My mother, who recently passed away at 81 was completely compromised by 4 UTIs within the last 6 months of her life. Why is there no program or focus on identifying a UTI early and treating it at home?
Thank you all for the great feedback. Since my caregiver days are over and I find myself an orphan, I am looking back at the situation that my mother went through and asking why is "waiting for symptoms to appear" the UTI treatment trigger.
In our case, each time her symptoms occurred (confusion and lethargy), her doctor would tell me to take her to the emergency room. Each emergency room visit (the last one took 11 hours before she was admitted) and hospital stay took so much out of her and robbed her spirit. When she was discharged from the hospital, we stepped up with resources and hired great CNA caregivers who provided 24/7 care. We/they did everything possible to keep her UTI free, including great hygiene practices, supplements and incontinence products. I do understand that some seniors are just prone to infections. It seems to me that there should be a better way to approach this big problem.
I am not a medical person but from what I read, UTIs identified early could be treated by oral antibiotics with good results. If early intervention is possible, the question is how to accomplish this. Here’s what my non-medical brain came up with:
* At the start of the program, an initial medical assessment and full urinalysis is to be performed to establish baseline chemistry. * Common sense daily preventative measures including supplements, hygiene and symptom/cognitive monitoring * Weekly dipstick testing focused on negative leukocyte esterase and/or nitrate test results (confirms no UTI). * Clinician oversight when a UTI is suspected for early intervention. * On-site "clean" urine grab/urinalysis if a UTI is suspected. Oral antibiotics ordered by clinician once culture is confirmed.
The goal of this "program" is to treat the UTI early at home to (hopefully) prevent a hospital re-admittance. I'm probably naive but in hindsight, I would have been more proactive if I had known then what I know now.
The only thing that could have been done early intervention wise was to have her checked regularly.
As said, UTI symptoms in the elderly may not show the same signs as a younger person. My MIL had a pain in her lower back. Both she and her doctor chalked it up to her arthritis. It was a UTI. My Moms symptom was she started hitting the aids in her AL. If they have Dementia its hard to see the difference in behaviour. With someone who doesn't have Dementia there may be behaviour changes.
My Mom was on a probiotic while taking an antibiotic because they cause yeast infections. She continued on that and a cranberry tablet. She had gone almost a year without a UTI before she passed.
Like said, not voiding completely can cause the problem. This can be caused by the bladder falling. Sometimes a "sling" is used to bring it back up. Other times not cleaning well enough. With my Mom they catherized her to get all the urine in her bladder. Then the antibiotics. A culture should be done to determine what antibiotic should be used.
Then there is the person who just keeps having them no matter what is done.
I'm so sorry for your mother's suffering, which do doubt caused you to suffer. There are many reasons for continued UTIs, such as the failure to empty a bladder as we age, holding urine in and refusing to toilet, not enough fluids, poor perineal hygiene, poor air circulation to help in getting the area dry, and use of baby powder.
I haven't heard of the supplement Geaton777 mentioned, but there are natural remedies. I've heard of offering unsweetened cranberry juice or taking capsules. Disclosure: research results and range from "this works!" to "this is a myth!" Taking probiotics is one I've read that can help prevent UTIs.
My grandmother is 84 and has suffered from recurring bladder infections. It took years of UTI's to figure out the only preventative med that worked - Vagifem. It's a hormone that works like a tampon. Medicare doesnt want to cover it so you have to get a letter of exception from doc once a year. And it's still $100+ for a month supply. We experimented with intervals to just twice a week (mon/fri) and have had 100% prevention for 4 years running. When she uses a bedside commode I check for traces of blood. That's all you can do. Low dose antibiotics quit working after a while, and you dont want them to build up antibiotic tolerance. Always keep 1 antibiotic at home for if one occurs.
I supply my MIL's LTC facility medical staff with D-Mannose, a supplement that is a simple sugar. I started her on it as soon as she was cleared of her last UTI last fall. I heard of this supplement on this website from an RN and, although I absolutely do not believe that supplements are the be-all and end-all for health, I was desperate to help her stop having one UTI after another. After starting the D-Mannose she has not had an infection since the fall 2019. Rustypipes I'm so sorry for your mother's struggle with UTIs -- they are the bane of the elderly. But for others reading this post, I can only tell you my personal experience with this supplement. Of course, always tell your LO's doctor whatever additional supplements you give them.
What early intervention? I am certain that she was treated just as soon as she showed symptoms... she wasn’t left untreated..right?
it would be every bit as dangerous to keep anyone permanently on antibiotics....which for a while would head off these infections. But, once resistance occurs then the constant use would ensure that nothing could treat it,
as caregivers it is very important for us to know the outward symptoms and take action quickly. But, sometimes it just isn’t fast enough even then.
In our case, each time her symptoms occurred (confusion and lethargy), her doctor would tell me to take her to the emergency room. Each emergency room visit (the last one took 11 hours before she was admitted) and hospital stay took so much out of her and robbed her spirit. When she was discharged from the hospital, we stepped up with resources and hired great CNA caregivers who provided 24/7 care. We/they did everything possible to keep her UTI free, including great hygiene practices, supplements and incontinence products. I do understand that some seniors are just prone to infections. It seems to me that there should be a better way to approach this big problem.
I am not a medical person but from what I read, UTIs identified early could be treated by oral antibiotics with good results. If early intervention is possible, the question is how to accomplish this. Here’s what my non-medical brain came up with:
* At the start of the program, an initial medical assessment and full urinalysis is to be performed to establish baseline chemistry.
* Common sense daily preventative measures including supplements, hygiene and symptom/cognitive monitoring
* Weekly dipstick testing focused on negative leukocyte esterase and/or nitrate test results (confirms no UTI).
* Clinician oversight when a UTI is suspected for early intervention.
* On-site "clean" urine grab/urinalysis if a UTI is suspected. Oral antibiotics ordered by clinician once culture is confirmed.
The goal of this "program" is to treat the UTI early at home to (hopefully) prevent a hospital re-admittance. I'm probably naive but in hindsight, I would have been more proactive if I had known then what I know now.
Please let me know what you think.
RustyPipes
As said, UTI symptoms in the elderly may not show the same signs as a younger person. My MIL had a pain in her lower back. Both she and her doctor chalked it up to her arthritis. It was a UTI. My Moms symptom was she started hitting the aids in her AL. If they have Dementia its hard to see the difference in behaviour. With someone who doesn't have Dementia there may be behaviour changes.
My Mom was on a probiotic while taking an antibiotic because they cause yeast infections. She continued on that and a cranberry tablet. She had gone almost a year without a UTI before she passed.
Like said, not voiding completely can cause the problem. This can be caused by the bladder falling. Sometimes a "sling" is used to bring it back up. Other times not cleaning well enough. With my Mom they catherized her to get all the urine in her bladder. Then the antibiotics. A culture should be done to determine what antibiotic should be used.
Then there is the person who just keeps having them no matter what is done.
I haven't heard of the supplement Geaton777 mentioned, but there are natural remedies. I've heard of offering unsweetened cranberry juice or taking capsules. Disclosure: research results and range from "this works!" to "this is a myth!" Taking probiotics is one I've read that can help prevent UTIs.
it would be every bit as dangerous to keep anyone permanently on antibiotics....which for a while would head off these infections. But, once resistance occurs then the constant use would ensure that nothing could treat it,
as caregivers it is very important for us to know the outward symptoms and take action quickly. But, sometimes it just isn’t fast enough even then.