Hello-
My 83 Y.O grandmother has been having confusion for a couple of months, and it seems to be getting rapidly worse by leaps and bounds......she was diagnosed with a e-coli, UTI and given 5 days of cipro....how long should it take for her confusion to clear? Thanks
At 89 yo (1.5 years ago) I put her in an ALF specializing in UTI prevention, daily Nitrofurantoin, a showering and diaper change schedule. There she had 6 diagnosed UTIs in 1 year and further became fecally incontinent.
Last week she was sent to the hospital with elevated heart rate, blood pressure through the roof, and fever, classic Urosepsis symptoms she'd had at previous hospitalizations. Next day she was released with no discernible symptoms but now believes she "does not live at the ALF and has to go home because her parents are worried about her". This bill for the ambulance/ER/Hospital day was $45,000.00
Each medical intervention and treatment has left her with more permanent confusion, delusion, incapacity to walk (for no reason other than doesn't care or want to).
Just last week I insisted no more hospitalization, realizing my mother is going to die of this ailment. Hospice accepted her and took her off Nitrofurantoin as it's warning is NOT FOR ELDERLY and causes confusion and weakness, and it is not to be taken for long periods. She'd been on it 2 years.
If your situation is like ours, what no one is telling you is that she isn't going to get better.
Now I have shifted our approach - with advice of Hospice doctors and nurses - to palliative care. Our goal is to make her comfortable not trying to treat her.
Factually all the treatments and interventions did not help but instead contributed to making her dementia worse. I've come to realize that at some point her diminished systems will be overcome by Urosepsis and will ultimately be the cause of organ failure and death.
I'm not trying to be a downer. This is my heartfelt struggle of over 8 years with my Mother. The medical system has literally churned my mother for at least $500,000.00 on a condition that was always made worse due to the side effects of the treatments. Today we believe that she should be allowed to pass peacefully without being a "guinea pig" in a medical system that fights to ignore the fact that sometimes it's best to face our mortality and embrace it with an emphasis on quality of life and peaceful passing.
My mother now has that with Hospice and a medical directive that I, as her POA, have established. It's pretty miserable to have to fight for your mother's right to pass. It has broken my heart, but I know it's right for her dignity and as the natural course of life.
Prayers and hopes for a good outcome
Make sure you get a urine sample a few days? a week?(whatever your doctor recommends) after stopping the antibiotic to make sure the UTI is gone. I always just get it at home and take it to the lab with a doctors order.
Jenna
Mom cannot grasp the front to back process so we got her a bidet with a remote.
She always liked to wear snug pants.Those all went replaced by airy loose cotton pants like culottes. (she does not like dresses.). Changed all her under to cotton.
She also retains a significant amount of water. This causes UTIs however we have yet to solve this situation. Her primary prescribed a medication for water retention but her reaction to it was not pleasant.
If it has been at least 3 days since the cipro, I would have her retested. Also I would recommend they do a culture test, not just the dip stick test. If she is prone to UTIs, it might require longer term antibiotic treatment (as well as proper cleaning.) It may require using a different medication too.
I was skeptical of all the UTI comments when I joined this site, until mom got her first UTI in the MC facility. She had severe sun-downing every afternoon/evening and would be fine in the morning. Of course this started on a Friday evening, so no help until Monday! Sure enough, UTI. We had to use anti-anxiety along with antibiotics until it cleared. No recurrence of the sun-downing, and the next 2 UTIs presented as night time bed wetting!
I would also be in the camp of less medication is better, but sometimes they are a necessity. Also beware that people can be allergic to medications, even those commonly used, which result in non-treatment of the condition and possible other effects! My mother is allergic to the mycins, and apparently my daughter is too (given for ear infection at about 9 months old, ear infection did not get better, it got worse, she couldn't hold down water after a few days on the meds AND developed hives! ER dxed and gave us a different medication, which resolved everything! Sometime later a member of her regular doctor team tried to Rx the mycin again and when I said no, she's allergic, his response was that it's 'not a very allergic drug!' I made sure he gave us something else.) Attempts to use Heparin on me was VERY bad (increased platelets, which should be reduced AND hematoma at the last injection site) and an attempt to use Botox to treat an issue resulted in hives, so I report those to whoever wants a list of allergens. No more of those for ME!
you have received some great responses here so far.
I believe the confusion should begin to clear up once the infection goes away.
My mom (83 yrs old) has Vascular Dementia but one time an undiagnosed UTI quickly turned into a serious kidney infection and landed her in the hospital for 3 days. I noticed an extreme delirium beyond her regular symptoms and I took her to the ER (thank goodness I didn’t wait any longer). Cipro among other antibiotics have there own possible terrible side effects so be on the look out for any of those, unfortunately antibiotics are needed to cure the UTI.
What I have been doing now with my mom is a daily cranberry supplement, 1 cup of Greek yogurt for probiotics in her smoothies, baby wipes after all urinating & bowel movements, making sure her depends or poise pad is dry and even so, changed a couple of times a day just from sweat, am & pm a wipe with a soft tissue with a little extra virgin coconut oil on it (that’s a natural antiseptic) and just rinsing on a daily basis with water and occasionally mild soap. So far no UTI, she gets her urine checked at the Dr office every 60 days along with blood work.
Good luck with your Grandma.
Prevent UTIs by having Gram drink cranberry juice, drinking lots of water, wipe front to back when cleaning after toileting, and bathing bottom more often.
See this:
https://www.webmd.com/brain/news/20160217/study-sees-possible-link-between-antibiotics-and-delirium-in-patients#1
Cipro is mentioned by name and it also says often it is the elderly that suffer (not always, others can had bad reactions too.)
But, remember the UTI itself may have started the confusion and the meds just made it worse. If she has finished the meds more than 3 full days ago, she can be retested for the UTI. Keep in mind it could be more than 3 days before the medication is fully out of her system. If it's been a week or more since the medication, DO recheck for UTI!!!
There are other medical conditions that can cause dementia-like symptoms. Just the fact that they didn't bother to test for UTI until recently, despite several months of issues tells me you need to find other doctors for your grandmother!
I would start with a Urologist and request a urine culture. They can get more specific with the antibiotics. Also consider she could either be allergic to the medication, in which case it won't treat the UTI which can make the other symptoms worse, or it is just a general reaction to the medication (which others pointed out - see the link above.) At 9 mo old my daughter had an ear infection. Doc gave us Rx. By day 3 she couldn't hold down 3oz liquid, day 4 developed spots (coming and going, which realized later was hives) and by day 5 I could only stand and hold her or she would scream. ER determined she had a BAD ear infection and hives. New meds, all was fine! New doc after that too! NOTE: same doc admonished my mother when my YB was not getting better - turns out he was allergic to the sulpha drugs he was given!
She should also have a complete exam, blood work and all. Urologist should be able to order that as well. Our mother showed signs of confusion (this was before dementia kicked in) when I stopped by to see her. I took her to the ER. She was admitted because her electrolytes were out of whack, esp potassium, which can result in confusion (and more serious issues.) In her case, due to being prone to UTIs, she was drinking too many liquids, thereby washing out her system *YES, you CAN drink too many liquids! The old 8-8oz glasses of water is not a good recommendation. It was based on some research that said we need 64 oz of fluids/day, BUT that includes liquid derived from ALL beverages AND water that exists in the foods we eat! It should also take into consideration someone's size (Ht and Wt) and activity levels - mom at 5' and fairly sedentary likely doesn't need what a 6' construction worker would need!
I would NOT accept this ridiculous explanation of her symptoms. Even if it was depression, what have they done for her regarding that (still not buying their excuse though)?
I would not let the doctors prescribe Cipro, it is a nasty drug. It gives me aura migraines. In a person with dementia they may not tell you they have blurry zig zags and flashing lights crossing their line of vision, its scary when you do not know the cause