AboutMary Gordon Expertise Several years direct experience as caregiver for family member who died of end stage AD. Did lots of research and dealt with a lot of health care professionals and caregivers over the 7 years from diagnosis to the end. Used various care options from community based resources to increasing levels of institutional. Mother of three, two born during our loved one's decline, so I know what it is to be the ham in the sandwich, taking care of the older generation and the younger at the same time and trying to balance everyone`s needs. Ask me, I`ve probably been there, done that. We made lost of mistakes and learned everything the hard way - but you don`t have to! If I can`t answer your question, I`ll steer you to a place or person who can.
Experience Currently a program manager for a large utility company. My Alzheimers experience comes from having the illness in our family. Out of necessity, we did a lot of research in order to understand the disease, plan for what might come next, and make the right decisions to help and support our loved one. Please note, I am a Canadian living in Toronto, and therefore am not the best person to ask about US regulations and insurance rules!
Question My mother is 81 and suffers from AD, as well as Hep C, Type 2 diabites and is in a wheelchair. My question to you is about Urinary Tract infections. Obviously, it's hard for her to identify a problem or pain. She doesn't know how to identify a certain pain all the time, as she's not sure where it's coming from. There was an odor from her urine 2 1/2 weeks ago. I suggested that they take a sample of her urine to be checked, which they never did. She is now in the hospital from a bad UTI (5 days). Could the infection have started 2 1/2 weeks ago? Just curious. Thanks
Answer Hi Allison, yes, absolutely, she could have been sick for a couple of weeks - and missing them in the early stages can lead to a more serious and entrenched infection, or even kidney involvement.
Having said that...it's not uncommon for the elderly in long term care facilities to have a diagnosis of a UTI either delayed or missed entirely. There are lots of reasons for that including the person having very muted symptoms or no symptoms at all. Add to that verbal difficulties where they can't tell you how they feel or answer questions and it can be a challenge to detect a UTI. Quite often in a person with dementia, all you will notice is a change in behavior - an increase in confusion or sleepiness. People with dementia often don't seem to feel physical sensations like a healthy person - for example, I do recall times when my mother in law should have been hungry, thirsty or in pain, and she seemed pretty much oblivious. Perhaps they feel the sensation and have no idea what it means.
At highest risk for UTIs include those with catheters, diabetics, people who are immobile, incontinent, on pain killers or anti-fever drugs,people who have a compromised immune system - and the cognitively impaired. I suspect your mom falls into a couple of those categories.
Reasons for staff missing the diagnosis include lack of laboratory facilities at the site, the lack of an on-site physician or family nurse practitioner, understaffing, staff turnover resulting in inexperienced staff being responsible for initial observations (i.e. they don't know what to look for, or they just don't know your mom), nurses with little time to assess residents. The condition of the residents themselves is like the final straw. The signs may be subtle or nonexistent on the physical side, or they may just not be themselves, or seem more out of it than usual. You have to be paying attention to see it.
You might want to have a discussion with the care staff. We used to have a chat every couple of months. I do think it's a concern that you raised the possibility and they didn't act on your perception. You know your mom, and if the alarm bells were going off in your gut, they should have taken that more seriously.
