Woman (91) with UTI had confusion, hallucinations. Family trying to have Alzheimer's diagnosis. Any advice?

It took two rounds of antibiotics two years ago for my 94 yr old mother when I brought her to live in my home, plus, making absolutely sure she dry pads on at all times, I started giving her D-Mannose and 1-2xd cranberry 500mg capsules and she has not had any more UTI's. Another problem that is rarely attended to is Candida yeast overgrowth, which causes terrible brain fog. The immune system is literally attacking it's food because there is only so much room in the gut for flora, so once the candida yeast is under control and the gut health restored with healthy probiotics then all sorts of symptoms can clear. It may take a few months but is totally worth it and then you can see what her dementia symptoms really are, or not.

What do you mean by "Family trying to have Alzheimer's diagnosis"? That is their opinion of what she has? The doctor has suggested it as a possibility and the family has taken it as a certainty? Or the family wants to take her to a dementia center for diagnosis? Could you explain that aspect of the situation a little more?

UTIs can very definitely cause behavioral symptoms and mimic dementia. For someone who has dementia they can make the existing symptoms much worse. (This is true for the elderly ... not necessarily for younger adults.)

I don't believe that hallucinations are an early symptom of Alzheimer's disease. They are an early symptom of Lewy Body Dementia -- often the first recognized symptom. And, as you've discovered, they can be side effects of drugs and also part of UTI behavior.

I would not accept a diagnosis of dementia based on hallucinations alone, especially in circumstances with other possible causes of hallucinations and confusion.

But, were there other factors considered by the doctor who made that diagnosis?

Has Mom been depressed for some time? Or is the Zoloft being used for some other condition?

I would take seriously the possibility of dementia, but not come to any firm conclusions until some time passes. Be alert for other possible symptoms.

For elders, having a culture, not just the quick "dipstick" is key, I believe.

Did your mother have a follow-up urine test to make sure that she no longer had an infection? In addition to a urine test/culture they should do a sensitivity test to see what medication is effective for the particular infection. Below is a website and some information I copied from the website regarding this. Also, there is no one definitive test for Alzheimer's disease. It's a matter of ruling out other things and doing other tests and scans to indicate what it MAY be. Get a second opinion and if it is determined that she has Alzheimer's disease then make sure she sees a neurologist and have someone who will advocate go with her each time she visits any doctor. Always speak your mind to the doctors and do for your mother what she may not be able to do for herself. As long as you are still respectful to them, NO doctor should mind the questions. If they do, get another doctor! Educate yourself as much as possible - doctor's aren't magicians and not every doctor has the same knowledge or experience and they aren't infallible. They are just human like us, so keep up the good work standing up for your mother. Good luck.
The information below was copied from
If test results are positive, sensitivity testing may be done to help make decisions about treatment.
What Affects the Test
Reasons you may not be able to have the test or why the results may not be helpful include:
Taking antibiotics or just finished taking them.
Taking water pills (diuretics) or drinking a large amount of liquid. This may dilute your urine and reduce the number of bacteria in the sample.
Taking a lot of vitamin C.
What To Think About
A urine culture done in the early stage of a urinary tract infection (UTI) may be less accurate than one that is done after the infection becomes established.
A urine culture may be done when an abnormal result from a urinalysis (such as an increased number of white blood cells) shows signs of an infection.
A urine culture may be repeated after the UTI has been treated to make sure the infection is cured.
A health professional may collect a urine sample by placing a urinary catheter into the bladder. This method is sometimes used to collect urine from a person in the hospital who is very ill or unable to provide a clean-catch sample. Using a catheter to collect a urine sample reduces the chance of getting bacteria from the skin or genital area in the urine sample, but catheter use sometimes causes a UTI.
People who have a urinary catheter in place for a long time are at high risk for developing a UTI.
To diagnose tuberculosis that has spread to the urinary tract, a special test will be done using all of the first morning urine on three separate days.
Sensitivity testing helps your doctor choose the best medicine to treat specific types of bacteria or fungus that may be causing a UTI.
Some types of bacteria or fungi may take several weeks to grow in the culture.

Go down to "Management of a UTI" for guidelines about treating them. Your nurse daughter can understand this better than a non-medical person.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3131987/

Here's another one (link and then specific recommendations):

http://jac.oxfordjournals.org/content/65/suppl_3/iii25.full

How long should a patient receive antibiotics for?

The optimal length of treatment for symptomatic cUTI has not been extensively studied. As there are many different causes of underlying abnormality, a simple recommendation cannot be made. Most clinical trials have evaluated 7–14 days of treatment, but a recent randomized multicentre study demonstrated that levofloxacin for 5 days was non-inferior to ciprofloxacin for 10 days in cUTI and acute pyelonephritis.31 Ten to fourteen days of antibiotics are usually recommended for patients with bacteraemia, hypotension and other signs of severe sepsis, whereas a 7 day regimen should suffice for those with a lower UTI.3 A 3 day course is usually not sufficient and is thus not recommended for cUTI.32 Clinical improvement should occur within 24–48 h after starting treatment. If the patient has not responded, the choice of antibiotic should be reviewed in the light of the culture results. They may need an urgent investigation to exclude an abscess that needs drainage. A patient can be switched to an oral agent when they are clinically improved providing they can tolerate it and the organism is susceptible.

The problem with extended use of antibiotics include diarrhea and C-Diff. If the MD's are saying Alzheimer's/dementia they probably have some brain images that prove that. Try not to second guess this unless you have seen the actual reports.

I totally agree with you. One time when my elderly father had a UTI he didn't even know what year it was or what state he lived in. Have you ever tried D-Mannose for UTI infections? It is sold online (Amazon, etc.) and at health foods stores, as you may want to consider it if she gets a UTI infection in the future. Elderly people have a much harder time handling medications (Zoloft), and the rest of the family should know that and understand her situation.