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I have heard many people talk about UTI's but don't they have some type of burning or something to clue you in that something is wrong? Mom does seem like she is tired more than usual and has not been going outside lately. Her hunger decreased and I began giving her Megace for that. When she eats she seems to have difficulty breathing almost like she is smothering so she was choosing not to eat much. EKG and Digoxin levels were fine. The blood test did show up with high white blood cell count so now they want me to bring her in for additional testing to figure out what is causing it and of course she is already throwing a tantrum that she doesn't want to go.

She has told us numerous times that she wants to die, so she refuses to tell us when anything is wrong because she doesn't want to leave the house and basically doesn't wish to live.

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This seems to be a very old thread that has been reserrected for some reason.
I totally agree choose your tests carefully for the very elderly and don't do the treatment if it is going to cause significant distress.
Lack of sleep for a prolonged period especially in an ICU can cause all kind of mental changes which hopefully will be reversible.
Sunnygirl i often put it the other way in that the decline causes the falls.
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Those falls sure seem to cause a decline. I'm so sorry to hear that, but it sounds like you have really explored all possibilities for treatment and rehab. Your plan sounds reasonable to me.
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A very smart geriatrician told me several years ago " if you know you're not going to do the treatment, don't do the test" . We had a similar situation with my mom a few years back. She had a pleural effusion ( a build up of fluid around her lung). They tapped it and upon analysis, saw some " a typical cells" so they wanted to do a bone marrow biopsy. We said no to that, but they had just done a full body CAT scan, so we were fairly certain there was no cancer. Might they do that?

Ask for a hospice evaluation while she's in the hospital. Certainly rehab at a SNF sounds like a good idea. You might find she enjoys it there!
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Lucky to have lived to 96 and still wanting to go on doing her AD
Ls with some assistance and being driven. Now comes hospitalization for UTI after bad fall and amnesia.
Symptoms of weakness and loss of cognitive sharpness in hospital EKG and neurological and CAT scan normal. Elevated white blood cell Dx infection given large doses of antibiotics. Slowly recovers almost back to normal functioning over two months. Then aide sees weakness and primary physician Dx high white blood cell count but urine clear. Ends up back in hospital and similar symptoms as before with addition of swallow problem. Given feeding tube to prevent aspiration. antibiotic given but not effective WBC maintains high. Doctors unable to locate source of infection: not gall bladder, not UTI. Not responding this time to antibiotics: weak, some confusion but talkative if somewhat unintelligible . Stroke ruled out. Blood pressure mostly normal. Anyone have any ideas? Would like to see her get a shot at rehab if they can build her up enough. Doesn't want to die, but if cancer as hematologist has hinted at I won't support a bone marrow biopsyToo many painful procedures already. If iridium (radiated white blood cell trace) comes back negative for an infection source then I think its hospice care at home. Reasonable?
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It CAN mean that. Like I stated before, I had to learn that my GM would get UTIs and show no discomfort/pain, but her urine would look cloudy, not clear like yellow water, like it should look. If I saw evidence of this, I got her tested for UTI.
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So cloudiness does mean a UTI? I noticed at the hospital that Mom's urine was cloudy.
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Raven - YOU are still alive! You did the correct action by calling 911, and you and your sister are to be commended for your quick actions. Now, relax, take a deep breath, and let the professionals take care of your mother. Her symptoms are probably a result of the meds she is getting to stabilize her irregular heartbeats and it is not uncommon for doctors to disagree with treatment. If you have your mother's Medical Power of Attorney just show it and the doctors have to discuss her case with you (or your sister). Have all her affairs in order should she not survive this, but know you did the correct thing by calling 911. At least she is safe, being cared for, and you can get some rest yourself. Best wishes.
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Raven You have done all the right things. Your mother is in a hospital ICU and is being treated for her unknown infection and her heart condition which could turn out to be a heart attack or undiagnosed atrial fibrillation (Afibb). The heart attack they will confirm with a blood test and they are already treating the heart beat irregularities. The mental deterioration may be due to the hospital environment or an unexpected reaction to needed drugs she has never had before. Elderly people often react in the opposite way when given a sedative as your mother clearly did. no way of predicting it happens. Please respect your mother's wish to die, she has expressed it many times. You have done everything that is necessary or expected this time and I know you are beside yourself with worry. Tell your Mom quietly how much you love her and that she will be missed but it is OK to go if this is the right time. reassure her that the family will be alright when she is gone and tell her you will take care of everything including animals.If she is religious call her priest or minister or request the hospital chaplain. Put a photo of your father at her bedside. Give her something soft to hold like a tiny soft toy. the hospital probably has a gift shop. Now take care of yourself. Take your Zanax and get something to eat and drink then find a quiet corner away from the ICU waiting room, there is too much nervous energy there from other relatives. Sit out side in the sun or walk around. Give the ICU staff your cell phone number and check back every so often, some places even have pagers. The Drs may not be communicating but remember their first priority is you Mom not you and it sounds as though they are doing the right things. Good luck and god bless you and your mother and sister. Keep in touch.
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Elderly people often have what is called hospital psychosis...a deterioration while in hospital. They often regain more balanced mental health when they get back to their usual environment. You need to find the doctor who IS on call.
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Mom seems to be having an anxiety attack, she can't relax or lay down it is nervous energy. I have panic and anxiety myself and this is how I am when they hit. We have nothing to give her and I would be afraid to try to use my xanax as I do not know what the inter action might be with her meds. I called her heart doctor and the phone person said he was not on call tonight and she would not call him because she did not want to get yelled at! Moms family doctor just retired and his new replacement got pregnant and went on maternity leave and therefore the next replacement we do not know, nor does she know us and they are now an HMO which she is not. When it rains, it pours!
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UPDATE: About midnight Mom walked into kitchen holding herself across her breasts and I asked what was wrong, she replied, "Pain bad pain across upper chest in her back and going up her throat." I got my sister and we began asking questions as Mom just felt it was indigestion and wanted to take baking soda and water. I told sister to call 911 as it sounded like a heart attack to me and reminded mother that this is how her father and uncle died, thinking it was indigestion. Mom became upset and began yelling stomping off to bedroom. We told her ambulance was on the way and got her back to the living room. They did an EKG and her heart was beating fast and irregular so they transported her to the ER.

When we finally got in to see her they had her on 2 IV's one for heart and one antibiotic. They had done an xray and found no pneumonia or pleurisy. They said they knew there was an infection from WBC so they began antibiotics. Dr said her heart was beating 180 beats per minute and the pain was from this. The blood was not able to travel through the heart because it was beating too fast so her organs were being robbed of oxygen and nutrients.

She was transferred to the cardiac unit for 3 days where they worked constantly to bring down the heart rate and stop the irregular beats. They increased her Taztia and Coumadin and found the Digoxin was fine. There was a debate back and forth between doctors as to an infection....they could find nothing. Her urine was cloudy so they went ahead and gave her antibiotic but another doctor said there was no infection, this was solely related to her heart. We felt like we were being bounced back and forth and never really knew who to believe or trust.

We had problems with no one sharing results of tests or electrocardiogram etc with us. It is like you are in the dark, they feel like only they need to know what is going on and you are too stupid to be told!?! We had to pry every bit of info out of them.

Mom seemed to have more of a mental break while there. It seems like because she was out of her element it made her worse. She wanted to walk the halls to see if she could find her mother, she thought the dog and kids were there, she forgot instantly where she was, she did not like the room, she thought my father was coming to stay with her (he died 7 years ago). I have never seen her like this, she was agitated like she was having a panic and anxiety attack and they had to give her a shot to knock her out, but she powered through and never went to sleep. This was a side of her that I have not seen and I feel like we need something on hand to give her should she do this at home...oh she is doing it now, got to run.
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Elderly experiencing UTI may have few symptoms, and may feel no discomfort at all. My GM had them, but never seemed in pain or uncomfortable. I learned to look at her urine for any cloudiness that would indicate UTI.
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I have seen now an elevated WBC recently in my father without any sign fever but of course showing general weakness, as his body response mechanism for fever could be not functioning well. If your mom gets treated with antibiotic IV, look for signs of side effects such as diaherra and internal bleeding. There will always be many side effects. Be observant for any sympton and let her doctor know immediately.
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Ferris, would you put a 90 year old through a bone marrow biopsy?
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I have never heard of "in geriatrics the rule of thumb is...". One tests to rule out more things, and a short-term antibiotic for an infection is better than hospitalization. Granted, if the tests show extensive illness, then at least you know what you are dealing with and make a more informed decision.
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In geriatrics, I understand that the rule of thumb is, if you aren't going to treat, don't do the test. So, would you treat pneumonia, a uti? Then you should do thevtesting. My mom who is 90 recently had a pleural effusion; when tapped, it showed some abnormal cells and a bone marrow biopsy was recommended. We turned this down as chemo or radiation would kill my mother long before sny cancer eould.
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In geriatrics, I understand that the rule of thumb is, if you aren't going to treat, don't do the test. So, would you treat pneumonia, a uti? Then you should do thevtesting. My mom who is 90 recently had a pleural effusion; when tapped, it showed some abnormal cells and a bone marrow biopsy was recommended. We turned this down as chemo or radiation would kill my mother long before sny cancer eould.
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As a nurse, I can tell you she has an infection going on somewhere in her body. Her EKG won't show anything wrong. But it is vital she go for more testing since it could lead to pericarditis (infection around the sac of the heart) or something else. Tell her to die on her own time, but not on your watch! This could be pneumonia which is surely going to lead to hospitalization and death. Pneumonia is known as the "silent killer" of the elderly as well as high blood pressure. So what if she complains about the testing. Have her doctor prescribe an antidepressant so she won't feel so depressed. Her infection (whatever it is) is also making her feel so tired and depressed I am sure. Best wishes.
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In older women the usual signs of a UTI are not the same.Often the only outward symptom would be they just feel a general malaise,not much energy,complain of just not feeling good with no specific reason.They may not feel any burning or other discomfort when urinating.They just need a urine sample which can be done at the doctor's office.
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She's probably dehydrated too.
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The difficulty breathing while eating sounds just like my dad. Several months ago I started noticing him coughing every time he ate or drank. 2 weeks ago he had high white count with no real reason why. Making long story short, 3 ER trips later he was admitted to hospital for observation. Chest x-ray showed "some" pneumonia. Because he had also had hiccups for 8 days, hospital did a "Barium Swallow test". It was then determined he had dysphasia (swallowing difficulty), and pneumonia was caused by aspirating his food/liquid. He was treated with IV antibiotics and now in skilled nursing rehab. His liquids all have to be thickened to "nectar" thickness now to prevent him from aspirating, and has just gone from baby food consistency to soft food diet. Good luck with your Mom.
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