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The cause of recurrent bladder infection/UTI is due to a distended bladder where at all times is holding urine and cannot fully empty. Enlarged prostate. Hospitalized a few months ago and after a few days delirium started. When discharged home delirium gone but after two months became fixated on one specific delusion. Recently EMS called because of the delusion but in hospital they found another bladder infection. It is so difficult to deal with the delusion/delirium. I don’t know if the bladder infection causes the delusion/delirium or is it early dementia? But how to prevent these recurrent infections when prostate surgery is not an option.

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hi carevdad

my dad spent 10 weeks in rehab after two falls during a uti. Since end october, 7 UTIs. One big one he couldn’t fight off and was back in hospital during his rehab.

dad has an enlarged prostate, CKD and doesn’t void so now has catheter. We saw a urologist and discussed low dose antibiotics with him plus he discussed a twoc (trial without catheter) and flow test to check voiding. The latter hasn’t happened yet.

i notice UTIs through changes in his behaviour as much as blood or cloudy urine.
end jan dad has a uti, then a poly vagal episode, in hospital for two weeks, hospital referred for an mri and memory clinic appt; maybe vascular dementia. Dad was at his best towards the end of his hospital stay, was okish about going to respite wanted to go home but understood he needs to get stronger, Catheter changed, into respite then UTI; he’s now shouting, getting upset, hates being on his own but doesn’t want to get out of bed (says he feels ill), so I now wonder if it’s delirium. It’s heartbreaking.

has your dad seen a urologist? Have they recommended any prevention treatment - low dose antibiotics, etc. dad was taken off low dose for a while, now back on them, There are side effects to most treatments, and with low dose it’s antibiotic resistance so they need to be rotated. Since catheter his kidneys have got better (egfr went up) but I don’t know if that’s just a coincidence as he drinking more fluids,

i womder if there is a connection between episodes of delirium and dementia - I wonder if each episode of delirium “chips away” at our loved ones. The effects of delirium can also last a while, and I also wonder if it stays longer each time, I’m aware you can also get hospital delirium, without any infection,

I also talked to the urologist about cranberry, d mannose and probiotics - he said d mannose is more for women and uti, but I give dad cranberry and probiotics supplements in a smoothie (not at the same time as his antibiotics, or I give him actimel drinks). Have you has a recent PSA blood test done? I would also get a GFR (kidney measure blood test) my dad was diagnosed with stage 3b nearly two years ago, after all the infections his gfr went down now after recovering it’s gone up and improved.

I believe a dementia diagnosis won’t be even considered until any potential delirium has gone. I checked with the hospital doctor about supplements in case they interacted with the meds dad was on. When your dad has a uti do they send a urine sample to the lab? Sometimes it can take multiple doses of antibiotics to shift a reoccurring uti, so I would also get that analysis rather than pee stick.

I wish you and your dad well
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Carevdad Feb 2022
Thanks for your response. It has been stressful for my mom and I to deal with the delusion. The delirium stopped when he got home from hospital but a month later he developed delusion that my mom was having an affair and is fixated on this idea, following her around and would not leave her alone. I had to call ambulance last week cause he would not stop. I did not know how to make him stop and things escalated when we were all yelling and screaming. I cried my eyes out when i walked into the ER and saw him held in a psychiatric cell, sitting there just looking out the corridor. They promised PSYCH was going to see him but for two days no PSYCH came and he was getting delirious in hospital. I had to get him home, along with prescription of antibiotics. He is better these past few days, leaving my mom alone, but still fixated on idea that she is having an affair. I have no idea where this delusion comes from and whether it will go away. One factual thing I know is that he can’t fully empty his bladder due to enlarged prostate so the UTI will be reoccurring. He is at an age where he does not want prostate surgery. I just can’t deal with the delusion every time there is a UTI
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Firstly I’m really sorry you had to go through this. It’s so hard seeing our loved ones so distressed. It seems like a good sign that it calmed with antibiotics. I would get a pee analysis to check it’s completely gone. Sometimes it takes a couple of rounds of antibiotics to shift a stubborn one. delirium is horrible, I had now idea until I saw it. I’ve also read about hospital delirium too. I found it hard to believe the effect a uti has on the mind.

re voiding, my dad is not a candidate for surgery either so he would be temporarily cathetered, but has had this one in for longer, I don’t know how long it will stay in. something the nurses tried to teach my dad was after he’d finished peeing to pause for a moment and then try and pee again.
is your dad on medication for the enlarged prostate?

can you get him to a urologist? I don’t know if longer term low dose antibiotics are an option in your situ, I would also get him drinking as much as you can, which can be hard too!
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Carevdad Feb 2022
Thanks Moxy234

My dad had seen a urologist after the first hospitalization when he came home with a catheter. He refused follow up regarding his prostate cause he doesn’t want surgery. The Urologist did say that if he was his dad he would not consider surgery either. The first hospitalization when he could not pee and had a catheter in, they did prescribed him Flomax, which he continues to be on. I am hoping that the delusion is linked to the bladder infection. This way, at least I know now that when he becomes delirious or delusional I will bring him to my family doctor to get his urine tested and antibiotics if requires. Hospital is no place for him as it makes him worse. He is always retaining urine so infection is a reoccurring thing. It feels like no one cares in hospital and if you ask too many questions you are seen as difficult and they apply strict visiting hours on me and kicked me out. While it has been a 24 hour job and stressful, i feel sorry for those who do not have any loved ones to care for them, and be left laying there in the ER for hours and days on end.
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