AboutMargot RN BScN GNC Expertise Please feel free to ask anything, but the more specific you are, the easier it is for me. Please share as many details as you are comfortable doing. I do check my Emails daily Monday through Friday so you should receive an answer within 24 hours on most business days. Thanks.
Experience GERONTOLOGY (NURSING ISSUES RELATED TO THE ELDERY) I have 15+ years experience working with the elderly. I would be pleased to offer any assistance I can. My areas of expertise include: Gerontology / Geriatrics, Long Term Care, Community Nursing, Palliative Care, Private Nursing Services, Intermediate / Extended Care. I also have a personal interest in Homeopathic and Eastern Medicine. If I can not answer your question I'll do my best to direct you to an appropriate resource. Thank you. Experience in the area 20 years of Long Term Care and Community Nursing, specialising in Geriatrics, Gerontology and PalliativeCare.
Education/Credentials Registered Nurse , Certified Gerontological Nurse, Bachelor of Science in Nursing
My mom is 89 and in a nursing home and from what I've read is possibly in the end stages. She cannot walk or turn herself in bed, she can barely feed herself, and although she has not lost any weight, she has no appetite (they give her ensure shakes every couple of hours, which she does enjoy). She has extremely bad osteoarthritis in her back and a frozen shoulder. Any movement is painful for her. Since she entered the nursing home, about 3 years ago, she has had persistent bladder infections. Unfortunately, it seems that she doesn't always have a burning sensation when she gets them, and the only way I know she has one is that she starts to hallucinate. (She does not have dementia and knows what is going on in the news, and remembers what we tell her about family, etc). I tell the nurses when I notice she is starting to hallucinate, and of course, there are some nurses who will listen and others who won't do anything about it unless I insist that they call the doctor to have a urinalysis done. (Obviously the aides are noticing the odor when they change her or they are not telling the nurse) She started getting one right before Christmas and when they took the specimen it got contaminated and it took another week before they did another one, so for two weeks, she wasn't treated. It seems that there are different strains of bacteria present when the analysis is done.
She was seen by a urologist about two years ago, who told me that her bladder walls were breaking down and there was nothing that he could do other than order prophylactic antibiotics. The nursing home called me today to tell me that the doctor wanted her to go see the urologist again; however, I don't feel that I want her to go through the pain again of the cystoscopy and I doubt very much if there is anything more that they can do, but to tell me that the nursing home needs to change her more often, and to have her drink more fluids.
Am I doing the right thing for her by refusing to have her go to the urologist? I just don't want her to go through more pain, especially if there is nothing else they can do for her.
Answer Hi Jeanne and thanks for writing,
I’m sorry to read about your Mother’s recurrent UTIs, that obviously cannot be comfortable for her.
I completely agree with you and think the Urolologist is a silly suggestion which would be a waste of time and an unnecessary procedure causing unnecessary discomfort.
A study was done about ten years ago that tested thousands of women in LTC homes and found that 100% of incontinent women who wear incontinent pads in LTC homes get UTIs, Our female anatomy does not provide much protection (with our very short urethras) against the bacteria that love t grow in the pads.
I would ask for a Care Conference to discuss the treatment plan for her recurrent UTIs. I advise “Treat the Symptoms” and have the Care Aides report to both you and the nurses when they see the symptoms and have Antibiotics started asap.
I hope this helped and I wish you all the best,
Margot
