Follow
Share

My mom is 97. She has dementia and congestive heart failure and is receiving hospice services, mainly because of the CHF. When Mom has had symptoms suggesting that she might have a UTI, the hospice staff has ordered a urine test and has prescribed an antibiotic if the test is positive for a UTI. It seems clear to me that a run-of-the-mill UTI is within the category of ailments that hospice allows treatment for. Right now, Mom has a UTI caused by an uncommon bacteria. This type of UTI can be difficult to treat, and it appears that the antibiotic that Mom is taking might not be vanquishing the bacteria.What are your thoughts about continuing to treat a UTI such as this in a hospice patient: (1) once a UTI, always a UTI; if hospice recommends treating it, I'll go along with that; (2) if a person is taking an antibiotic to prevent potentially life-threatening complications of a UTI, we're outside the bounds of hospice; (3) something else. I'm not the decision-maker. I know what the decision-maker (one sibling) would do. Sibling might accept input from me or might not.Thank you.

Yes. UTIs are treated in Hospice. This is because the continuing condition can cause comfort and distress. Think of this as comfort care. Many conditions are still treated in Hospice. Pneumonia is often treated to keep airways clear and reduce shortness of breath and sometimes CHF, if it increases breathing difficulties due to left sided heart failure, is treated.

Think of it this way. The goal is COMFORT.
Speak with Hospice. That is their "other" specialty. They are there with clergy, nurses, social workers to give you answers.
Helpful Answer (18)
Reply to AlvaDeer
Report

I think the best rule of thumb is to treat unless the cure is worse than the ailment being treated, and UTIs can make life miserable
Helpful Answer (12)
Reply to cwillie
Report
Rosered6 Nov 11, 2025
Thank you.
(1)
Report
Update: My mom seems to be doing better after one course of the antibiotic for the sometimes-treatment-resistant bacteria that caused the UTI. I'm relieved that she doesn't need additional testing or more antibiotics.
Helpful Answer (7)
Reply to Rosered6
Report
AlvaDeer Nov 16, 2025
Rose, thank you for this update to us. Thinking of you, and your Mom.
(2)
Report
Hospice failed to recognize a UTI in my mother even though I requested her to be checked (I lived five hours away). Three weeks later, she ended up in the ER after literally going crazy, was diagnosed with a UTI, but then sent home with antibiotics that my father couldn't get her to take and hospice wasn't there to assist. After two more trips to the ER and a stay in a psych hospital over the next week, she ended up in a nursing home with a new diagnosis of dementia, which I believe was brought on by the too-long-undiagnosed and untreated UTI. She passed shortly after. This is not how my mother wanted her life to end. By all means, treat the UTI.
Helpful Answer (5)
Reply to graygrammie
Report
Rosered6 Nov 16, 2025
Thank you.
(0)
Report
See 1 more reply
Something to think about with recurring UTIs on hospice.: My mom has had recurring UTIs for years. Her doctor recently stopped testing her unless she was clearly symptomatic / uncomfortable. She said that her bladder is colonized and that antibiotics will never fully clear the bacteria that live there, so she will always test positive. If she were younger, this would be more of an issue. For me, if she, was on hospice, I would not want them testing for or treating a UTI that was not making her uncomfortable. She's already fully incontinent, and I would just have them give her pain meds if she was having any pain, burning, or irritation. Hospice is about living as comfortably as possible, not prolonging life.
Helpful Answer (5)
Reply to ShirleyDot
Report
Rosered6 Nov 16, 2025
Thank you, ShirleyDot. My mom was tested for a UTI this time because she was, as my sister put it, "more confused than usual." For example, Mom was asking whether she should use the call button if she needed help getting the people on Food Network out of the TV and into her room. Sister visits Mom every day, is the POA agent, and supports Mom receiving hospice care because it means Mom is seen regularly by health-care professionals. Sister still struggles with the limitations on treatment aspects of hospice.
(1)
Report
Another update: Earlier this week, Mom was exhibiting symptoms of delirium. Yesterday, Mom was in a deep sleep all morning. When the hospice nurse and hospice CNA arrived, they suggested that Mom be woken up and taken to the dining room for lunch. This went okay. After being up for about an hour, Mom was ready to lay down and go back to sleep. Last night, an employee of the facility called my sister and said they were concerned because Mom was "unresponsive." They called hospice, and my sister went to the facility. Mom hadn't peed all day. She finally did last night after being roused from her unresponsive condition. A urine test was done. She has another UTI or the same one was not fixed with the first course of antibiotics. This time, the treatment is a broad-spectrum antibiotic.
Helpful Answer (3)
Reply to Rosered6
Report
MargaretMcKen Nov 21, 2025
My sympathy for all of you for a very difficult situation. Love, Margaret
(2)
Report
See 1 more reply
Thank you.
Helpful Answer (1)
Reply to Rosered6
Report

There are some infections like ECBL that put my Mom into hospital for two weeks . It cannot be treated by oral antibiotics !
Helpful Answer (1)
Reply to Kpel1221
Report

Thank you, MargaretMcKen. My mom has had several episodes of unresponsiveness this year, some related to UTIs, some not. As my mom's long-time friend used to say, old age is a shipwreck.
Helpful Answer (1)
Reply to Rosered6
Report

Today's strains of UTI's are tougher to treat than those of 30 or 40 years ago due to antibiotic resistance even in young women.

We found the IV antibiotics to be the most effective but Mom could only get them in an ER setting. Hospice would only prescribe antibiotics in pill form.

Mom had celiac disease which by definition meant she had compromised digestion. I suspect the average 97 year old also does not have really great digestion and absorption of pills and absorption of medications through the digestive tract.

Support to you and your family in these challenging times.
Helpful Answer (1)
Reply to brandee
Report

See All Answers
Ask a Question
Subscribe to
Our Newsletter