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Old 01-24-2013, 08:32 PM   #1
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Test for UTI

Is there a second more definitive test for a UTI? My 90 year old mother has vascular dementia and is in a memory impairment AL. She had a UTI about a year ago, which I had suspected, but was diagnosed when she was catheterized while in the hospital for another reason. She had been found unresponsive in her room and an ambulance was called. I have always wondered if she was in that condition because of the UTI. It was established enough that she was on IV antibiotic and stayed in the hospital for a couple of days.

She has since shown signs again of what I believe may be another UTI...., after weeks of being in a good mood, interactive, her cognition stable , she is suddenly weakened and very combative. I have spoken with the caremanagers about leaving her for long periods in Depends without changing her, as I am concerned this can contribute to another infection developing(this is the only time she becomes difficult, toileting and showering, so I believe they put it off as long as they can). They claim to change residents on an as need basis, but my sister and i are there daily, and it is clear that the staff have a set routine around care.

The last urine sample they were able to get, was negative. I'm not sure how it was obtained. The nurses joked, that if need be, they would squeeze it out of a wet diaper. I thought I remember reading that there is a more sensitive test that can be done. Thanks, Susan

 
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Old 01-31-2013, 09:25 AM   #2
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Re: Test for UTI

I know that UTI can make the demented person feel terrible and angry. Also, at the same time, the dementia can get worse as well given a long time. I am not sure why it is so hard to test the urine. Sometimes it may be the urine testing process. It seems harder for older people. e.g., my Mom was given this plastic pan on the toilet so the urine could flow down there and may be contaminated.
However, if it is truly UTI, the test should show it.
I personally think that your Mom also has other issues: staying in the hospital can irritate her and make the dementia worse slowly. Getting catheter can make her miserable and make dementia worse. It could be the demenita. It may not be UTI. Talk to the doctor to see if there is any way to get the test done properly. My late FIL was given the catheter for a short time to get the urine sample to be tested. My late FIL became combative over toileting when he reached severe stage so he was given anti-psychotic drug/sedative to calm down.
It could also be other conditions. Talk to the doctor and discuss your concern.

Hugs,
Nina

Last edited by ninamarc; 01-31-2013 at 02:04 PM.

 
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Old 01-31-2013, 10:02 AM   #3
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Re: Test for UTI

I would like to ask a related question re: UTI, if I may. We all know that UTI can strikingly diminish cognition in people with dementia. Having never experience UTI myself, I am wondering how UTI might affect the mental functions of someone with normal brain functions. Does or can it make the person feel a big foggy, groggy, or what?

 
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Old 01-31-2013, 12:33 PM   #4
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Re: Test for UTI

Can answer that one having experienced a couple of UTI's per year for a while after pelvic radiation. No effect on mental functions in my experience. My mother had dementia and as soon as there was any change in her demeanor there was an immediate test done for a UTI. Was considered a major mood changer in dementia patients and those living in a close proximity environment.

 
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Old 01-31-2013, 02:53 PM   #5
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Re: Test for UTI

@ Olderstudent: at present, I am not aware of an alternate, non-invasive test for urinary tract infections without sampling the urine. Others please correct me if I am mistaken. So, I don't think there is a way to bypass the urine collection step.

@Cejayab: thank you for your personal experience, re absence of mental status change with UTI in a cognitively healthy person. This really sets me wondering. If healthy people do not have any cognition presentations with UTI, but dementia patients are profoundly affected, then at some point in the development/progression of dementia, people will turn from refractory to profoundly affected.

Can anyone enlighten me as to when this point might be? Do you think it is very early in the cognitive decline process in dementia, or do you think it is in the mid- to later stages? Moreover, if the cognitive side effects to UTI is so dramatically different between healthy and demented folks, might this be a useful way to highlight individuals suffering from the earliest stages of dementia but still sufficiently "together" to escape detection in most of today's assessments? What do you think?

 
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Old 01-31-2013, 07:22 PM   #6
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Re: Test for UTI

My experience with my mum, observation of others in her 12 bed situation and chatting with carers. Later stages...and more prevalent in the more sedentary patients. Mum had no problems when she was able to stroll/go to short events etc with me. In other words...remain active. In her last two years when she prefered to stay in the home and was less active the UTI's started [she was 92 mind you!]
I don't think that UTI testing could be used as an early detection highlighting tool.
I think that it is more prevalent with severe results in dementia patients on account of their living situation....however clean and careful...and because the sense of knowing what is happening to their own bodies also diminishes with their lack of general awareness so potentially small problems escalate. Other people will have different experiences and may have researched this. I am not a researcher...seems to be so many negatives in all things that I prefer to do the best I can and be positive!!

 
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Old 01-31-2013, 08:54 PM   #7
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Re: Test for UTI

Susan, proper cleaning is important before the urine sample is taken. There is a plastic tray that can be put under the ring of the toilet that will catch the sample. If Mom will sit on the toilet and pee then they can get a good sample eventually. It may take a few tries but if they place her on the toilet and turn on the faucet it will eventually work. When you get the sample ask for not only the quick stick test but also a urinalysis culture. I am not in favor of catherization for urinalysis because it is too easy to introduce bacteria that can cause exactly what you are testing for or other infections. It may take a couple of attempts to find out if your Mom does have a UTI. A negative test does not mean she doesn't have one. It just says it is not bad enough for the test to be positive. There is a connection between hygiene and UTIs but the biggest factor seems to be hydration.

Luau, a UTI can make anybody cranky and feel bad but the major cognitive effects seem to be limited to the elderly. I have seen a UTI have a negative effect on the cognition of elderly patients without dementia or in the very early states of MCI. It can affect the cognition at any stage of dementia. Mom had her worst UTIs when she was in the mid stages but she also had them in the early stages and the late stages as well... yes she was prone to UTIs. It is not a good way to determine if someone has dementia because it can be just as relentless in an elderly patient without dementia.

Love, deb

 
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Old 02-01-2013, 09:49 AM   #8
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Re: Test for UTI

I personally don't think UTI affected my mood when I got them before. More about worrying but was not affected in the mood.
I think they took the urine from the catheter for my late FIL because there was less urine or that it was difficult to get it from my late FIL. It ended up with UTI so it was not clear if it was contaminated or it was true. He was very moody anyway.

Hugs,
Nina

Last edited by ninamarc; 02-01-2013 at 09:53 AM.

 
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