Again I gotta thank you for your suggestions.

My Mom had a UTI in Jan. and again in early Mar. when I took her to the ER and an aide and I held her down while she got a vaginal exam. (She also had a fungal infection.) She got Diflucan for that, and Keflex for the UTI. It cleared up, and so did the urinary retention.

I asked the doctor, per suggestions from this Board, about antibiotics as prophylaxis. Now she's on Ciprofloxacin and has improved remarkably! She can now get out of her chair by herself, with some difficulty, but she can do it. I hummed a dancing tune this morning and she broke into a graceful dance. She laughs, and, although she has aphasia, she has been trying to talk and when I told her I love you when leaving for work, she replied, "I love you, too." Just like that! She has a robust appetite, which she had not had for months. She is more cooperative, although resistant once in a while.

The point: she is doing great, and seems healthier, both physically and mentally! She is still in stage 6, and needs help with everything, but she is doing great!

And addition to the meds is a baby doll her sister-in-law gave her that looks EXACTLY like a 3 month old baby, complete with two teeth. She simply adores the doll, holds it all day, and wants to sleep with it. (It disrupts both her and my stepdad's sleep so we manage to run interference and hide the doll 'til the next day.) She had seven children so babies were her world.

Just thought you'd all enjoy a positive outcome.

Wonderful news! I am so glad your mom is doing better. My mom has also perked up after getting rid of the latest UTI.

After I told you about the Urex, they took it off the market so I was wondering what would happen. My mom has been put on Urelle - a weird purple pill that turns her urine blue. It's not covered by Medicare Part D so I think I'll be talking to her urologist about other options.

Saribet - Thanks for the uplifting story. I'm so glad to hear your mom is doing better. It sounds as though she's happy and has found peace again...love the baby doll story.

Thankyou for such a wonderful little update.

I loved the baby doll idea too!

What wonderful news! So happy that Mom is doing so much better. Peace

Thanks for your caring. Robin, regarding the Urex, I did mention it to the doctor (thanx!) and she decided to try to educate me on the benefits of drinking cranberry juice which prevents bacteria from adhering to the bladder walls! Sigh. That is ALL we drink here. What people don't know is that Oceanspray juice has sugar. The cranberry juice that really, really helps is the frozen concentrate which is quite tart which is sold at health food stores. That's the one we need to buy.

Anyway, she did not prescribe the Urex, said she'd ask her supervising physician. Another sigh.

P.S. Regarding the baby, it has blue eyes and you all know Blue Eyes are the greatest physical trait ever granted to humankind (see Toni Morrison's The Bluest Eye; I'm being sarcastic here.) Anyway, there is an older gentleman in a commercial on t.v., wearing a white fedora with a black band. My Mom has had a crush on him for some time and leans forward, nods and smiles at him as he pitches his product. Well don't you know that when he comes on now, she turns the baby towards him so the baby will see him, too? I swear her fantasy is that man is the baby's daddy! Gotta love her, which I do!

I'm happy your Mom is doing well. I don't post very often, but I was moved by this because it is close to my situation.

Mom was hospitalized for a week because of a UTI. She spent nearly the entire week laying in a cardiac chair in the hall near the nurses station. This was good I suppose because they could keep an eye on her. And she was busy watching all the movement, though confused.

Mom is (I am told by Dr.) the early part of the last stage where I transition from telling what to do, how to do it, to having to do it for her. She just does not understand a complete sentence. I'm working on it, but is difficult to wiping and bathing those certain areas. But that is not my questions for the moment.

Now I wonder every time something seems off, I don't know how to tell if it is a UTI, or progression of the disease. I can't be running her to the ER every other week, or calling the doctor every week for a urinalysis.

How do you tell when they are sick, or when is it the disease?

Dear Saribet: How delighted I feel for both you and your mother. This says it all - never, EVER, underestimate the power of a UTI.

It does indeed perplex me that even some of the MD's discount that is what is happening. I've run into that three different times with three different doctors AND hospice. After I gently insisted, they decided to mollify the dunderheaded daughter and do a urine check, guess what? A UTI! Imagine that!

I think the reason for this disbelief is that it is because so many times it is a "silent" UTI. No change in color or substance, no odor and no burning - just that change in our LO's behavior.

Jacque: Therein lies a very valid question. If your mother can physically cooperate to obtain a sterile specimen directly into that sterile cup, then you can get sterile specimen cups from both the doctor's office as well as from the hospital lab by telling them your doctor wants a urine specimen and mother must do it at home.

I actually got several sterile containers from the MD's office, (gave 'em to me), and I kept them sealed in a cupboard until needed.

Do NOT have mother void into a different container, a bedpan or a bedside commode bucket to obtain a specimen. It would be very contaminated from outside organisms so as to render the speciment totally useless. It must be voided directly into the sterile cup after cleansing the vulva with the antiseptic cloth which comes with the containers.

If your mother cannot void into a sterile cup due to physical limitations, then that presents a challenge. This eventually happened to my mother. Difficult thing to capture.

What I would find would be an abrupt onset of change in behavior (especially behavior), and/or cognition, and/or function. This would be something out of the ordinary. For my mother it became all about increased negative behaviors and sometimes an abrupt change in her usual capabilities.

After this happens a few times and the urinalysis is positive, one develops a "sense" about it.

With my mom, when she was no longer able to physcially cooperate with getting a sterile specimen and it was a taxing effort for her being extremely difficult to get her in for a specimen, (she was pretty much housebound and nearly bedbound), I called the doctor's office and asked for a home health nurse to come out and do an in and out cath so a specimen could be obtained.

I did not do this unless there was a STRONG and almost certain suspicion that she did have a UTI. Inserting a catheter either indwelling or in and out, though sterile technique is used, can sometimes introduce organisms into the bladder and be the cause of an infection, so I never had that done unless it was fairly certain Mom had another UTI.

It isn't about every time something is off; it is about a sudden very big change in that behavior/cognition/function.

There came a time; twice in fact, when Mom was going from one Stage into another that she had such sudden huge changes, I had her checked for UTI, and it wasn't an infection, but rather a change in the dementia. But that was two times out of many. At lease the profound change was analyzed for causality.

This is a difficult dynamic. Don't do it for everything, but when it seems the most likely thing and your instinct tells you something is indeed going on, then that is probably time to get a check.

Best of wishes,

Saribet, just to let you know, we have found Oceanspray, sugar free, cranberry juice for our mom and she loves it.
Magpie

After Karen had a UTI a friend told me to go to Sun Harvest and buy cranberry chewable tablets, or capsules, which ever worked best.

So far Karen cheerfully munches on chewable tablets and it has worked. For us that was a better solution than a lot of cranberry juice.

Take care, Marge

Johanna C
Yesterday you discussed getting a clean speciman of urine and not to have her go into another container because of contamination. I do have a hospital hat for the toilet. Before I use it each time, I pour boiling water in it and then swing it back and forth like a fan to dry it. Is that clean enough?
Along the lines of clean speciman, Mom will sit and pee in the hat. I don't physically clean her area with a wipe. I just can't bring myself to do that - yet.
I have no problem getting the speciman containers because I work in a hospital and just go ask the lab. All I do is call the doctor, and he faxes an order up to the hospital so I take the speciman with me to work. I'm just wondering how steril it is.
I could be taking specimans every three weeks.

Would Medicare pay that often?
Is the strange behavor the disease progression, or is it uti? That still troubles me.
Take a speciman, or waiting longer to see?

Thanks,
Jacque

I cannot begin to tell you if the "hat" is clean enough. I am one to use bleach for decontamination, but then one would have to rinse it EVER and ever so well so the bleach would not kill the organisms voided into it.

Since you work in the hospital, give a call to the Epidemiologist there and hopefully they will have the answer.

Why in the world the specimen containters cannot be made with a wider mouth to more easily accommodate the female anatomy, I just don't know. Oh yes, probably costs a few cents more to manufacture. They do forget we're setters, not pointers!

As for Medicare covering; they will ONLY pay if there is an actual coded diagnosis sent by the doctor as well as your doctor's order. If this keeps coming into them routinely, they may overlook it or they may question it. Don't know.

Hopefully, there is an adequate code and all will be well. Doctor can always have supportive documentation in the record of, "chronic UTI's" and symptomology to go along with it. But I don't think it will come to that.

If any Medicare billing comes back as non-covered, check with the billing office, most often it is because the correct ICD-9 Code is not present to support the test and/or treatment. It's all about proper codes.

Best of wishes,

The cranberry tablets are great! Being a diabetic, the sugar in the juices isnt good for me, and yuck to diet drinks!

Saribet, thank you for the update! So glad that your mom is doing better. It's really amazing how UTIs and bladder infections can cause such drastic changes for the worse. Take care. Big hugs!

Sure enough, confirmed UTI yesterday. Back on antibiotics and doctor to visit her at the daycare center today. Trying to keep her out of the hospital again. I will ask at the hospital if boiling water is enough to sterilize the hat. Thanks!

I have what may be a silly question....can elderly men get a UTI? Considering the anatomy difference, I wasn't sure.

Here's the reason I'm asking....my 84 y/o Dad with mid-stage AD and dementia started having hallucinations and increased confusion very suddenly on Thursday evening. He was hospitalized Friday for observation and testing. He's on razadyne and Namenda and has had no medication changes for months. All the preliminary tests have come back negative, however, the urine test was not done via a catheter. Would this type of urinalysis detect a silent UTI?

ST

Sweetart,

It depends on what they tested the urine for. Getting a clean catch specimen or a cathed specimen is important for accuracy.

To answer your question, yes, men do get UTI's. I read that despite the anatomy, it is common for males with dementia to get the UTI's. My DH's Neurologist asked me to take DH to the lab for a U/A when we were dealing with escalations in delusions, etc.

Thanks for your prompt reply, Diana. Well, I'll be asking the doctor exactly what Dad's urine sample was tested for. The possibility that they didn't test for infection never entered my mind. I should've remembered the advice which I'm always giving to my kids....ask questions and assume nothing...LOL!!

I hope and pray that his sudden decline is due to a UTI and not the dementia. From everything I've read here, this certainly sounds like what has happened to him. *crosses fingers*

ST

Hi Swee Tart...elderly men can get a UTI. My dad (78 yrs. old) just recovered from one last month that he's had since late last fall. It turned into a bladder infection, and he had to have a stone removed from his bladder. He had to have multiple rounds of antibiotics to clear it up.

I feel stupid asking this. But does anyone know...are UTI's common in Alzheimer's patients? I've read that they tend to be prone to infections...is this the most common kind? My dad is in the moderate stage...I'm trying to get a handle on what to expect. The Exelon and Namenda don't seem to work as well as they did. During the past month, he's starting making the same noise over and over...it's like he's sucking and chewing on a hard candy. It'd be helpful if I knew which infections are the most common, so I can watch out for them. Sorry for the rambling...

re getting a urine sample: I got the sterile cup from the lab, put on a glove, and held it in the appropriate place ---- worked for Karen (and me!!).
Take care, Marge

Never posted before. Just wanted to let you know, because of your posts I was aware that an UTI could be the cause of my dad's symptoms but somehow still feel guilty that I waited and was thrown off track because he had up and down days that seemed to fluctuate with the weather.

Hi Sunny,

Hi Sunny,

Welcome here. So sorry your Dad is afflicted with AD.

Always glad to hear when people have benefited from shared experiences and information. And glad you've posted. You'll find many sources of comfort and information here.

Are you taking care of your Dad yourself? Or is he in a care facility?

Thanks Diana,
Yes I have been taking care of him myself. It has given me a chance to become closer to my dad. Hard but also good. He goes up and down with the weather, so it made it hard to know if he was sick. I thought it was the disease progressing. He is in the hospital now because of a UTI and also had a touch of pneumonia. He will be going to a Rehab for as long as Medicare will cover then I want to bring him home, again. Doctor seems to be pushing long term care. Says he is too much. I say I'm getting better at this everyday. My dad can be aggressive but he is calmer for me.