UTI confusion?

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UTI confusion?

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My 83 Y.O grandmother has been having confusion for a couple of months, and it seems to be getting rapidly worse by leaps and bounds......she was diagnosed with a e-coli, UTI and given 5 days of cipro....how long should it take for her confusion to clear? Thanks

Antibiotics Cognitive Decline Senior Health Urinary Tract Infection (UTI)

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My moms Geriatric doctor put her on a low does daily Macrobid pill. This has prevented repeat UTI’s fo mom. Mom is on now on Hospice and still allowed to take the Macrobid. It saddened me to read in one of the answers above a mom with repeat UTI, is on hospice and they will let her go sepsis and die from that.
I would not let the doctors prescribe Cipro, it is a nasty drug. It gives me aura migraines. In a person with dementia they may not tell you they have blurry zig zags and flashing lights crossing their line of vision, its scary when you do not know the cause

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We also had a geriatrics doctor say he never would give an antibiotic for a UTI without a wide spread probiotic. We have found in a facility you have to ask for it. They will give it and it is helpful. I think the best we can do is be an advocate even with hospise. Prayers for all trying to care.

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Thank you very much for your replies. My grandmother has been complaining of a “mental fog” for about 3 months-4 months but no doctor requested a UTI test until recently, and now it seems like things are even worse after two rounds of cipro (5 days and 3). She was driving up till a couple of weeks ago, complaining about confusion but not totally confused. Last drive out she got lost right by the house and had to call me to come get her. After the last round of cipro she’s now not able to remember barely anything short term. Sometimes it comes and goes thru the day where she is sharp in the morning....Like a delirium.... in the afternoon or in The morning , in and out. Several doctors refuse to refer her to neurology because she passes whatever tests they give her, and they have attributed her past “mental fog” to the fact my mother (her daughter) passed away over a year ago (depression). Thank you all again for your help

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"... they have attributed her past “mental fog” to the fact my mother (her daughter) passed away over a year ago (depression)." Seriously??? I can understand someone being depressed after losing a child, even an adult one, but over a year ago and now many months later lumping in confusion and sun-downing like symptoms a result of depression? I would still suspect the UTI, as it can do this to people and it likely hasn't been fully treated. If it went on for several months before being "found" finally and treated (once), they **should** be doing a retest.

See this:
https://www.webmd.com/brain/news/20160217/study-sees-possible-link-between-antibiotics-and-delirium-in-patients#1

Cipro is mentioned by name and it also says often it is the elderly that suffer (not always, others can had bad reactions too.)

But, remember the UTI itself may have started the confusion and the meds just made it worse. If she has finished the meds more than 3 full days ago, she can be retested for the UTI. Keep in mind it could be more than 3 days before the medication is fully out of her system. If it's been a week or more since the medication, DO recheck for UTI!!!

There are other medical conditions that can cause dementia-like symptoms. Just the fact that they didn't bother to test for UTI until recently, despite several months of issues tells me you need to find other doctors for your grandmother!

I would start with a Urologist and request a urine culture. They can get more specific with the antibiotics. Also consider she could either be allergic to the medication, in which case it won't treat the UTI which can make the other symptoms worse, or it is just a general reaction to the medication (which others pointed out - see the link above.) At 9 mo old my daughter had an ear infection. Doc gave us Rx. By day 3 she couldn't hold down 3oz liquid, day 4 developed spots (coming and going, which realized later was hives) and by day 5 I could only stand and hold her or she would scream. ER determined she had a BAD ear infection and hives. New meds, all was fine! New doc after that too! NOTE: same doc admonished my mother when my YB was not getting better - turns out he was allergic to the sulpha drugs he was given!

She should also have a complete exam, blood work and all. Urologist should be able to order that as well. Our mother showed signs of confusion (this was before dementia kicked in) when I stopped by to see her. I took her to the ER. She was admitted because her electrolytes were out of whack, esp potassium, which can result in confusion (and more serious issues.) In her case, due to being prone to UTIs, she was drinking too many liquids, thereby washing out her system *YES, you CAN drink too many liquids! The old 8-8oz glasses of water is not a good recommendation. It was based on some research that said we need 64 oz of fluids/day, BUT that includes liquid derived from ALL beverages AND water that exists in the foods we eat! It should also take into consideration someone's size (Ht and Wt) and activity levels - mom at 5' and fairly sedentary likely doesn't need what a 6' construction worker would need!

I would NOT accept this ridiculous explanation of her symptoms. Even if it was depression, what have they done for her regarding that (still not buying their excuse though)?

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If the Urinary Tract Infection persists, you may want to try OTC Azo medication.

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How long ago was the UTI? Was there a follow up urine culture and urinalysis performed to determine if the infection has cleared? It could be that the infection exacerbated her baseline confusion. Sometimes a UTI can contribute to a condition metabolic encephalopathy. Have you spoken with her physician and had her examined to rule out any other conditions that could cause confusion. Lastly a CAT scan or MRI may be of value in determining Alzheimer's disease.

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I replied to this post already but remembered something else to tell you. Another source of confusion and hallucinations can be low sodium. Please have her sodium level checked.

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Ask her doctor to put her on a UTI maintenance antibiotic (Nitrofurantoin). My 84 year old mother was having one UTI after another so the maintenance meds are working like a charm! With dementia, they don't even know they have a UTI. Try to encourage drinking more water.

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Perhaps the RX for the U.T.I. wasn't as long a number of days needed.

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To gdaughter: e coli is present in feces, both animal and human. If a person esp female has diarrhea or issues with improper cleansing after a bowel movement, e coli can migrate into urinary tract. The food poisoning thing comes from produce that was fertilized with manure and improperly washed.

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I know about ecoli and it can also happen as a result of someone having it handling food that is then passed on to consumers of the food. We had a case in our town at a restaurant where just that happened and impacted multiple people and the cases were confirmed by lab tests by the board of health...all because someone didn't wash their hands and touched food...

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OH NO!!!! This is something that I have had to struggle with for 10 yrs. Same thing as you said above, given the cipro amongst other things because my mother just could not get rid of it. The confusion for my mother cleared when she was taking the antibiotics each time, and would be good for 2-3 weeks after antibiotics done, but e-coli and UTI always would recur again and again each year. Personally, I just had to live with it, because the e.coli always caused the UTI and we just could not kill the e.coli.

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Sorry your Gram has a UTI. It may take a bit longer for her to pop back to normal based on - toxins from amount of bacteria causing symptoms, how well her immune system at fighting the UTI, how well her liver does at transforming toxins into less harmful substances, and how well her kidneys (and other organs) do at excreting the less toxic substances. I would say if she isn't more like her normal self in 2-3 weeks, check back with her doctor.

Prevent UTIs by having Gram drink cranberry juice, drinking lots of water, wipe front to back when cleaning after toileting, and bathing bottom more often.

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When my 90 year old Grandma got UTI's she was extra confused, after the Dr's prescription they took another urine sample, and she was clear. Grandma was still confused for a few days until she had a few visitors, and got a laugh. A few weeks later when she got the UTI again, I gave her cranberry pills with the Dr's prescription. My Grandma has not had any UTI's in month's.

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Hello,

you have received some great responses here so far.

I believe the confusion should begin to clear up once the infection goes away.

My mom (83 yrs old) has Vascular Dementia but one time an undiagnosed UTI quickly turned into a serious kidney infection and landed her in the hospital for 3 days. I noticed an extreme delirium beyond her regular symptoms and I took her to the ER (thank goodness I didn’t wait any longer). Cipro among other antibiotics have there own possible terrible side effects so be on the look out for any of those, unfortunately antibiotics are needed to cure the UTI.

What I have been doing now with my mom is a daily cranberry supplement, 1 cup of Greek yogurt for probiotics in her smoothies, baby wipes after all urinating & bowel movements, making sure her depends or poise pad is dry and even so, changed a couple of times a day just from sweat, am & pm a wipe with a soft tissue with a little extra virgin coconut oil on it (that’s a natural antiseptic) and just rinsing on a daily basis with water and occasionally mild soap. So far no UTI, she gets her urine checked at the Dr office every 60 days along with blood work.

Good luck with your Grandma.

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I suspect we had undiagnosed UTIs in Memory Care. They were good about giving the residents cranberry juice and trying to keep them clean. My father also had vascular dementia. His level of confusion varied; it was never an extreme change. I wish we had been more diligent. He went into the hospital with a mild UTI and responded quickly to antibiotics and fluids, but it got complicated when he received too much fluids. They kept him a week and then released to rehab but he was too weak to participate. With all the environmental changes contributing to his confusion, it was difficult to determine the cause.

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The UTI can bring on confusion and sun-downing symptoms. You don't indicate when the UTI was found and when treatment ended. My mother used to get UTIs all the time when she was living alone and dealt with it, but generally after treatment it cleared up (this was pre-dementia, so no sun-downing or other signs.)

If it has been at least 3 days since the cipro, I would have her retested. Also I would recommend they do a culture test, not just the dip stick test. If she is prone to UTIs, it might require longer term antibiotic treatment (as well as proper cleaning.) It may require using a different medication too.

I was skeptical of all the UTI comments when I joined this site, until mom got her first UTI in the MC facility. She had severe sun-downing every afternoon/evening and would be fine in the morning. Of course this started on a Friday evening, so no help until Monday! Sure enough, UTI. We had to use anti-anxiety along with antibiotics until it cleared. No recurrence of the sun-downing, and the next 2 UTIs presented as night time bed wetting!

I would also be in the camp of less medication is better, but sometimes they are a necessity. Also beware that people can be allergic to medications, even those commonly used, which result in non-treatment of the condition and possible other effects! My mother is allergic to the mycins, and apparently my daughter is too (given for ear infection at about 9 months old, ear infection did not get better, it got worse, she couldn't hold down water after a few days on the meds AND developed hives! ER dxed and gave us a different medication, which resolved everything! Sometime later a member of her regular doctor team tried to Rx the mycin again and when I said no, she's allergic, his response was that it's 'not a very allergic drug!' I made sure he gave us something else.) Attempts to use Heparin on me was VERY bad (increased platelets, which should be reduced AND hematoma at the last injection site) and an attempt to use Botox to treat an issue resulted in hives, so I report those to whoever wants a list of allergens. No more of those for ME!

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Have them recheck to see if the cipro cleared it. Often, in older people with chronic infections, they will need another antibiotic. If it's working, it should be clearing up the confusion

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What is her history of UTI infections? My 97 year old for the past few years has had chronic UTI's. I think we have turned the corner with a regimen of preventative supplements and changes. Those being, 1. Keep well hydrated 2. Cranberry Chews daily. 3. Probiotics for females daily 4. Cranberry juice a glass a day. 5. Pumpkin seed extract daily.
Mom cannot grasp the front to back process so we got her a bidet with a remote.
She always liked to wear snug pants.Those all went replaced by airy loose cotton pants like culottes. (she does not like dresses.). Changed all her under to cotton.
She also retains a significant amount of water. This causes UTIs however we have yet to solve this situation. Her primary prescribed a medication for water retention but her reaction to it was not pleasant.

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Saw some device on TV a few nights ago that is about the size of a CPAP machine with a cord and tampon-like thing at the end. For incontinence. I guess it sucks the water out of you while you are sleeping. I can't imagine trying to use something like that myself as I am a wild sleeper, but might be worth checking out. I just can't remember what it is called.

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What a horrible situation to cope with. Others may have already pointed out: A urine re-screen can show if the UTI is still present; I'm not sure of what the best treatment plan is for e-coli...which is often a food poisoning related problem...I'd be wondering how that happened...some people have reactions to cipro and it's cousins...can have some very unpleasant side effects. Only you know your grandmother...while she could have been harboring the UTI for a long while...it could also be she has some cognitive issues and so even getting the UTI tended to might still have her with the confusion. Do you like her medical care providers? If not, I'd be thinking of a switch or a consult with a geriatricians or neurologist type person...

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If she is not clear retest. A second round of antibiotics may be needed. Also caffeine may aggravate a UTI, however decaf coffee and tea is often ok. Also we had a PA prescribe a cranberry type of supplement/med to help avoid a recurring UTI. That seemed to help. Also, can she easily reach a drink? Dementia residents sometimes need a reminder to take a drink. It is a journey... hale to caregivers.

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While she's on antibiotics of any kind, have her eat yogurt every day if possible to help prevent yeast infections. Confusion may clear but not always. The antibiotic given may not clear the infection so keep an eye out for symptoms clearing or lingering. May need followup with medical.

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Yogurt is a wonderful antibiotic, bc my mom detests it with a passion, I mix a cup of Greek yogurt in a smoothie with Blueberries (other fruits) on a daily basis...she can’t tell it’s in there, tastes great and drinks it!

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If you don’t see it going away Suggest you take her to an infectious disease specialist. My mother also has this and requires a 3 blend IV of antibiotics given over a week to get it out of her system. Else she ends up in hospital. The specialist knows how to manage this best - why mom’s doctor sent us. Cipro and bactrim don’t work for mom unfortunately. Once over we give mom Cystex liquid and Mannose as preventatives. I hope they told you to be careful about wearing gloves when cleaning her and the like. Good luck!

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Cipro is a very strong antibiotic and I had problems with it (I'm 63 and it gave me a yeast infection). I test my Mom using AZO Test Strips (bought them at Amazon) and I give my Mom D-Mannose powder (also bought from Amazon) in either water or apple juice to prevent UTI's. My Mom has been less confused since taking the D-Mannose powder.

Jenna

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Ive seen a person with a UTI get better as soon as the antibiotics get out of there system as sometimes the antibiotics cause other issues. Cipro is hard on the elderly and can cause side effects, glad its only for 5 days. (You have to treat a UTI with antibiotics so hang in there.)
Make sure you get a urine sample a few days? a week?(whatever your doctor recommends) after stopping the antibiotic to make sure the UTI is gone. I always just get it at home and take it to the lab with a doctors order.

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UTI is certainly a problem with advanced dementia. You need medical advice, but there are some things you can do that might be helpful: 1. If you can get a urine sample in a small bottle, you can hold it up the light. If it is cloudy, that is a strong indication of UTI. You will then need appropriate medication. 2. After the prescribed course of medication, you can get another urine sample in a bottle and hold it up to the light. If it is clear, that is a strong indication that the UTI has cleared. 3. In order to prevent UTI, especially when there is fecal incontinence, you will need to make regular changes of any diapers and keep everything very clean. One helpful thing you can do is get some Feminine Wipes and wipe carefully inside the vagina. If the wipe comes out clean, great. However, you may need to wipe several times with the corner of the wipes before the wipe comes out clean. Nurses and agency care workers may not be allowed to do this, but within a family someone of the same gender can do this; and it might prevent UTI.

Prayers and hopes for a good outcome

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My mom started having diagnosed UTIs at @ 85 while living at home. Likely she'd had it earlier contributing to her confusion & delusional behavior. She was hospitalized 3 times: given intravenous antibiotics and sent home with maintenance antibiotics, cranberry pills etc. Within 1-3 months it came back. She had been incontinent and wearing diapers which she was not changing regularly. Nor was she showering fighting the home health staff - all due to her UTI-accelerated dementia-like behavior.

At 89 yo (1.5 years ago) I put her in an ALF specializing in UTI prevention, daily Nitrofurantoin, a showering and diaper change schedule. There she had 6 diagnosed UTIs in 1 year and further became fecally incontinent.

Last week she was sent to the hospital with elevated heart rate, blood pressure through the roof, and fever, classic Urosepsis symptoms she'd had at previous hospitalizations. Next day she was released with no discernible symptoms but now believes she "does not live at the ALF and has to go home because her parents are worried about her". This bill for the ambulance/ER/Hospital day was $45,000.00

Each medical intervention and treatment has left her with more permanent confusion, delusion, incapacity to walk (for no reason other than doesn't care or want to).

Just last week I insisted no more hospitalization, realizing my mother is going to die of this ailment. Hospice accepted her and took her off Nitrofurantoin as it's warning is NOT FOR ELDERLY and causes confusion and weakness, and it is not to be taken for long periods. She'd been on it 2 years.

If your situation is like ours, what no one is telling you is that she isn't going to get better.

Now I have shifted our approach - with advice of Hospice doctors and nurses - to palliative care. Our goal is to make her comfortable not trying to treat her.

Factually all the treatments and interventions did not help but instead contributed to making her dementia worse. I've come to realize that at some point her diminished systems will be overcome by Urosepsis and will ultimately be the cause of organ failure and death.

I'm not trying to be a downer. This is my heartfelt struggle of over 8 years with my Mother. The medical system has literally churned my mother for at least $500,000.00 on a condition that was always made worse due to the side effects of the treatments. Today we believe that she should be allowed to pass peacefully without being a "guinea pig" in a medical system that fights to ignore the fact that sometimes it's best to face our mortality and embrace it with an emphasis on quality of life and peaceful passing.

My mother now has that with Hospice and a medical directive that I, as her POA, have established. It's pretty miserable to have to fight for your mother's right to pass. It has broken my heart, but I know it's right for her dignity and as the natural course of life.

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Kudos

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I can only go with our recent experience with my 85 you mom, but she's been having confusion and emotional instability for the past few weeks and urine (and even blood tests) keep coming back negative. Unfortunately for us, we've had to accept that she's probably moved into the later stage of dementia much sooner than expected. We are seeing her neurologist today for confirmation. I'm hoping that isn't the case for your family and the confusion will resolve quickly.

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Test again. Even if the cipro worked on the ecoli, there may be another bacteria present, hiding behind the ecoli. It will show up on follow up test, and need a different antibiotic. This happened to Mom and took a few weeks to get over.

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Agree! Please make sure that her urine is no longer infected. E. coli resistance to antibiotics is variable in communities and facilities. The culture and it's sensitivities is imperative to clearing it.

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You don’t say how much time has passed since she was treated or whether her urine was re-cultured to check if the infection was gone. My mom had a UTI that eventually led to her being placed in a facility. She was on three different antibiotics and they did clear up the infection, but she remained very combative and confused while hospitalized and they evaluated her for dementia. She failed the tests and it was suggested to me that she could no longer live alone. Speak with her doctor to share your concerns.

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Doctors at hospitals a lot of times say 'cant live at home' its to protect the doctor because if the doctor sent her home and something happenned he is afraid you will sue. Take what doctor says with grain of salt.

UTI confusion?

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