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Hi all. I need some help. My mom was dx w/ dementia last year - mainly short term memory, she was actually doing okay, but very repetitive and had some mounting anxiety. She also has MS. She fell 3 times in a week in Dec. Discovered she had a UTI. Begged the doctors for help, got nowhere. On Feb 5, she fell and fractured her femur. Was in ER for 24 hrs then transferred out to a SNF. She had another UTI at that time. She has essentially had them non stop since. She gets crazy vicious, yells, screams, hallucinates, is delusional, etc. Last week, the SNF decided she was competent, sent her home AMA, never called me. They emailed me at work 15 mins before 5 and I wasn't in my office. I couldn't get any help. Finally got her to the ER on Wed night, as she can't walk or stand, and I can't lift her. She was there until Sunday. Found a board and care, she blew out because she began trying to break the tv, pulling tablecloth off, etc. Back to the ER on Monday. They finally admitted her under a psych hold. She did test pos for a UTI. So she has literally had one for 6 months straight, and been in this angry, screaming mode. I keep begging the docs to do something. I think it is possible that she may have had a stroke at one point during an acting out episode. I guess my question is, any thoughts, advice, anything? I know in my heart something is wrong. Her decline is way, way too fast.

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It just sounds terrible. Has she seen a urologist? My mom battled UTIs until she finally got to a good urologist, was throughly tested and put on small daily dose of antibiotics.
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Is there some reason that medications are not addressing her UTI?

Does she act out, when she does not have a UTI?

I might seek out a geriatric psychiatrist to have her evaluated. What did they say about her after the psych hold?

Sometimes dementia can cause people to act out aggressively, but the doctors would be in the best position to make that call. And they can refer to Neurologist to check for strokes. Does she have Vascular Dementia?
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Could you clarify some issues? I must be missing something.

1. "Discovered she had a UTI. Begged the doctors for help, got nowhere."

Who discovered the UTI? I would think it had to be diagnosed through a urine test, and that would be done by medical professionel(s).

What kind of doctors refused to help? ER? PCP? And why? Was she hospitalized at that time? Did you report any of the doctors to the AMA or state medical association? Did you report the hospitals, or contact any Ombudspersons for assistance?

Treating it would be a standard of care issue.

2. "Last week, the SNF decided she was competent, sent her home AMA, never called me. They emailed me at work 15 mins before 5 and I wasn't in my office. I couldn't get any help."

So the SNF acted against medical advice of apparently its own contracted physicians and sent her home? This seems very unusual.

Was the "competency" decision based on neurological evaluation, arising from her dementia?

Were there no discharge instructions from the SNF? Who picked your mother up from that facility?

3. "She did test pos for a UTI. So she has literally had one for 6 months straight, and been in this angry, screaming mode. I keep begging the docs to do something. "

Something really doesn't make sense here. If she's had a UTI for nearly 6 months, SOMEONE must have diagnosed it. And those "someones" had a standard of care obligation to address it.

What kind of doctors were you "begging" for treatment? Are you saying that whoever you begged refused to treat her? All of those who were "begged", for 6 months?

There must be more to this. It would help if you provide more explanations so others can help you.
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I feel your pain. My mom has had almost continual Uti for more than six months too. Finally docs figured out she has ESBL bacteria in her urine that means she is resistant to most antibiotics. Even knowing that, and giving her IV antibios for days in hospital, she comes home and a week to ten days later she starts acting nutty again and we know its back. We too are at a loss on how to proceed.
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Red, something is very wromg with this picture. I cannot i!agine a nursing home would send mom home against medical advice! I suspect that they found your mom competent so she left of her own accord. No, that is not right! Who has Mom's POA? Does she have one? If not, and if mom is competent paperwork needs to be completed asap! Do you have a HIPPA? If not, at a minimum get one. If mom is not competent do take care of POA the only option is guardianship.
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Red, if your mom is "competent" she can refuse treatment, which i guess is what she's doing, yes?

Is she still on a psych hold? I hope they ll be able to get her calmed down with meds. As mentioned above, she neds a urologist. Also, probiotics sometimes help with preventing UTIs.
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Redhd, my mother used to have recurrent UTIs. Her doctor put her on a prophylactic dose of Bactrim three times a week. I also give her a strong cranberry supplement capsule each day. For her it has worked (knock on wood). If the antibiotics are not working for your mother, I don't know what might help. Windyridge's advice to consult a neurologist sounds like a good idea. It may be that your mother has a resistant bacterium. It could also be vaginal problems or even a fistula. It is good to have someone who really knows what they are looking for.

UTIs can make elderly people psychotic. My mother gets semi-psychotic even when she has a mild bladder infection. She turns into a zombie if the infection is more serious. The signs are unmistakable. Look around for a urologist who works often with older people. He/she might be able to figure out how to give your mother some relief. It may save her from kidney problems and sepsis, as well. Please let us know how it goes. I wouldn't try any psych treatments since it may just be UTI by itself doing it. The only thing is her doctor may want to add a mild sedative, e.g. lorazepam, to help with anxiety and sleep.
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UTIs are terrible and can cause such issues with memory and stability. mom has had one pretty much since beginning of February. Only time she is pretty much on the ball is when she is on the correct antibiotics and is getting enough liquid. Otherwise she goes to sleep and does not know where she is
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No one will care for your loved one like you do. ADVOCATE ADVOCATE....make them listen
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