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I just got a call from my husband’s care facility that he has been acting out and so they think he should be checked for a UTI. He is uncooperative and incontinent. He won’t be able to just pee in a cup. Is there any other way they can test?

Ok didn’t realize I already answered this earlier!
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Reply to CaregiverL
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He needs a catheter & that is how they can test urine.
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Reply to CaregiverL
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Yes! Put a catheter on just to get urine sample...that’s how it’s done for my mother...peeing in a cup is not possible
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healthinfotranslations.org/pdfDocs/UrineSampleMale.pdf
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Reply to Llamalover47
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Again?
Take him to an UROLOGIST, they will take care of him properly.
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Ahmijoy Oct 5, 2018
No, this is the original post from 9/23. It got another answer so it was bumped up. Yikes. I hope the poor guy is ok by now!
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If a bad smell isn't present and you suspect UTI then they may use a catheter to get urine to test. Many docs rely on smell and symptoms though.
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Their are many ways to get urine for a sample. As others have said they can use the balloon attachment to collect but that's not strictly clean catch. They could also use a catheter or even use a needle to draw out a sample directly from the bladder. The doctor should be able to tell you more.
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Reply to faeriefiles
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He might need to be treated in a hospital or doctor's office with high-dose antibiotics you get through an IV.
Most health care facilities lack hygiene and not all of their caregivers CLEAN the residents properly -- I hope this more or less answers your question.
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It is impossible to get a truthful uti reading in a bucket. The first urine that comes out will have bacteria. You first have to let some urine stream get lost into the toilet, THen you collect a sample of the mid stream,
ASsume it is either electrolyte imbalance, dehydration, and start to read up on giving either Mannose 4 g, every 4 hours, OR the easiest cheapest thing to do is give just 1/4 tsp baking soda in 8 oz of water and sip slowly. Swirl it around because the baking soda powder sinks to the bottom. Maybe add a liquid vitamin to it. Baking soda bakes the urine alkaline of whom the card belongs to, II assumed it was you, If you get the urine alkaline, the bacteria can not live, But that poses other problems if you do the baking soda too often,. So in the mean time try to learn why this is happening when baking soda enters the bladder..
I give my mom 1/4 tsp of Celtic Sea Salt in 4oz of water every morning to get my mom hydrated upon waking, If there is a refusal of the taste, add stevia with a splash of cranberry juice, Olive leaf liquid also works and is very potent if you get it from Barleans. Oregano oil is a choking hazard but behaves like antibiotic so do not use it unless you must and with supervision, as it causes massve choking episodes as it burns when it goes down so you have to dilute it with some coconut oil or butter and mix it into food till it disperses. DO NOT put oregano oil directly in the mouth. YOU CAN DIE from a choking fit. It is best to spread it into a saucey garlicy ginger tasting stew to hide the stinging taste of Oregano oil. Silver colloidal is also good. I have had the most luck with baking soda and keeping the bowels moving. But they say the baking soda puts your body off balance. I believe that, but what else is there?
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angelaK Oct 4, 2018
Seems complicated..
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Yes, a catherization is possible but just another way to introduce another infection if he doesn't have one to start with! Use to have a device that looked like a condom you can slip over the penis and has a tube attached. Otherwise I would suggest pushing fluids and giving him an antibiotic. Or sitting him on a bedside commode after he has consumed a large amount of fluids and sit with him and distract him with something. A lot of dementia patients enjoy just folding wash clothes, looking at a picture album with a relative, etc until he voids. With a bad bladder infection they can get delirious and very confused and agitated.
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Reply to grannynanny01
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Why aren't they using the catch basin that fits over the toilet seat?
He sits; he urinates. Clean catch urine sample.
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truthbetold Sep 30, 2018
It isn't a clean catch like that. It is only a clean catch when the first urine stream does NOT get collected in the basin. The first urine that comes out will have bacteria in it which is always in the urethra. The midstream urine will be the best sample to collect as the first urine that comes out will wash out what ever bacteria is in the urethra. So many urine cultures come out positive but it is from bacteria that was in the urethra and not in the bladder. Then antibiotics get prescribed which good bacteria and probiotic microbe balance in the gut which get destroyed. The neurotransmittors need the good bacteria in order to make the brain work properly. So use other defences and bladder support before using antibiotics. There is no need to anymore.
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They did a strait cath on my Mom to get a specimen.
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Reply to Nancynurse
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This facility doesn't have a doctor on call? It does have an RN doesn't it?

I love the hat. My Mom went to a urologist regularly. He wants a sample everytime a patient comes in. He can test there. The last time I took Mom her Dementia was bad. She had no idea how to pee in a cup. His bathroom was 2x4 and I refused to get on my knees and get a sample. There were people sitting right out of the door. I told them I would have my RN daughter get a sample and bring it back. Then I had to take her for bloodwork. Again I was expected to get the sample but...I was given a hat. So much easier. With all the elderly the urologist has as patients, I don't know why he doesn't offer this.

I guess this memory care is like an AL. You are still responsible for their healthcare. Thats what I liked about the NH. They had RNs on duty and 4 doctors to choose from. Dentists, podiatrists and eye doctors came to the facility.

I dropped the urologist. Mom was 89, if she contracted cancer we were just going to let it run its course. Her thyroid doctor had gotten her Graves under controll it was just a matter of testing her levels every so often.

With ALZ violent behaviour is normal. UTI is first thing they check but if not the problem then it may be time for meds to calm Dad. If a UTI is found you may want to start Dad on cranberry tablets (not juice because of the sugar). Also, a probiotic while he is on antibiotics which cause yeast infections. The cranberry tablets can be given to help prevent more UTIs. A UTI is serious in men.
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Reply to JoAnn29
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As he is in memory care do you actually want to treat the UTI? Another approach through not ideal is to simply treat him with the antibiotics usually used for UTI.
If the poor man has advanced dementia and needs diapers, the chances of him sitting on a toilet and urinating in a hat are probably slim to none.

If he is at least semi mobile and not bedridden makes sense to put him in diapers otherwise he will be walking everywhere with pee running down his legs. The other patients may not notice but the visitors will!

Good luck anyway. I think M/C was really trying to get a feel of the way you wanted end of life care to go.

I used to think that not allowing patients to wear diapers but sit on chucks was not very kind but having been in that poition when very ill it was a lot more comfortable getting cleaned up
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Reply to Veronica91
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He may need to be sent out to get a catheter specimen and he may also be dehydrated which can also cause mental problems. You can request he go to Hospital for observation where they will most likely hydrate him and where they can collect a urine sample to test for UTI . All the best to you...
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Reply to Alzh101
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Yes the can catharize him and get a clean specimen- they should know this but it may take a doctors order
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Reply to dinamshar9
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The facility said your husband should be tested for a UTI. Typically, facilities use a basin-type cap that is placed over the toilet to collect urine. The person using the toilet isn’t even aware that it’s there. If you have concerns call them back and ask how a sample will be obtained. It is very unlikely that a sample would be taken using a cup.
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Reply to Susanonlyone
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How did your son make out at the Dr. with your husband? How’s he doing?
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Reply to rocketjcat
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I sympathize with you. My M-I-L in assisted living with dementia has had frequent UTIs. One of the first clues for the staff is behavioral changes. She is unable to give an uncontaminated urine sample.

We've taken her to a urologist where they do a catheterization. It is a relatively quick procedure done in the MD's office. She's had this done twice in order to get clean samples.

Good luck
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Reply to Sanibel01
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don't always assume acting out is a UTI. Most people in care facilities will act out because they know it is not home..funny thing about Alzheimer's their long term memory is more intact while their short term is virtually gone. use a urinal--one that was never used. just put the urinal between his legs until he goes. but you want it off to the lab within a half hour. You need to stay with him and make sure he keeps the urinal between his legs and make sure they put it in a collection cup and sent off to the lab while fresh. That's the only option you have other than straight cath and that would cause him a considerable amount of distress and of course you will need a doctor's order.

there are many reasons for acting out and not necessarily UTI.

I don't know why people use diapers when they are bed ridden. If they are bed ridden there is no reason to use diapers. A bed protector underpad is best because if they have a bowel movement it will not be as apt to contaminate the areas that can cause UTI. Bed ridden people are a lot easier to care for without diapering.
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Reply to cetude
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The facility called you to let you know that there is a problem and tell you what they proposed to do about it. If you are your husband's health proxy they needed your permission to go ahead with the check.

But I hope to goodness that if you had asked them at the time they could have explained to you how they planned to obtain a reliable urine sample, and that it wasn't the case that they were expecting you to come up with an answer. They may need your consent to investigation and treatment, but they're the trained professionals!

I hope by now it's all under control and your husband is feeling better.
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Reply to Countrymouse
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I wonder if there is any way to wring enough urine out from the diaper he wears? they don't need a lot to do the test.
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Countrymouse Sep 27, 2018
There are test strips that can be placed in diapers and - rather like home pregnancy kits - change colour if there are telltale proteins or bacteria in the urine. I (lay person only) imagine that you get quite a lot of false positives this way, but at least it's a guide.
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Those "plastic hats" that fit under the top toilet seat are disposable, so you can ask the Drs office if you can take it home to reuse it, along with a couple of sterile urine sample cups home, so you have them the next time you suspect a Urine Infection. If the Drs office has the white collection hat set up in the toilet Before the patient is directed into the lavatory to leave their specimen, he may not notice it is even there, and will pee right into it, just be sure that he does not flush the toilet!

If the patient is totally uncooperative, he may need to be catheterized, which is not all that difficult or all that uncomfortable in men.

Getting a catheter in both men and women is the cleanest collection possible, as outside debris and bacteria isn't collected in the sample, but not all Drs offices go to the trouble of doing it that way. Either way, a Urine Culture should be requested (and ordered by the Dr regardless), so the most appropriate Antibiotics are prescribed! Somme times they will start the patient on an interim Rx until the Culture is back in, usually about 3 days. It is said that Cranberry juice and increased fluid intake helps to flush bacteria, and lessen symptoms of a UTI, although I'm not sure about the "acting out and Mental side effects of Dementia patients.

I hope you get your Husband seen to, without too much difficulty!
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Reply to staceyb
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He is in a Memory Care facility, not a nursing home. They do not have an on-call physician. (I’ll be writing a letter to them about that.) He will be taken to an urgent care facility this morning by my son. I’ve called ahead and they know he won’t be an easy patient and that he has dementia. It’s hard to tell when he needs to urinate anymore. He cannot verbalize it and doesn’t understand what is happening anymore. The last time I visited him he told me his knee was freezing. Eventually I figured out he had urinated. Since he wears diapers I didn’t know if they could test from that. It sounds like they will need to catheterize him. I’ll let my son know. Thanks.
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Ahmijoy Sep 24, 2018
I hope it went ok. Come back and let us know.
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Mom can now sit on the toilet for a catch, but there was a time she couldn’t and they used a processs called a straight cath. I witnessed it once and held her hand while they inserted it. After it was in place she said it didn’t hurt and the urine came out. I would imagine a similar process is used for a man. If this is a NH I’m surprised this isn’t common practice, but in Moms NH they do need a script for it.
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Reply to rocketjcat
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If hubby won’t cooperate with sitting on the toilet, they may need to use an in and out catheter to get a sample, or a condom cathether with a leg bag. They had to use a catheter with my mom in the ER when she wouldn’t cooperate and sit on the toilet.
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Reply to Ahmijoy
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I'm surprised they don't already know how to collect a sample from a client. I cared for Mom in her home, and her doc had a standing order for a urinalysis for a UTI.

The lab or Mom's home health nurse gave me "hats", plastic cups with wide edges. I'd place a hat under the toilet seat. I'd keep an eye on Mom and ensured she went to the bathroom, but didn't put toilet paper or feces in the hat. When Mom was finished, I'd pour out the urine into a lab's plastic jar, then take the jar to the lab.

For your husband, I would guess the facility should be able to get him to use the toilet, with the hat installed, at some point, but that would take some observation from the facility staff to make sure he made it to the toilet in time because of his incontinence, and the urinalysis is as "clean catch" as possible. I don't know if it's possible for you to assist in this. Good luck, BillsLiz.
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