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My mom is a person who suffers with having chronic UTI. She just got over one last week and I think she has another one now. What can I do I make sure she wipes right because I wipe her myself when she is at home. I worry about her having these UTI's so regularly, she is 93 and has Alzheimer's/dementia. Her doctor recommended a one time antibiotic for her which works for her but now she is acting the same way again.  Any advice?

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Heidindsrespit1, This is the pits, I know. Unfortunately, SNFs are mini hospitals with all sorts of germs and bacteria floating around; not the greatest place for people with frail immune systems. But unfortunately this is the only place some folks can be for at least a portion of their recovery time. I know what you are going through (I already left a comment once before in answer to the poster's question). My Mom had loads of UTIs after she fractured her femur before her 94th birthday. Including ESBL which necessitated isolation on two occasions. Did all the aides wipe properly? I'll never know for sure. What I do know is that she was periodically left unchanged with a BM in her briefs. Certainly that was not helpful. She made it home after three months, during which she was hospitalized for a UTI, and was discharged with a UTI. That one cleared up but she got one again 6 weeks later. I got her on a list of things (see previous comment) and she has not had a UTI since then. Your presence and assistance will make a huge difference for your mother because you will be keeping an eye on everything that is going on every step of the way. If my Mom had not had me looking after her daily, I don't think she would have made it out of the SNF alive, because on top of the UTIs, they could never seem to get her Parkinson's meds administered correctly. That was a constant struggle for me to make sure they were giving her those meds properly so that her PT and OT could be effective. And that was considered one of the best SNFs in town. Hang in there. I know this is tough.
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I'm in the same boat right now, my mom has had 3 since march 7th.. it keeps coming back and im worred about resistance.

When she gets delirium The things she says are : deeply insulting and hurtful...
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Whenever a person is on antibiotics you must follow up with probiotics such as those found in yogurt. The antibiotics kill good as well as bad "bugs" in the gut and you must replace them or the whole system gets out of balance.
Gonna brag a little here, I make my own yogurt, it's delucious, fairly easy and cheaper than store-bought.
Also, re cranberry juice: hardly anyone can drink the pure unsweetened stuff, but the cranberry juice cocktail has so much sugar it does more harm than good! Reduce the patient's intake of sugar to reduce infections, that should help. My dr told me that you have to drink 2 liters of pure cranberry juice a day for it to do any good (gag!) but the Azo pills can help. Ask her dr ! Good luck!
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Since being hospitalized with sepsis from recurring UTIs, I've had my 95 year old mom, who's immobile, on an OTC liquid cranberry supplement with the following ingredients
vit c
d-mannose
bromelain
prebiotics

it has made a huge difference
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My Mother was in the hospital 4 times for the UTI also. It turned out to be an infection in her gallbladder. After treatment for the infection in her gallbladder( she had to wear a bottle and drain it for 6 weeks). Hasn't had another UTI. I would have her gallbladder checked.
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She needs to drink lots of liquids, water preferred.Or cranberry juice as others have mentioned. If she loves milk, do half milk half water; orange juice - half orange juice half water, etc.

If she’s at a day facility you need to talk with management about the problem and let them know you will be making more frequent visits to check on her. Do not rely on having management simply say they will look into it, “oh yes we agree absolutely, blah blah blah blah blah.” Check her when you drop her off to make sure she’s dry before you leave, check her when you pick her up to make sure she’s dry before you leave, and do surprise visits and literally check her. If you do that, care for her will increase.

I used tissue paper and then wipees just for that little added cleanliness. And I bathed her privates daily When I put her to bed eventually.

Good luck & God bless
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In general about UTI's. I'm almost 80 and, although I've never had a UTI, I know elders are vulnerable so I eat some dried cranberries every day... about 2 tablespoons. (If you're near a Costco, they sell a giant bag which keeps without refrigeration.) In texture, dried cranberries are like raisins. To prevent them from getting stuck in my teeth and contributing to dental cavities, I put them into a tea strainer and drop it in my morning green tea to soften, then add them to my hot cereal (or you can add them to hot soup or vegetables. then let them cool to taste.) I've been doing this for at least six years. I've still never had a UTI and I'm not up to your level of meticulous about hand-scrubbing. (No dental problems either.)
I think you could do this as a preventive measure with any elder who eats solid food. (My husband drinks a jigger of unsweetened cranberry juice every day and doesn't have UTI's either. He says you get accustomed to the lack of sweetness, but I suppose some sugar or stevia could be added.)
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this may not help but whenever i go into any bathroom i use hand sanitizer whenever its available. Then i go into the stall and quickly “wash” my hands after closing the door and before sitting down.

Tho its inconvenient i now wipe correctly.

Also ... my innards have fallen and when i sit any bowel discharge is pushed around on the pad i wear and i can only hope i dont infect myself.

All this sounds gross so i keep reminding myself its a normal occurrence. It can happen to any woman.

But maybe it will help you and your mom. I havent had a uti for awhile now since using the hand sanitizer.
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My late mother, who was incontinent, got frequent UTIs. She remedied it herself by keeping cranberry juice on hand at all times.
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hubby incontinent & dementia had multiple utis successfully treated each time with various antibiotics depending on the offending organism as identified in culture, but kept recurring periodically. About 18 mos ago put him on low dose Bactrim (sulfamethoxazole/trimethoprim) and hasn't had a UTI since.
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I am going through the exact same thing, same age - everything. What I have also learned because my mother broke her leg and is in a SNF right now, so they wipe her and they do it correctly and my mother has another UTI, so I am beginning to think it has nothing to do with wiping. It must be something else. I am now going to look into an ESBL: www.healthline.com/health/esbl
because I think this might be why after her antibiotics, she’s in the same boat again.
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My Mother was put on a daily antibiotic because she kept getting recurring UTIs in the nursing home. That solved the problem.
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I use a probiotic they are a miracle they have the probiotics for womens urinary tract health . The antibiotics do their job so good that the antibiotics kill ALL THE BACTERIA but everyone needs what is called GOOD BACTERIA so after all the antibiotics are gone even the GOOD BACTERIA is gone therefore letting in the BAD BACTERIA ....which causes infections like U.T.I. or even C.DIF.my Doctor explained this to me! also my mothers Doctor has her takeing probiotics everyday and we all drink Activa and take cranberry supplements drink WATER my mom is on WATER restriction PER ..C.H.F . but we get her slowley to consume more water from popsicles ...And italian ice cups too funny moms like a kid with her popsicles haha but her dr. Approves of this as most popsicles have little to NO sodium and there are sugar free tooo ....just to suggest ideas for you GOOD LUCK!!!
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ccheno Feb 2019
Folks with dementia may have difficulty finding the bathroom, or getting up out of the chair, or walking, or removing depends, or sitting. Do they drink less fluid (or are they offered less in facilities) to prevent having to go so much? Can you imagine if they really drank "8 cups of water daily" like we're advised! My 93-year-old MIL with dementia got used to using a moist flushable wipe each trip to the bathroom.
Any kind of yogurt with live bacteria culture has the pro-biotic effect, plus is tasty and easy for an elderly person to swallow. Mom said she hated yogurt, so I called it custard and she ate it happily. I poured her unsweetened cranberry juice in a pretty glass before dinner, replacing wine or other types of drinks she consumed when younger.
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I used to get lots of UTI’s & started taking OTC Acidophilus (recommended by nurse practitioner)—1xday & that was 5 years ago & no UTIS since
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Hi there....
Our doctor said, some elders live for years with infections...
Eventually, there will be nothing you can do. The body is breaking down...
Treatments for my relative no longer work, and she is just living with it (it's been nearly 2 years now). And surprisingly, she's doing ok.
Even if you do the treatments, sometimes they cause side effects that aren't worth it (for my relative, it was months of off-and-on diarrhea that made her totally miserable until her gut recovered from the medication).

All the best to you and your mom!
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Lizhappens Feb 2019
I think you need to get another doctor. Doctors who say that don’t care about their clients anymore. You should never put up with long-term infections like that and in the elderly they get more severe and can cause death. He’s wrong and he’s going to get a malpractice suit thrown on him someday. I would.
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My 82 year old husband was getting continual UTIs, caused by an inability to fully empty his bladder thus causing bacteria buildup. He had radiation for prostate cancer 12 years ago which eventually compromised his bladder function. In December, 2017 his urologist prescribed Methenamim-E HIPP 1 gram tablet to be taken 2 times a day “forever”. The UTIs stopped for over a year until he refused medication of any kind, at which point the UTIs have recurred. He has been diagnosed with Alzheimer’s but has been deemed by his physicians as competent to make his own decisions so he, for the time being, (and ultimately I as his primary caregiver), live with the consequences of his “bad decisions” which, by the way, are many. There’s lots more about my story, but this reply primarily addreees the UTI question.
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Leonine1 Feb 2019
💜
" ..... and ultimately I as his primary caregiver), live with the consequences of his “bad decisions” which, by the way, are many. There’s lots more about my story, ......"
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My mom , age 88 with dementia and other health issues, was just placed on prophylactic antibiotics. She was getting UTIs every few weeks.
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I sympathize and understand your concern. My mom is almost 96 and had a bunch of UTIs in 2017 after breaking a leg and winding up in hospital and rehab. She now takes everything everyone else has mentioned here: Methenamine 1/2 GM twice daily (she started out at 1 GM twice daily), 1 tsp of D-Mannose powder in her water each day, 500 mg Vitamin C daily, Cranberry extract capsule daily, and 1 probiotic capsule daily. She has not had a UTI since October 2017. The wiping is a big deal of course, and I don't know what to suggest there. My mom lives with me and I do all the wiping. I also make sure she has a full container of water she can drink from and remind her to drink throughout the day. That helps, too. Hopefully others here can give you ideas on the wiping issue. Let us know if you implement some of these things and how it goes. Everyone here knows what you are going through and how worried you are.
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Lovingmymom1957 Feb 2019
I have written down all the subjection so when I go back to her dr. I will discuss these with him and see what he thinks because I don't want to do anything to damage her kidneys
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Cranberry pills once or twice daily helps my mother and me.  Also, ask your doctor if he would prescribe Macrobid (nitrofurantoin) once daily as a prophylactic.  it is what is often given for UTIs and given daily will keep them at bay--works for me.  The topical Estrace suggested below, or another topical or oral of that type, will help also.  UTIs can cause other serious issues in patients with dementia.  I have heart issues, and I have noticed that even if I am coming down with one and don't know it yet, my heart acts up.  It is important to keep them in control in an elderly  person for many reasons.  Good luck!
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Lovingmymom1957 Feb 2019
Hey Jenny she has had so many since I took over her care three years ago until now I no the symptoms because she want tell me but by Mr paying close attention I know her 😀 macrobid she has been on that quite a few times until now her dr. say it's become nonreactive so they don't even give her that anymore I like it because it really seems to be good for her
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The bladder pools the urine and bacteria starts. That’s the anatomy as we age.
The correct wiping also helps. More ambulation/walking throughout the day every hour or so a short walk if she is mobile.
QUESTION : does she have loose stools all the time with Dementia it is common stay on top of that. Imodium AD.
More fluids during the day is important as well.
Craberry juice if she isn’t on a restricted diet.
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Lovingmymom1957 Feb 2019
Hey lmaxwell she does not have diarrhea a lot but 2 years ago when she was admitted into the hospital they discovered that she did have a kidney stone but by her being as old as she is it was more dangerous for them to not move it and it's not that big it's a very small one so they decided to let it stay where it's at so I think that's a lot of her problems too and she's mobile but I don't understand how she constantly gets them and I notice her whenever I go to the bathroom with her I clean her and everything on my own but she continually gets them she is not on a restricted diet she eats mostly what she wants trying to get her to drink is a problem to have tried everything
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My 87 year old M-I-L with dementia also was getting chronic UTIs.

In addition to Methanamine and Cranberry pills her MD prescribed Estrace .01% topical 2 x/week. The addition of the Estrace cream has made all the difference. It has been almost a year and (knock wood!) she has not had another UTI. She lives in an AL and under staff supervision and direction she applies the cream herself.

Good luck. I know how frustrating it is.
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My 85 yo mother has a long history of UTI. And we found few antibiotics she could take. We have even had to do IV antibiotics for 7 days once to just get her cleared. She had a stroke 2 years ago and the UTI became more frequent. When discharged from rehab, I took her to a urologist and he treated her UTI and put her on methemamine 1gram with Vit C twice a day. The methemamine breaks down in the bladder to form formaldehyde and prevents bacteria from growing. I give her a Chewable Vit C and cranberry gummie with each dose. It’s over 2 years now and no UTI. She also has dementia and is in continent.
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My Mom was also having UTI’s frequently. A lady who worked in the Drs office told me to try D-Mannose cranactin. My mom never had another one.
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My Mom was on Cranberry pills and a probiotic. Probiotic because antibiotics cause yeast infections and probiotic fights against them.

Some people have mentioned being allergic to the Depends material they use. Which sounds good to me since I cannot use any Kodex products.

Its also been said that a culture needs to be done to make sure antibiotic is for that particular infection. Also, make sure she is catherized to get all the infected urine.
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You know I had these for years. Garlic supplements with parsley. Stops the burping. Cranberry juice not from groc store, but unsweetened and from health food store. Some people give cranberry pills.

I have not had another in 30 years and i had to be hospitalized. But I am not elderly. That is a different equation entirely. It's never just one thing, like so many things in life. It's layering.

Hydration number one. Wiping. Hydration with coffee doesn't count. Others. Will chime in with their experiences too. Good luck.
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