My Momma who is 89 yrs old and has Alzheimer's Dementia and is plagued with constant UTI's for years and who was taking PTNS (shock treatments once a month to her bladder to help prevent UTI's) Her new caregivers and her urologist is pushing for my Momma to have a surgical procedure done called a Insterstim Bladder Pacemaker put into her low back. The main device is located under her skin, but there are leads coming out of her skin connected to a battery pack that she would put in her pocket. It's supposed to provide little shocks to her bladder on it's own and would last 5 yrs.
I say that this is a bad idea, especially since Momma is in the later stages of her Alzheimer's Dementia and she is plagued with constant itchy skin. My fear is she would forget what those leads were for and pull them out potentially causing infection and other problems.
I need some advice on this matter and if any of you have any websites I could look at about Alzheimer's and Bladder Pacemakers being a bad idea, I'd greatly appreciate it. Thank you all in advance.
Has she tried a daily capsule of the supplement D-Mannose? It has been magic for me. Was getting >4 infections a year, and none now for more than a decade. Recommended to 2 friends; worked for them as well. I am retired RN who doesn't even BELIEVE in vitamins or supplements, but I do believe in this. Powder or capsules. I use Source Natural from Amazon, about 30.00 for 120 capsules. Worth a try. Powder easier to swallow and tasteless. Works like cranberry, keeping bacteria from adhereing to bladder wall, but works better and without the acid.
Surgery for someone with dementia is difficult.
The chance for her to pull on the device is high, even if they place it where it would be more difficult to reach I would never underestimate the ability of someone with dementia to do something that "they are not supposed to be able to do".
Late stages of dementia..I would not worry about UTI's, she may be at the point where shock or not she will develop them due to decreased intake of fluids, being incontinent and wearing briefs or tab type products will retain some urine close as well as having wet briefs on occasionally (no one can change someone "immediately") so there are times when a person may remain in a soled brief for a little while. Also the probability of not thoroughly cleaning the area each and every time so some urine may remain.
And as the decreased fluids the urine will be more concentrated
And the kidneys will also begin to shut down as she nears the end of life.
So push fluids as best as you can.
Change as often a possible
Clean as best as possible
Accept that there will be setbacks.
And answer this..if this were you what would you want your POA for health to decide for you?
I guess u have tried everything. When my Mom had her last UTI, she was given a probiotic and cranberry tablet daily. Both continued when she went back to the LTC. She died a year later but never had another UTI. I like Alva's idea. My Moms LTC kept her clean better than the AL she was in. Grandma's ideas are good too.
If you're having trouble deciding and want advice beyond here I'd suggest finding out which is the best regarded hospice service in your area and seeing if your mom doesn't qualify...as well as a group called Curadux which has experts to objective professionals to weigh in on complicated situations. This doesn't seem complicated to me, it just seems like you are using common sense and are right. My gut tells me that the MD involved possibly doesn't have his/her patient's well-being at heart.
Stick with your gut instinct and let us know how it goes....
Couldn't get her to stop wiping wrong and she was on Hospice for terminal cancer as well. Their solution was a permanent catheter. She was on meds, antibiotics and cranberry pills and something that made her pee orange to relieve the burning sensation she felt, until she passed. Thank God for the catheter. She had to dribble every 15-20 min....ALL NIGHT LONG! For 3 months I never got decent sleep because I had to carry her to the bathroom in a wheelchair. I had to explain to her OVER AND OVER AND OVER about the catheter. But it was better than going to the bathroom every 20 min. I wouldn't even think of placing something with external wires to a battery in an ALZ patient!
D-Mannose was mentioned, try this. There is also a firm Uqora that has a D-Mannose product in combination with vit C and other stuff, something to look into. Probiotics, make sure you get the right one. A pharmacist, or good vitamin store consultant should be provide direction on this, a female probiotic specifically to help with UTI's. There are also some good bidet seats that attach to the toilet, but she may not be able to operate one if her dementia is advanced.
There are medications that voids the bladder of left over urine. Talk to your doctor about these. I have never heard of a badder implant device. It sounds a bit radical for a dementia patient, but it also sounds very interesting. Love to read these comments. Good luck,
The doctor added botox after a few years, and together they work perfectly. She doesn't have to think anything!
Recently when mom started to refuse to walk/stand, they put a lanyard on her with a call button. No harm to her, but she has no clue what it is. Sometimes she just pushes the button because it is there! Having to deal with any incisions, wires, battery packs, I would give this surgery a hearty NO.
I'm not even sure what the shock treatments do for her. You say "...is plagued with constant UTI's for years and who was taking PTNS (shock treatments once a month to her bladder to help prevent UTI's) If she's been getting this treatment for years and is still getting UTIs, then I would put a halt to THAT treatment as well.
I would also consult with another urologist, perhaps one who might specialize in caring for older people. There are many reasons why someone might get UTIs - wiping wrong, not changing often enough, etc. There also should be a culture done, to determine the specific antibiotic that would work best. One urologist told me that if I had continued to get UTIs (only had TWO), it would mean getting on an antibiotic long-term, at least 6 months. If this were the case, get a recommended probiotic as well - last thing you need is #2 issues, to counteract the good antibiotics might be doing! These new "care-givers" need to be more diligent, perhaps, in seeing to it that she is clean. They might be thinking this will reduce their work load?
There is also another condition that may make it seem like one has a UTI - interstitial cystitis. Mom was told she had this (but sometimes there WERE UTIs) and was given a list of things to eat/not eat, told she wasn't emptying her bladder and needed to "drain" herself with little catheters, etc. Funny that she still continued to get UTIs, but when dementia started, she either decided she didn't need to do this or forgot. The result was FEWER UTIs. Go figure.
Seems like you and most who have responded are in agreement - why put mom through this? There isn't even a guarantee that it will stop the UTIs (clearly the monthly treatments don't seem to be, why would this be any better?) This is invasive and mom isn't going to be very compliant with the "after-care".
Get another opinion. Culture. Long-term antibiotics. Ask about catheter. ANYTHING but not surgery.
So, like my mom with IV'S and catheter, she pulled them out, constantly.
she is 89, make sure she is changed and cleaned constantly, put her on antibiotic give her probiotics, and give her happiness.
the mechanism may last 5 years, but will your mom? Something foreign in the body, may cause worse issues... She doesn't need that. You don't either.
My neighbor had a procedure done, with a mesh to change the angle of her bladder. She seems okay with it, no more leaking. She is 90, no dementia.
They sell alkaline water now in most stores. In our area these is an alkaline water dispensary, they have a whole lab stype store, for alkaline. $2.00 a 5 gallon jug.
I was visiting the Chinese restaurant when a lady pulled up and was filling up her bottles with alkaline water. Plunked in cash, and out came the water. I asked if it was worth it. She drives up there every week just for water. She lives about 10 miles away. She e=believes in it so much, she gives it to her dog as well.
I think I will try it sometime.
I agree with you. It sounds like a bad idea.