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Very frustrated!! M-I-L with dementia in AL gets frequent UTIs. Each time this happens the staff say they are unable to get an uncontaminated urine sample from her. They push (or I could say try to bully us!) to take her to the E.R. where she can get a straight cath for a clean urine sample. So far we have avoided this as her MD has been willing to prescribe antibiotics (based on her history) pending a visit to the urologist. We've been able to get her into the urologist office within a couple days where the NP would do the straight cath to get a clean sample. Now the NP has left the practice and is not going to be replaced. The MDs will not do the procedure.


There just has to be a better way! I just can't believe it is in the best interests of M-I-L to spend hours in an E.R. waiting to be tested for a UTI! The only places, at least where we live, to have a straight cath done are an E.R. or urology practice.


I'm trying to be proactive and have a plan in place should the MD refuse to prescribe without test results next time.


Any suggestions would be appreciated. Thank you.

Thank you everyone for responses and advice. Rocketjcat, I love your suggestion of the two hats in the bowl. I will ask the AL about that. The MD has been reluctant to prescribe a daily antibiotic but I will bring it up again and ask about Macrobid. Ahmijoy, thanks for your tip about daily site baths. M-I-L has only two showers a week. I'll see if the AL can do the daily.

Friday I did find an urgent care (and it is right down the street from her AL!) that does do caths as long as the patient is compliant and has a lab on site. So that is at least another option if we need it.

Having this site available is a comfort and I appreciate all of you!
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Reply to Sanibel01
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She needs to be straight cathed. They need to get all the contaminated urine out and run a culture to see what antibiotic is needed. If this isn't done she will continue to have them because its just been hit and miss up to this point. So I agree with your doctor.

Once they find out what antibiotic should work, ask her doctor to prescribe a probiotic. This will keep her from getting yeast infections while on the antibiotic. Then ask for cranberry tablets to be given daily. These help with not getting reoccurring UTIs. These are OTC but the AL will not allow them without a Drs order. My Mom had a UTI 10/16. When to ER, straight cathed, started on the probiotic and cranberry tablet never had another UTI up until her death 9/17. It has been said here that Incontinent briefs could be the culprit. She may have an allergy to the material in a certain brand or the fragrance used on them.

The clean sample was Moms problem too. The staff are CNAs and Med techs. They cannot do a straight cath. Even the RN may not want to do it. They are correct in asking you to take her to the ER and your Dr. is right too. Mom needs to find out why this is continually happening.
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Reply to JoAnn29
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Ahmijoy Dec 21, 2018
You’re right. And one other issue with my mom was personal hygiene. The nurse at the ER told me to make sure mom had at least a site bath every day. She said that would go a long way toward prevention.
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Anytime my Dad had a UTI, we would go to the nearest Urgent Care facility where they would run a test while you wait.
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Reply to freqflyer
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Agree with rocketjcat. My mom had chronic UTIs in the SNF and they’d send her to the ER as well. Actually, she was so out of it she didn’t know where she was. She’d just sleep which was ok because if she was awake, she was so off the wall and combative, she’d wind up tied to the bed rails. They started doing monthly tests on her and then put her on a daily antibiotic.
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Reply to Ahmijoy
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A couple of thoughts:
How often do theses UTIs occur? My friends mom (an active woman w/o dementia) gets them so frequently her urologist has put her on a routine dose of macrobid. You may want to ask about that.

My Mom always had a problem aiming into the hat for a clean catch, until we started using 2 hats butted against each other. That covers the entire hole of the toilet bowl so any urine will hit at least one of the hats. Also it really helps if I’m in the bathroom with the CNA, helping direct the circus.

Even then we sometimes have to resort to a straight cath. Luckily the LPNs at the NH can do it. Can you call your local urgent care to see if they can do it without a trip to the ER?
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