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Mom in ALF with Alzheimer’s. Has been in pull-up incontinence briefs now all the time last 7-8 months. Constant problem with UTIs like every 4-6 weeks. Impossible to get a sample, so every time caregiver calls me it’s back to ER again for catheter. She ends up in hospital 2-5 days each time and gets better, but keeps coming back!


I have talked to her primary several times about a long term low dose antibiotic but they are afraid of resistance. Cranberry capsules and juice has not helped. This last one was bad; Mom couldn’t even stand up and was very lethargic and out of it. Anyone else have to fight with doctors about this? I think more stressful back and forth to ER and having them running catscans, xrays, catheters, and not eating well in hospital worse than risking restistance?!

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Ask the doctor what their recommendation is for long-term treatment of chronic UTIs. Ask the doctor if they will not prescribe low dose of antibiotics, if they will just prescribe antibiotics when she shows signs of UTI instead of sending to hospital for catheter. The hospital is to be avoided when not necessary, especially with people with dementia.

If the doctor's only answer is to send her to ER each time and then prescribe antibiotics, when clearly this is a chronic issue, find a new doctor.
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These suggestions have been mentioned by others on the forum:

First, don't use cranberry juice it has sugar. I would continue the cranberry tablet and maybe a probiotic. Probiotics are used with antibiotics to prevent yeast infections. Mom used both even after antibiotics were done.

The elderly have a hard time completely voiding. Let Mom sit on toilet a little longer. Have AL change her as soon as possible or ask that she still be taken to the bathroom every two hours.

When in the hospital, make sure a culture is done to make sure what bacteria is causing the problem. Hospitals tend to start with a broad spectrum antibiotic. This was not good for my Mom. She was given one with penicillin and she was sensitive to it. She did a 180. They changed her antibiotic and she perked back up.

Your Mom may be allergic to the brand of pull up you are using. Change brands and see what happens. I personally can't use Kotex products.

And water, make sure she is drinking water.
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As we age, the body breaks down. Chronic UTIs are not uncommon.
My dad has been living with UTI for over 2 years...and no antibiotics (due to allergies and diarrhea from it).
We let go, and he's still here regardless...it's part of the aging process.
Eventually the drugs don't work, there's nothing to do, except enjoy the time we have left.
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fantasmagorical Mar 2019
I had the same experience with my FIL. He lived with no real issues with a UTI. He had refused antibiotics because he would have issues with diarrhea for a month or more after taking antibiotics.
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Has your mom been seen by a gynecologist/urologist who specializes in urinary issues?

Fit my mom with chronic it is, the solution was a probiotic called rePhresh and a vaginal cream. These docs are called genitourologists, I believe.
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Hygiene and hydration are both important- how often does mom receive help in changing her brief ?

my mom had many recurring UTIs at her memory care and was hospitalized with sepsis- she made a slow recovery and is now immobile- since then, we use a lanolin based protectant and she takes an OTC cranberry, d-mannose and probiotic supplement daily
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Long term antibiotics are not the answer. Antibiotics kill off the good, natural gut probiotics which improve our mood, digestion, ability to fight infection, etc. etc. Scientists are just learning how much healthy gut bacteria affects our brain.
The answer is to get to the root cause of the UTIs and solve that problem and/or provide nutritional supplements that help address the issue.
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My Mom had chronic UTIs, it was driving her crazy (literally) as well as me.

I found that she was wearing the Depends too long as she stated that it was very difficult for her to get them on and off. Also, she would "see" that they depends was not used and she would reuse them (gross). She also would not drink enough water.

I finally got her to a Urologist. He was able to culture the bacteria causing the issue and prescribe a specific antibiotic to resolve. He also prescribed a preventative low dose antibiotic. The Urologist resolve the UTI and she's only had one recurrence since.

If the Dr won't prescribe the low dose, I'd seek another opinion. I'd also suggest a Urologist.
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I've never heard of that, but, it sounds serious. I hope she's feeling better.

I do get how you are trying to avoid having your mother taken to the ER, catheter, strange people, pain, etc. My LO would get so scared when take there from her MC. She didn't understand and would cry aloud and keep repeating, I'm scared! I'm scared! It was like torture to her. After several of these visits for this and a couple other things, her doctor suggested that she be evaluated for Hospice. She was and they now treat her with antibiotics when she has symptoms. The hospice nurse sees her once a week. (She can do the test, if necessar). Plus, she has a Hospice aid several days a week, so, with this additional attention, she hasn't had any more UTIs. But, if she does, she won't have to go anywhere for tests, but, she will be treated.

There is supposed to be a way to test the urine from the patient by using their diaper, but, I'm not sure how that works.

Also, my mom has a terrible time with recurring UTIs. She finally saw a Urologist who said that he would put her on a daily antibiotic, but, you have to accept the risks. If you accept the risks, it might be something to consider, considering that she has this terminal illness (dementia).
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Annie48 Mar 2019
Thanks Sunnygirl; didn’t think of hospice evaluation cause she is normally pretty mobile. Hoping this will turn around once meds kick in. She was only diagnosed 6 years ago and is only 75. Doctors tell me she is in pretty good health save for the brain. This disease is so horrible; hoping she will bounce back soon and we can get out of this recurring cycle. Lots of great advice on this site; invaluable and so comforting to hear others experiences. Especially when your family/friends don’t know how or want to deal with the daily struggles.
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My mom had a MRSA UTI once. I asked her doctor if I should tell her that. " Good lord, no!" he said. It cleared up fairly easily.
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Partner went through that last spring through summer, multiple infections, superbug uti's, sepsis, revolving door hospital stays, where he PICKED UP the super bug. So many antibiotics it was scary. Cathed etc.

The upside ...we won the battle. The culprit in my book-DIAPERS-they are just EVIL and are collectors of kooties esp with the elder doesn't shower every day or two. GET RID OF THEM and have the accidents without the bugs being given a nice dark moist environment to grow in.

Push the water, push the cranberry juice and Orange juice. Also garlic and honey are natural antibiotics, try to get some of both into her diet daily. CLEANLINESS, ditch the diapers, maybe try a panty pad/thick kotex instead. Or even a puppy piddle pad on the bed that can be more easily changed with COTTON undies. DO NOT do the low dose or any dose antibiotic because of resistance. Your doc is right on that one.
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