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Has been treated 6 x in the last 5 months. But tests come back negative after she has started antibiotics. She has a constant burning sensation in vaginal area plus her Dementia waxes and wanes. I'm not sure if I need to schedule a appointment with a gyno. Anybody else experience this with their parent?

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This is going to shock people. My 89-year-old mother had recurrent UTI for decades. There was some words like "interstitial" associated with it to explain why the infection was never absent for long regardless of any type of medication or other treatment. ANSWER: My mother never properly wiped herself after defecating. Why did it have to be me who figured this out during my three-year caregiving stint decades later? You have to investigate the most basic causes, things you couldn't possibly THINK were at work.
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I have interviewed many cna's and just hired one to come and help me 2x a week. She worked many years in the best most expensive assisted living/nursing home place in the State. On her first day I sat and watched her attempt to bathe my Mom. I was shocked to see her use one cloth and was about to use the same water for Moms back and peri areas, before I stopped her that is! She told me they are only allowed 2 cloths and her entire body was one and then face and hair the other. She bathed 12 dementia patients a day and each one in a bucket of water for the entire body. I said no wonder they get UTI's all the time! She agreed but said she has to rush and she rinses the cloth well. Ugh! Dont assume your NH is cleaning properly. My Mom is bathed at home, is 91, never had a bedsore and no uti's since she was at daycare.
TonyRovere, good for you advocating for your Mom!
RR
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My mother, 95, is celiac and any gluten really makes her incontinence worse. I recently removed orange juice from her diet and it has helped a lot. She gets up maybe once at night and perhaps half of the depends used. It isn't perfect, but much improved. She is on a low dose antibiotic Cipro... and we have not had an infection in 6 months or so now.
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My Mom also seemed to always have UTIs her doc put her on a regimen of a daily sulpha drug/antibiotic - which seems to be working- we had it changed to a liquid because the pill was huge - ask the doc about the generic for "Septra"
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My poor mother has UTI's constantly. It affects her behaviour, and it breaks my heart each time the nursing home phones me and tells me another round of antibiotics are being started. She is in a wonderful facility, I do not doubt their care, but she just seems prone to them no matter what they have done. I know they do the cranberry juice but sometimes she won't drink it. The doctor had her on a med to help prevent them, but it didn't seem to help. I am going to definitely research the D-Mannose.
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Sapphire, you said the tests came back negative after starting the antibiotics? Did that mean it was NEVER a UTI or that the meds solved the problem quickly? I know for me, I have had chronic bladder infections so my doctor put me on a preventative antibiotic. But I also have 'vaginitis' which causes burning when going to the bathroom, but NOT an infection. My age and the thinning in that area due to decrease of hormones, causes it. I thought it was ALWAYS a UTI, but not evidently not necessarily so. Who would have thought it. :)
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I had this issue with my mother when she was first admitted to the nursing home after my mother's heart attack. What happened was that after her initial release from the hospital she could not stay in the nursing home for more than 3 days without going back to the hospital for a UTI.

After the third time I grew suspicious and after investigating realized that the nursing home was not properly caring for her. It was so bad that the emergency room staff at the hospital gave me a picture of my mother's backside showing my that the catheter was not being cleaned and my mother was suffering from bed sores.

I was furious and immediately contacted the state Ombudsman's office to file a formal complaint and went to work finding another nursing home.

With a new resident and better staff, my mother's symptoms disappeared.
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There is an over-the-counter supplement called D-Mannose (vitamin store) that, when taken, coats the bladdar and helps to prevent the bacteria from sticking to it and causing a UTI. Check with your doctor first, but it has helped my mom greatly. You can sure tell when a UTI is suspected by the way their personality and behaviors change. Good luck.
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My husband is prone to frequent UTIs because he has to self-catheter in order to urinate. UTI's can be very serious for people with dementia. The symptoms with my husband start with irritability and confusion followed quickly by a loss of all motor planning skills so that he isn't able to walk or figure out how to do something as simple as sit up in bed. He has been hospitalized on a few occasions for this and has had delirium on at least two occasions. Fortunately his doctor trusts me to recognize the earliest symptoms of of UTI and has given me antibiotics which I am authorized to administer immediately so that the condition doesn't progress dangerously, particularly during those times when his doctor isn't available (evenings, weekends, holidays, etc.)
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I'd suggest some other alternatives. Cranberry juice works well, as does lowering sugar and sweets intake.
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Thank you very much!
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A bit more clarification would be important to be able to give you better information, but I think I now know what you are implying. First off, one would have to know what is the basis for her doctors treating the UTI in the first place. Presumably they did a urine dipstick which would have been suggestive for UTI, although it is not diagnostic unless you have a urine culture to back it up, which takes several days to get a result for. Then you may be saying that the urine culture has kept coming back negative. Is that correct?

As far as what's going on with her "vaginal burning sensation", it is important to distinguish whether it is actually vaginal or urethral, which can be hard to do considering they are in the same general region. A urethral burning sensation will worsen during urination because urine is acidic and irritates any inflamed tissue that is present. Then it would be important to distinguish whether that burning with urination is felt near the urethral opening or further inside. There are other potential causes for "urethritis" other than urinary tract infection. Further history and examination would be required by her doctor to sort it out. On the other hand, if there is no burning felt with urination, it may be more of a vaginal irritation, which has its own set of potential causes and could be evaluated by a gynecologist.

The problem with trying to figure this out in an elder with dementia is that she may not be able to tell you where and when she feels the pain, but if you can elicit that difference out of her during one of her more lucid periods, that would be very helpful.

One thing for any elder with dementia and burning sensation, whether vaginal or urethral, you want to make sure hygeine down there is very good and that wiping is done front to back. Having leftover stool/urine residue can be quite irritating on its own.

If you have further questions about this topic, feel free to contact me directly.

Best wishes,
Vik Rajan, M.D.

DISCLAIMER
The health information provided above is FOR EDUCATIONAL PURPOSES ONLY, and DOES NOT CONSTITUTE MEDICAL ADVICE/OPINION, is not meant to diagnose or treat any illness or disease, and is not a substitute for the medical evaluation and advice of your (or your loved one’s) primary care physician or other medical professional. No doctor-patient relationship is established with this interaction. While striving to be factual and exact, no warranties are made with regards to the accuracy of the information provided above. You are always advised to talk with your (or your loved one’s) doctor about any health concerns that you have and about any of the information provided here. Sole reliance on the information provided above is not advised and would be solely at your own risk and liability.
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What I was trying to say is, they treated her for a uti. But tests results come back negative.
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I'm happy Dr. Rajan is providing an article on this. UTIs are very common in elderly people, and sometimes they don't even feel pain. My mother-in-law's symptoms were dizziness and confusion. The UTI was found during a physical. It's not uncommon for people to fear their loved one has dementia, when the problem is a UTI, so it's always vital for the elder to have a complete physical.
I look forward to reading Dr Rajan's article along with you.
Take care,
Carol
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Let me correct myself, the article has just been published and can be found on my profile. If you have further questions beyond what is addressed in the article, let me know.
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This question is well-timed for an article I just submitted yesterday to agingcare.com regarding management of recurrent urinary tract infections in elderly patients with dementia. It is quite comprehensive and should help you out. It will be published anytime in the next couple of days, but if you would like to know more about it sooner, you are welcome to contact me directly (see my profile for details).

Best wishes,
Vik Rajan, M.D.
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