UTI or Just a Progression of the Disease.

marier · September 20

My DH has been sleeping almost around the clock for the last 3 days and eats only small amounts of food when hand feed. He will walk with assistance but very slowly. He does not appear to be pain. This new behavior came on suddenly. He was walking unassisted, feeding himself and sleeping maybe 8-10 hrs a day prior to the last 3 days.

We do have hospices on board. The RN came out and didn't think he had a uti based on odor from his depends. The RN thought it was the progression of the disease. She didn't recommend antibiotics. However if I wanted she would request them. I agreed with this. However now I am having 2nd thoughts and I am thinking perhaps to error on the side of using antibiotics just in case he does have a UTI. I would not want him to suffer .

I am asking for feedback or advice.

midge333 · September 20

A urine culture would be helpful if you are going to administer antibiotics. At some point in the advanced stages of dementia, it becomes reasonable to forgo treatment of UTI and pneumonia. At some point, living with severe dementia becomes worse than dying of a UTI. Ultimately, you will need to make that call.

M1 · September 20

I agree with Midge. I’m not far behind you, my partner sleeps most of the time, can tell me if she’s hungry or if she’s had enough, that’s about it.

I think the only relevant question is whether he’s comfortable or not. If he’s comfortable, I’d leave well enough alone. Even oral antibiotics can have serious side effects.

My own mother was brave enough to go sit with her 98 year old mother and did not treat the last UTI. It was a peaceful passing.

jfkoc · September 20

"A study found that using urine odor to identify a UTI resulted in error in one third of cases. "

An untreated UTI can be very serious. I know that first hand. My husband almost died.

I would request a new nurse.

terei · September 20

If your LO is not acting uncomfortable, I would not test or treat.

ImMaggieMae · September 20

Marier, my DH has had similar symptoms from time to time, although sleeping maybe a max of 12 or 13 hours. At times it was a UTI but other times these symptoms go away after 2 or 3 days. I don’t know if it’s progression or just one of those unknown things. I do try to make sure he stays hydrated. When he had the UTI’s antibiotics got rid of it. We use those AZO home test strips that I get from Amazon. They haven’t been wrong yet. If positive I get a culture done.

SDianeL · September 21

I would request a test before I agreed to antibiotics. It could be progression.

fesk · September 21

I'd recommend getting the home test strips and testing. He could definitely have a UTI with no odor. The RN should know this. I think you have some larger decisions to think about, but get the test strips or culture and see if he has the UTI. Then you can at least make an informed decision.

jfkoc · September 21

You can have what is called a silent UTI…no discomfort…it is just as serious.

Pat6177 · September 22

Regardless of what you decide about the antibiotics, I would push fluids to see how much of the weakness is just dehydration.

marier · September 22

Thank you all for your helpful thoughts and information. I did do a home test (very difficult at best) No UTI. He is comfortable, no pain and is drinking water a little at time and eating somewhat as long has he is being fed.

ImMaggieMae · September 22

https://alzconnected.org/discussion/comment/223511#Comment_223511

Definitely push the fluids. My DH had a lot of problems with weakness once when he wasn’t drinking enough.

jfkoc · September 22

I hate to be "negative" but the home tests are not very reliable so please keep a close watch.

UTI or Just a Progression of the Disease.

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