Mom's repeated mystery illness... Anyone ever experience something similar?

A couple of questions:

Are you quite sure that the UTI specimen is being tested for every UTI? I once had a second one, not picked up the first test, which needed a different antibiotic. The litmus-type test in the doctor’s surgery is certainly not enough.

Also, we recently had a post about an elder ex-nurse who was self-administering fecal removal from her bowel. The problem was that she didn’t clean underneath her finger nails afterwards. Have you checked that as well as ordinary hand-washing?

When does your mother have these episodes? Is it during activity? Or are they when she is just sitting down?
I had a homecare client who used to literally pass out unconscious after having a shower. Not during the shower, but when she was all dried off and dressed. I asked her doctor what was causing this. He said it was the activity of showering (she was nearly bedbound) would get her blood flowing pretty much and she'd be overcome. She was never unconscious more than a few minutes.
I stopped showering her and we did only bed baths. The fainting stopped.
Then she started passing out while sitting in the wheelchair. If she was in the chair more than 15 or 20 minutes or so, she would pass out. Her doctor said this can happen to people when they become elderly and feeble. He did every test available and found nothing other than what he already knew. This client lived for several years after these fainting spells or "episodes" started.
My mother's friend (85) has been having fainting episodes for about a year now. Her health is all right and her doctor said the same thing as my client's doctor.
Sometimes it's a phenomenon that just happens with elderly people even when their health is pretty stable and there's no crisis happening.

She's 90.

Perhaps her body is simply wearing out. They're not made to last forever. What worked once or twice for a mysterious illness wouldn't necessarily work a third.

We work so hard to find the causation of illnesses in our elderly LO's and often the answer is simply 'they're wearing out'.

Yet, I would also continue to pursue these odd symptoms.

“Being Mortal, Medicine and What Matters in the End” by Atul Gawande is helpful in understanding the end of life decisions on whether to keep treating.

It appears your mom’s care team believe the problem is one with her kidneys or bladder and mom doesn’t want to pursue that line of investigation by visiting a urologist or is it she doesn’t want to leave the facility for anything?

I had a mystery illness in the height of covid. Lots of tests, lengthy hospitalization. Nothing came of it except I got tests that show what I don’t have a problem with. Which was good to know. I know from personal experience. It is sometimes not easy to find the answer.

However, in your moms case, I think I would ask for a Urinalysis and culture in a few weeks to make sure she is clear of a UTI and not wait for it to make her so ill. After all they really didn’t get a definitive answer on the last one since it was contaminated.

Let us know what you find out. I’m hoping March is a better month for you and mom.

Ninety is a good long life. Cover the necessary things, keep her comfortable and just let Nature take it's course. Old people are the cash cow of the medical establishment and trust me they will keep the tests going until they find something to treat. Got to be your Mom's advocate and don't let them go overboard. I also am old and I find myself reining in my doctor when he goes too far.

Your Mom should follow up. There are some non-invasive treatments of things, yes, or invasive only in that they involve catheter-introduced medications that do a "wash" of the bladder. Your Mom perhaps could tolerate that. The urologist, unfortunately, was the best appt she could have; they could identify say an interstitial cystitis from a bladder infection. I honestly, as a nurse, haven't a CLUE as to what this could be, hence the importance of finding OUT what it is, and THEN making a decision as to what you can do that is not invasive, because I agree with your Mom on that, rather that would be MY decision. Best to you both.

If there is something making her sick, it will show up sooner or later. If there's a hidden UTI, it will spread to her kidneys and it won't be hidden anymore. If there is a malignancy in her urinary system, other signs like blood in urine will appear. It's OK to wait and watch.

I think a urologist is the answer. She might be having small bladder or kidney stones. These can also cause infections. It's possible that the first antibiotic in January was appropriate for that infection. The February infection may not have been susceptible to the antibiotic.
Convince Mom to go to the urologist and accompany her. Remind her that going to a doctor is not invasive. Some recommended procedures do not hurt and could be performed quickly. This could provide valuable information.
Best wishes.

Dr. Ashley Winter, urologist,
recommends vaginal estradiol to keep all menopausal women UTI free. Ask your GP.
e.g. Vagirux
Estradiol (10mcg vagnal insert)

Check for aspiration.
Will cause oxygen saturation issues, fevers, muscle weakness as lungs are impacted. Comes and goes as body fights lung infection, then is re-infected by foodstuffs/liquids.
.

As many have said, I would check for UTI. My mother (85) gets a very similar issue - nondescript feeling of overwhelming fatigue, weakness, dizzy, no appetite. Turns out it is UTI related - doctor put her on Macrobid which perked her back up and she gets stronger each day. I am learning that the UTIs can wreak havoc and unfortunately many older women are very prone to them. The cultures can also be a bit murky in terms of helping interpret what's going on. We are seeing a urologist soon to see if there is anything we can do preventative - I think we have tried most of the suggestions here. Best of luck to you!