My mom (93) in Assisted Living keeps getting UTIs. I feel like the PA who serves as the facility "doctor" isn't doing enough to ream them out. For one thing, when my mom starts showing symptoms and the nursing staff takes a sample, the PA doesn't call in a prophylactic antibiotic to cover the days while they're waiting for results. Mom has clear symptoms, and I find this frustrating. Any time I've ever had a UTI my docs through the years have called in a covering antibio until the test results come in and they can better target them. So Mom suffers for days until the results are in. (And yes, she might suffer anyway if it's the wrong antibio, but she's had enough of these they should be able to look at her chart, see if there's a pattern and if so, choose the prophylactic based on that). I also don't feel like Mom is on a long enough course to fully ream out the infections in the first place. They just keep coming back.
I generally don't feel like this PA is worth her salt, for other reasons (my dad had a TIA a few months ago and she wrote off his symptoms as "probably neuralgia" because he has a history of that; he also had a TIA in 2024, so he has THAT history, too. He just happened to have an MRI scheduled the following week after this latest one for follow-up on something else and the neuro caught that second one).
I have some other issues with the way the nursing staff handles things, but they're based on hearsay from my folks, and I can't be sure I'm getting the straight story there.
I've talked to their Director of Wellness on two occasions -- nice guy, knows how to talk the talk, and I did get some movement on a couple of things, but this UTI thing is still a problem. I've talked to the charge nurse, who promised things she never delivered.
Should I ask to speak to the PA directly? Go through the director again? Stop meddling and let my parents handle it? I've got chronic illnesses myself and I know if I don't advocate for myself I don't get good care. But because I have chronic illnesses, it's exhausting to have to take this stuff on. I thought having them in AL would take the burden off me, and to a large extent it has. But I still get the occasional 7am call with my mom crying and in pain because she has a UTI and no antibiotics while she's waiting for the culture to come back. I shouldn't be getting those calls.
Hospice doesn't mean that mom is going to die within six months, as some people assume. My mom, who died at 95, was in hospice care for 2.5 years. My husband has been in hospice care for 1.5 years.
That being said, I did have to take care of my mom for several years and she was almost a regular patient in the ER. They knew when we came through that she undoubtedly had a UTI. The older one gets, the more UTIs become an uphill battle. It's just a part of the aging process. I don't know the science behind it, but most caretakers will tell you that the patient they're caring for has had multiple episodes. So, do please take that into consideration. I have never had the interim antibiotics of which you speak. Mom was usually diagnosed at the time of the visit and, if it was really a bad one, she might spend the night so that they could give her bigger/continuous doses. On the rare occasion, she might spend a couple of days in the hospital.
Definitely talk to the PA about your concerns, but realize that at advanced old age, it can be very hard to get rid of UTIs. The bladder doesn't fully release all the urine, and that's what causes the infection. By the time my father started getting back to back UTIs, we had hospice on board and comfort meds to help him. Hospice still administered antibiotics though.
Our involvement with our folks in AL can be never ending, I know, my folks lived in AL from 2014 until 2022. I was constantly being called for one thing or another, or to meet with staff, doctors, get mom supplies, approve meds, see her in the hospital, rehab, a million things. And that doesn't include the calls from mom. By the time mom passed at 95 in 2022, I was diagnosed with stage 4 cancer and given 2 months to live not 11 months later. The cancer is in remission now, but stress takes a big toll, in reality.
Why not speak to mom's doctor about a hospice evaluation? Idk what her other health issues are, but they may qualify her for extra care, supplies, etc.
Wishing you the best of luck with a difficult situation.
As for your dad, a physician's assistant is not qualified to diagnose any neurologic condition or stroke (TIA). Take Dad to see a neurologist for proper diagnosis and treatment.
To answer you question, Yes, you should advocate for your parents.
However, the care provided in Assisted Living is limited. It is not a substitute for seeking medical care from a doctor. They can listen to your complaints, maybe say something to reassure you, but they probably can't or won't do any more than they have been.
So maybe it's time we discuss a higher level of care, if she's expected to go out somewhere when she needs "minor" care. She can't do it. Or won't.
My Moms AL had an RN who handled the medication prescriptions and talked to Moms primary. You can take Mom to a PCP. Its good that a culture is done but a broad spectrum antibiotic can be given until the culture comes back. Some times an IV is the way to go and that means a hospital for a couple of days. Once she is cleared up, then its prevention time. My Mom was placed on cranberry tablets with a probiotic. In the last year of her life, she had no recurring UTIs.
Mom needs to drink water. She needs to clean thoroughly when she wipes. I used Huggies with my Mom. Bigger and thicker than those women ones. No soap near the urethra. My Mom never had a UTI living with me. For bathing I used a handled shower head using just clear water when cleaning that area.
And if you aren’t able to continue to advocate for your mom see about finding someone who can. Antibiotics are horrible to get over so I can appreciate them waiting on the culture but it looks like they should have something to help her until. I’m sorry she is dealing with this and you by default.
I see Costco carries the cranberry tablets in a big supply and some people say an over the counter called D-Manoose really works well to treat and prevent.