Hubs on hospice 9 months now for Parkinsons. Also has late stage dementia. We are pretty good about identifying when he has UTI after 7 years of formal dementia diagnosis. He had smelly urine starting about 2 weeks ago, hospice kept telling us to push fluids, he got more passive, then a few days ago the smell was overpowering. I called hospice they took temp (normal) etc & nurse said have to wait till it's over 100. Dr just said push fluids & call in the a.m. Next day his temp was 99.2, then 99.9, he was sweaty & urine very smelly, then agitated and definitely uncomfortable. After refusing all day our caregiver called the hospice owner & Dr.; ordered cath urine for culture (he is incontinent) & I dipsticked it before the nurse took it away & it showed max infection. Dr. still wouldn't order an antibiotic. So I called his primary & told them what was going on & they immediately ordered an antibiotic which we started him on last night. Our Dr. said they'd contact hospice & tell them. Well, today he's a new man. Next time his urine smells I'm going to call his primary right away unless hospice Dr. will take urine for culture & start him on best guess antibiotic. Have I misunderstood the role of hospice? I thought they were supposed to take care of stuff like this.
Many hospices do discourage the use of antibiotics because they are regarded as curative. You may agree or disagree with this philosophy but if you want something treated you do need to speak up when things are not gone the way you want. Many people actually don't want their loved ones treated.
I wouldn't be surprised if hospice policy is to ignore the low-level grumbling uti's that are extremely common in very frail elders; but the rising fever and the strong odour should have made it obvious that treating this infection was not at all incompatible with palliative care.
Which makes me wonder if it was a communication problem, which I guess wouldn't have been so if you'd done the communicating. Do by all means take it over, you are your father's advocate; but why not get in touch with the hospice doctor yourself now, with the crisis well in hand, and see if you can establish a good, constructive relationship there.