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Mom, 89, and with dementia, has had chronic utis throughout this past year involving visits to the ER, 3 Day Hospital stays, and then extended stays in a Nursing Home temporarily for rehab and skilled nursing because of them.

She just came home from the NH two weeks ago treated for a UTI, and then three days later developed another which I detected by her altered mental status.

I feel like she is developing one every week, and that despite whatever I do with intake of fluids, UTI-Stat liquid, special overnight diapers and booster pads, good hygiene an aid comes in every am 5 days week to wash her, and every 2 hour visits to the bathroom, that it is not enough.

The geriatrician's attitude is that it is her age and dementia, and that we must be careful not to have her develop another bout of C-Diff which she had in the past. She does take probiotics.

To be blunt it sounds like we are now at a point where we have to treat her every other week with antibiotics until we encounter one so resistant that we do nothing and then the inevitable. I am very frustrated.

They did do bladder ultrasounds and the results are that her retention ability is typical of her age. The only time that she totally emptys her bladder completely is at night while sleeping so well due to Paxil and Klonopin to help her sleep.

Is this going to be the norm now rather than the exception? Am I the only caregiver who is experiencing uti deja-vu?

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As most people know UTIs in the elderly woman are extremely frequent and you are doing all the right things. Just wiping with toilet paper may not be enough and using paper towels with warm water may help of course wiping from front to back with a new towel for each swipe. Change the diaper at every visit to the bathroom even if it is only slightly damp. immediately treat any redness or soreness. If she goes to bed long before you do try and change her when you go to bed. so as not to disturb her rest you can give her her night sedation when you have to change her. Sometimes antibiotics are used routinely to help prevent infections often a week on then a week off
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No, you are most assuredly not alone in this: my dad (93) tends to be a UTI repeater. Good job giving your mom probiotics! They definitely help. Will she drink cranberry juice? It truly, truly helps also...but only if it is 100% cranberry juice with no sugar AND if you can get her to drink it. Dad balks occasionally at drinking cranberry juice--I found that I consistently give him 3 8-oz glasses every single day and now it's part of his routine. Give small amounts at first and gradually add more. It was a long drawn out process on our end but WOW, he isn't getting as many (only 2 so far this this yr!!). Good luck and many blessings to you.
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Hi in reading your problems with UTI's I use cranberry capsules bought at the drug stores and give them to my mother at nite. She has only had one UTI and that was when the doc took her off her meds after a bad bleeding stroke. She has since found her way back and is doing great so now she is back on the cranberry capsules. I had a nurse suggest this when mom stayed at an assisted living for respite care.
Its worth a try, my mom also has dementia and is 88. I have personal wash toweletts that she uses to clean herself every morning when she gets dressed and changes underware. I never let her wear the same underware even if they are dry. Women can take on a very funky smell if not cleaned everyday.
Hope some of this helps. It is the hardest job I have ever done but I will be glad I did it someday. It just gets very isolating when I can't go out and even run errands ect. I have to wait till my husband is home so he can stay with mom while I run.
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The woman I take care of has a vaginal insert she gets once a month. I can't remember the name but I will ask my boss tonight and I will post the name on your wall. Another thing that will help is washing her vaginal area with soap and water morning, night and every time you change her depend.
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My mom recently had a UTI and was given antibiotics. One of my friends who uses natural products recommended one that my mom use when she gets another UTI. I have no idea if it helps but my girlfriend said that she used to get them very, very often and used this product and it helped her. As I said, I have not tried it when my mom got one but you might want to give it a try.
Probiotics after a bout of antibiotics. I even had a pharmacist recommend them and he recommended kombucha, which I drink often. I don't think I'd be able to get my mom to drink it since it has a very distinct flavor.
I'm interested in any other suggestions that others have on this subject. Seems like my mom is susceptible to contracting them also. I've started with the cranberry juice on a daily basis.
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After running through 25 courses of antibiotics, we have exhausted that method. These days we do the following things:
Lots of liquids
Vitamin C
pills to boost acidity in bladder
pills to control bladder
D-mannose caplets
estring vaginal inserts
topical estrogen for external use
unsweetened cranberry juice extract dilited in plain water
cranberry tabs
dried cranberries in oatmeal
a bidet
frequent changing of pads
Kegel exercises to help with continence
and after all that, we know we've done the best we can, and when we have to we just try to ignore it, and live with the inevitable. We stay vigilant for signs that the infection has moved up to her kidneys (fever, pain, blood, vomiting) which can be fatal.

I sympathize -- it is an unending battle. So many hospital and ER visits, too many visits to the urologist, too many fights with nurses over the best way to get "clean catch" urine samples from someone with arthritis who can't do it and the problems of catheters and the infections they can cause...

We are so grateful we did not take the advice of one doctor who offered that "mesh" for her bladder -- what a disaster they are.

I guess my best advice is just to do the best you can, accept the problems with as much grace as you can, and try not to get too caught up in the drama and emotions. It can be exhausting and frightening, I know. And not many of us have the training and knowledge to handle these things with professional detachment and skill -- we just learn as we go.

Best of luck.
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Stephen you are the first person to mention the use of a bidet. I am an. advocate of their use especially in caring for the hygiene of the elderly. The patient can sit on the bidet which is far more comfortable than trying to stand over the toilet.
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I can't quite believe that I we are conversing about bidets, but here goes:

You can buy them inexpensively from Amazon and they are easy to install. You can also get expensive heated ones that need to be professionally installed. I understand from a friend that they are not used in Sweden, as there seems to be a health concern, but I have not researched that, as I assume that if they are used carefully they'll be okay. Occasionally I notice that the bathroom wall is wet, and finally figured out that occasionally my mum forgets to turn the bidet water off before she gets up. No harm done.
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it was the D-Mannose tablets and powder supplement that my girlfriend recommended.
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I sure can relate to all of these posts! I have not heard of UTI Stat liquid or kombucha. My story is VERY long but I do not deal with Alzheimer's, but my Mom is nearly 92 with a cystocele and rectocele and she has urine retention. I was doing intermittent catheterizations for awhile but that did not help either or course this included keeping her clean and dry but also sending away for heavy briefs through Cheap Chux. I have also used Estrace cream vaginally. Moms primary and 2 urologists said no to a Foley catheter recommended by a visiting nurse so I found another urologist to get her examined and he mentioned the Foley. I know this is very controversial and also probably not a good idea with a dementia patient because pulling it out would be terrible! But I have added 2 new things to her routine and they are a probiotic by Natures Way called Optima, it is in the refrigerated area. The next product is by NOW and it comes in a box, it contains packets to be mixed with a juice glass. It contains cranberry, D mannose and some other components. I had always given her the maximum cranberry pill and D mannose but this seems to be the ticket. One other product is for cleansing the perineal area it is called Senicare, it supposedly helps kill E. coli which is one of the biggest bugs with UTIs. I have seen how sick UTIs can make a person including sepsis and numerous hospitalizations, then the side effects of all those antibiotics! My Mom has not had a UTI in 3 months and that is a miracle. Good luck to all of you and thank you so much for sharing your stories, this job can be so isolating its so nice to not be alone!
L
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All of the above is wonderful advice! You may also want to take her to a urologist that will surgically scrap the scar tissue from the floor of her bladder, ONLY if it's suitable for her current health. I had chronic UTI infections for 8 years. A friend had it done 10 years prior to me. The urologist stopped doing the surgery because the drug companies convincing them it wasn't necessary with the advancement of antibiotics.

I could not find anybody that would do the surgery. I persisted and finally settled with one urologist. I begged, pleated and cried. He told me to let him try to treat me with meds first. I refused to take a low dose of antibiotics for the rest of my life. After begging and crying more, he caved. He told me that he had not done the surgery in over 12 years for the reason I stated above.

It was a complete success! It has been over 12 or 13 years ago. Here is how a nurse explained it to me.... When you get an infection scar tissue forms. You take antibiotics and it clears up, so you think. You may stress your bladder by holding urine, sexual activity, or any other trauma. The scar tissue rips as your bladder experiences trauma and bacteria that was caught in the scar tissue rips or stretches and releases the bacteria that was hiding deep in the scar tissue. You get into a horrible cycle of more in the same. See, blood carries antibiotics and distributes the antibiotics. However, blood cannot flow through scar tissue. That's the beginning of the vicious cycle.

Scrapping an elderly lady's bladder may be more dangerous. I have no clue. I am not a doctor. But I have suffered for many years only to be cured with this surgery.

Please keep in mind that the doctors liked the idea of not performing the surgery because there are some related dangers. I guess one could possibly be puncturing the bladder, but it was worth any risk for me. I have not had any bladder infections since the surgery years ago.

If you look into it don't be surprised of all the "no" answers you get. A confident and reputable urologist should consider doing it. I had absolutely no problem. My doctor however, cured and then lost a patient. I had no need after the check ups to ever return. I will always be grateful and I refer him every chance I get.

The urologist did tell me that he was going to perform the surgery again if mine was successful on another patient. She waited patiently for my surgery and recovery, then had the same surgery. Her surgery was a success as well.

Good luck! Prayer also helps!
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My mom has had uti's twice so far this year. A occu therapist recommended to get one of those plactic bottles that they use for ketchup and fill it with warm water and spray it up and down when they are on the toilet. Kind of like an outside douche. Good Luck
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My mom takes coumidin (stroke)and the the biggest NO NO on her list of things that thin blood is cranberrries. Anyone have a parent on blood thinners with reocuuring UTI's using cranberry for UTI?
Im assuming you have had to adjusr coumidin levels.
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My Mom also takes Warfarin for blood thinning due to a pulmonary embolism. You are right about cranberries interfering with this medicine but I think the dry form of this is different in some way. I had to do my homework and Mom has had no problems and no adjustments to her medicine! All of her doctors are aware she takes cranberry. I had posted earlier that I gave her cranberry capsules and D Mannose but now I give her the NOW brand that is a packet you mix with water and it is really pretty good, I even like it better than cranberry juice. The cranberry capsules were first suggested by a urologist. They were more worried about D Mannose as it is a sugar but it does not elevate blood sugar because of the way the body uses it. One other change I made was giving her 1000mg of vitamin C. Ask your Dr. what he(she) thinks and can research for you and maybe her INR can be checked a little more often to make sure. It's been fine for us and best wishes to you!
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same thing with my Mom, multiple UTI's. She is now in a rehab center and is taking yet another pill for UTI. I do not have an answer why, but you are NOT the only one.
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Thanks for all the info Moomoo
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I am experiencing the same with my father. He had a stroke in 2007 and then developed dementia. I have him at him own home with 24/7 care. He was having UTI's every week, month etc....at the ER constantly. He has had C-diff, mersa. He now has a catherter and it has to be changed every other week. He is now on Mancodantin everyday for the rest of his life and if he gets another one or sick, they have to switch up the anti-biotics to Leviquin liquid. It works!! He just got over a bought with pneumonia and again...Levaquin. He was allergic to sulphur drugs like Bactrim-DS that gave him terrible diarreha and dehydrated with and back to the ER for fluids. He hasn't had one since March of this year. Prophylactic anti-biotics seem to do the trick, but he has to watch for tolerance to the drugs. Dad is also on Paxil. Sleeps fine. Sometimes too much. Takes it in the morning. He also has Visiting Physicians that come out to make sure he is doing well. His urine looks great now, but I just hate the fact that he is confined to bed now. Hope this helps....good luck and God Bless.
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I moved my family member in with me almost three years ago. She was being treated for UTI about as often as your person. Now with me, I am assisting with better bathing and cleaning in the area along with lots of water and cranberry and I must say they have subsided. Not entirely gone BUT with monitoring things are better. I took her to the doctor about emptying as she has the sensation to go when she has just returned from bathroom so we know there is nothing there BUT it also keeps her moving with the only exercise she gets through the day walking back n forth. Will not do adult day care or activities. I wish you well BUT this is what helped me. I also stopped all those meds natural cranberry tablets.
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My mom is on cranberry capsules twice a day, equal to two glasses of cranberry juice. The assisted living she goes to for respite care suggested this or a glass of cranberry juice for each meal. She is 88 and I also buy the bathing clothes for her to clean up with when she changes her underware(depends) each morning or more if needed do to incontinence.
She has only had 1 bout with UTI's since caring for her for 8 years and after 2 strokes. Hope this helps:)
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