription they took another urine sample, and she was clear. Grandma was still confused for a few days until she had a few visitors, and got a laugh. A few weeks later when she got the UTI again, I gave her cranberry pills with the Dr's prescription. My Grandma has not had any UTI's in month's.
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Ask her doctor to put her on a UTI maintenance antibiotic (Nitrofurantoin). My 84 year old mother was having one UTI after another so the maintenance meds are working like a charm! With dementia, they don't even know they have a UTI. Try to encourage drinking more water.
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UTI is certainly a problem with advanced dementia. You need medical advice, but there are some things you can do that might be helpful: 1. If you can get a urine sample in a small bottle, you can hold it up the light. If it is cloudy, that is a strong indication of UTI. You will then need appropriate medication. 2. After the prescribed course of medication, you can get another urine sample in a bottle and hold it up to the light. If it is clear, that is a strong indication that the UTI has cleared. 3. In order to prevent UTI, especially when there is fecal incontinence, you will need to make regular changes of any diapers and keep everything very clean. One helpful thing you can do is get some Feminine Wipes and wipe carefully inside the vagina. If the wipe comes out clean, great. However, you may need to wipe several times with the corner of the wipes before the wipe comes out clean. Nurses and agency care workers may not be allowed to do this, but within a family someone of the same gender can do this; and it might prevent UTI.

Prayers and hopes for a good outcome
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Hello,

you have received some great responses here so far.

I believe the confusion should begin to clear up once the infection goes away.

My mom (83 yrs old) has Vascular Dementia but one time an undiagnosed UTI quickly turned into a serious kidney infection and landed her in the hospital for 3 days. I noticed an extreme delirium beyond her regular symptoms and I took her to the ER (thank goodness I didn’t wait any longer). Cipro among other antibiotics have there own possible terrible side effects so be on the look out for any of those, unfortunately antibiotics are needed to cure the UTI.

What I have been doing now with my mom is a daily cranberry supplement, 1 cup of Greek yogurt for probiotics in her smoothies, baby wipes after all urinating & bowel movements, making sure her depends or poise pad is dry and even so, changed a couple of times a day just from sweat, am & pm a wipe with a soft tissue with a little extra virgin coconut oil on it (that’s a natural antiseptic) and just rinsing on a daily basis with water and occasionally mild soap. So far no UTI, she gets her urine checked at the Dr office every 60 days along with blood work.

Good luck with your Grandma.
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Invisible Feb 2020
I suspect we had undiagnosed UTIs in Memory Care. They were good about giving the residents cranberry juice and trying to keep them clean. My father also had vascular dementia. His level of confusion varied; it was never an extreme change. I wish we had been more diligent. He went into the hospital with a mild UTI and responded quickly to antibiotics and fluids, but it got complicated when he received too much fluids. They kept him a week and then released to rehab but he was too weak to participate. With all the environmental changes contributing to his confusion, it was difficult to determine the cause.
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Sorry your Gram has a UTI. It may take a bit longer for her to pop back to normal based on - toxins from amount of bacteria causing symptoms, how well her immune system at fighting the UTI, how well her liver does at transforming toxins into less harmful substances, and how well her kidneys (and other organs) do at excreting the less toxic substances. I would say if she isn't more like her normal self in 2-3 weeks, check back with her doctor.

Prevent UTIs by having Gram drink cranberry juice, drinking lots of water, wipe front to back when cleaning after toileting, and bathing bottom more often.
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I replied to this post already but remembered something else to tell you. Another source of confusion and hallucinations can be low sodium. Please have her sodium level checked.
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