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I took my Grandmother to the hospital today because she has barely eaten anything in about a month, and the past 2 days she refuses water and pills. She has gotten a lot weaker, and has a almost non stop stomach pain for a while. At first we thought it was just the dementia, but when we took her in to quick care 3 weeks ago, they diagnosed her with a bladder infection. Her dementia has gotten worse, and that's obvious by anyone who spends 5 minutes with her. At the hospital they said she was malnourished, dehydrated, low in potassium, sodium, and magnesium. They put her on an IV and released her around 12 hours later saying that all of her tests look good. The infection was gone, her levels have returned to normal. The only thing they couldn't figure out was an irregular heartbeat (which is new to us), and a small black spot on her chest x-rays. However, because she's 91 they passed it off as normal and discharged us telling us to follow up with our PCP. She's still not feeling good, dizzy, stomach ache, and she didn't even remember being at the hospital. She keeps saying that she spent the entire day with her sister (who died around 50 years ago), and they were getting ready for Christmas. I'm at a complete loss right now. First they were worried, admitted her to the hospital, ran all the tests. Then the doctors switched (end of shift) and it's all the tests looked good, and there was no reason to keep her over night. This doctor is supposed to be one of the best at the hospital, according to the nurses. Yet, she spent 2 minutes with my Grandma, and didn't even know anything except her name. She asked a few broad questions, scanned over the test results, and then told us we were free to go as soon as the nurse brought the discharge papers. I'm so confused right now. It's still another 2 weeks until we can get in with our PCP, but even at the hospital she barely ate anything. Am I going crazy and just over thinking her health? Because it really feels like something is missing.

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KayKay, no you are not going crazy. You have a right to be concerned. I would demand to get in earlier to see your PCP. My late Mom was right where you describe your Grandmother as being. When we took her to the emergency she had 24 hr. around the clock care in the ICU for two days. She was then transferred to the cardiac ward where she spent two weeks and then was transferred to another ward. All together she was in hospital six weeks.

I live in Canada so our health care system, although flawed is a little different than yours but it sounds to me like you should take your Mother back immediately and demand that she be held and monitored at least until she is stable.

I am not trying to alarm you but at your Grandmother's age, things can go south very quickly.Good for you for caring. Please let us know how things progress.
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KayKay13, Gershun and Countrymouse have given their usual sound opinion. And I agree with littlemisskitty. UTIs make dementia much worse, and even give dementia symptoms to people who don't have dementia! And I can't believe it can be cured in one day. But I can believe the test showed clear. Here is my experience:

I went in thinking I might have a uti. The ER doctor ran the tests and said no uti showed up. This first, quick-result test is like the one you can buy in the drug store. If you have a certain type of infection this test will show it and they can get on with treating it. But if you don't and you have symptoms then the medical professional will run an addition test that takes 24 hours before results can be read. If the hospital ran the quick test before discharge (and they must have, right?) then Grandmother could still have a uti that only the longer test would detect. Of course I can't say that is what happened, but it would explain how the second doctor saw good test results and discharged GM.

And I agree that GM must get in to her PCP or some other doctor in that clinic, now rather than later. Most doctors keep some slots open in their schedules for emergencies and also clinics have doctors on rotation to handle urgent cases. So unless the PCP is the sole doctor in a private practice someone at the clinic should be able to see GM Now.

But, you have to know what to ask for. You need a SAME DAY appoint for GM. Two weeks from now will not do. She has been to the ER who advised follow-up by the PCP. Yes, if necessary you can see the doctor on call that day, but you would prefer the PCP.

This is a bit off topic but it has some relevance. Many years ago the drug store said my prescription had expired and the clinic was not renewing it. I talked to the clinic administrator. She scolded me. "The doctor has to see you to renew the script. We have sent you two notices to make an appointment." "Yes, I got the notices and I made the appointment. The earliest they could get me in was three weeks from now. I figured that the doctor would give be a short-term script until she saw me." "Oh," the administrator said in an exasperated tone, "You should have asked for a med-check appointment. They are very short and we schedule those within a few days of request." By this time I was in tears. "Ma'am, I'm being treated for depression. I've been out of the drug for a week. I don't know how you expect laypersons to know the jargon of making appointments, but I surely do not appreciate being scolded for not knowing it." She apologized and I did get an appointment for that day. I also wrote a letter to the clinic head, suggesting better training for administrative staff.

So I know first-hand that it makes a difference how you ask for the appointment. You want a same-day appointment for follow up of an ER visit.

Good luck!
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Kaykay I agree with Gershun. Get on the phone to your PCP's office first thing, tell them exactly what has happened so far, and don't let them hang up until they have given you clear and practical instructions about what to do next. If they say they'll call you back, note the time and the name of the person you speak to and ask when to expect the call. If they don't call you by that time, call them back.

Be calm and polite, of course, no matter how stressed and frustrated you feel. But don't be shy: remember, it's the squeaky wheel that gets the grease.
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Dementia gets way worse with a UTI. My grandma gets them all the time and it always takes a while to get over them. I also think just as she's in the middle of a UTI that I won't be able to care for her anymore but then she gets better and snaps back to herself (which is dementia mind you but nothing like what she is like when having an infection). My grandma sees dead people, talks to them, gets sun down all day, talks nonsense, complains of back pain, won't eat or sleep and eventually gets to the point of where she can't walk, if she has a UTI. You also need IV drugs for 3 days to cure a UTI or at least oral drugs for a week. Having someone treated for a UTI and released within a few hours of being diagnosed with one and not being given drugs to give to her, is not treating the UTI correctly. I'd get in to see your PCP earlier or even take her back to the ER for a follow up UTI test. You can even get one of those over the counter tests just to see for yourself if anyone might show up (Doctors seem to hate it when you bring it in as proof but it will at least give you piece of mind if it shows up negative or if it shows up positive, it will help motivate you to fight). I'm dealing with my grandma not eating or feeling good and she has pneumonia. At first they said she was dehydrated but a second visit to her PCP had us back in the ER and it resulted in pneumonia and congestive heart failure (not related to your problem but doctors can make mistakes). Keep fighting. I'd not take that answer. You know your grandma best.
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KayKay, something I learned from being a member of this community? That just because the doctor tells you that "you're free to go" doesn't mean that you have to go.

A couple of year ago, after my mom was hospitalized several times in the course of 6 weeks for spiking blood pressure, among other issues, and yet another doctor told us he was discharging her, I said "No, you haven't fixed the problem". (I am not like this, I don't stand up to authority).

My mother started to weep; the doctor was flummoxed. I said "she's been in and out of here X times in X weeks; I'm not taking delivery of her until you fix whatever is wrong". The doctor left to consult with his staff; my mother begged me "not to make her into a difficult patient".

As I said, I was emboldened by what I had learned here. They got in a geriatrician as a consult and somehow, magically, THAT doctor saw my mom as a whole person, not just the sum of her organs. A psychiatric consult was sought. We got mom on meds for anxiety. We talked about the fact that she needed a more supportive environment that living alone in a big house in an isolated suburb. In other words, the REAL issues got addressed.

KayKay, this is hard, I know. But if you don't get good answers today from your PCP, get her back to the hospital for a complete workup of her condition (my mom's "tests" always looked fine; still do; she's dying of congestive heart failure and vascular dementia, but all of her blood tests look dandy) and perhaps to rehab for a few weeks afterward. Good luck!!
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Update: I can't get in with my PCP because she is out of the country. We will most likely end up taking her back to the hospital though. Today she woke up sick. However, she's been sick for a while (one reason we went in the first place). I just don't want to have to put her through all those tests again. She's acting like she's ready to give up. At this point it's starting to feel like it's hurting her more than helping.
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When you say "sick" do you mean with stomach pain? I think I'd call 911 and insist she be transported to the hospital.

Dehydration can be deadly. If nothing else,, they can get her on an IV to get fluids into her.

Does her doctor not have someone covering the practice while she's gone?
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I wish your grandmother could get relief for her pain. Is that what the meds were for? Who is her Healthcare POA? Does she have an Advanced Directive? Has the Primary talked about what to expect with dementia as it progresses? Has anyone mentioned Hospice? The ER doctor suggested it for my LO when she was there with dehydration and Last stage dementia. I think they really are limited in what they can do, except for give IV fluids and keep them comfortable.  Also, going to the ER bothers me, because it's full of sick people and the patient runs the risk of catching lots of stuff while there, like the flu or a staff infection.  While I was there, I wore a mask the entire time and 3 days later, a friend who was there did come down with the flu. 
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@Barb We took her to the hospital yesterday, and they gave her fluids and meds. This morning when she woke up she had a low fever, dizzy, and throwing up. I want to take her back, but at the same time they put her through hell for nothing. So I'm not sure...
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You take her back insist that they admit her. Tell them "you need to figure this out and not just treat the symptoms. Otherwise, please tell me that she's dying and tell me that it's time to call Hospice.

I'm not leaving until you make this right"
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