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My mother moved into my home almost 3 years ago. Up until a week ago, mom was able to go to the restroom and shower herself when I convinced her to do so. Almost overnight, she changed. She won't go to the restroom until she soils herself, leaving a trail both #1 and 2. She wears depends so I don't know why there is such a big mess. She has forgotten how to take her pills with water. Because she is diabetic, she has to eat but refuses because she isn't hungry...her gluclose reading was 45 this morning. I am overwhelmed and feel helpless. I would appreciate any advice on caregiving. Thank you.

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Uti (urinary tract infection). Rule that out first. It is *always* worth ruling out, but more especially it's a suspect with your mother because she wears Depends - waterproof, essential for someone who's incontinent, but they also create a lovely warm moist environment for bugs to grow in.

In any case, such a drastic change in abilities and behaviour warrants medical attention. Call her GP/PCP. I hope this setback will prove mainly (and quite easily) reversible - please let us know how you get on.
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careformickey Nov 2020
You are right. Just came back from ER (10 hour ordeal) and mom has UTI. I'm praying most of her confusion will clear. Thank you for your input.
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I'm glad you're both back safely, and with a nice clear result to work on :)

If I were you I should take this as a timely opportunity to do some care planning with your mother's primary doctor. E.g., about her dementia: although labels have their limits it is useful to have some idea of what you're dealing with. Nobody conforms to an exact timetable, and I think it's fair to say that most people with one presenting type of dementia are also affected by other types too (multi-factorial is the fancy term), but even so knowing if you are or are not dealing with Alzheimer's, vascular dementia, Lewy Bodies or any from the rest of the pea-patch at least gives you some pointers.

You'll also want to ask about prophylaxis, to head off further UTIs. D-Mannose seems to be taken seriously by the learned journals and is kinder to the gut than antibiotics (or so I read), but I'm not at all sure if it's suitable for diabetics - [does anyone else know about this?] - again, talk to your doctor about it. Hands up, I used to give my mother cranberry capsules: there is no evidence that this does any good at all, but at least I can attest that they didn't seem to do her any harm.
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Geaton777 Nov 2020
Countrymouse, last year I learned about D-Mannose on this site from AlvaDeer. My MIL is in LTC and was getting UTIs literally monthly. The staff tortured her with vast amounts of cranberry drink and water, and it did nothing to prevent UTIs. When she was clear of infection I had the staff start her on D-Mannose daily and she went through a period of many months where she had 0 UTIs, then she got covid and her daily care changed plus I don't think they were able to coax her to swallow the pills, so she is back to having UTIs and I'm just waiting for her to be clear of infection to start back up. I am an evidence-based person when it comes to science (I work in med-tech) and there is no evidence that most supplements do anything except get peed out and cost a lot. BUT there is little risk with D-Mannose and from my own personal experience it works.
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Agree with Countrymouse, also because of the "sudden" change - very typical of a UTI and very treatable with antibiotics. If it is that, please be aware she will get them very regularly.
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careformickey Nov 2020
Thank you for your input. Not looking forward to more UTI's. This was a scary experience.
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As mentioned by the 2 previous posts it is possible that a UTI is responsible but since you do not give any info in your profile detailing your mom's problem(s) it is also possible that if she has Vascular Dementia small strokes may the cause for a "sudden change"
Some Dementia's the decline is slow and at a steady pace but Vascular Dementia there can be some pretty drastic almost overnight changes.
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careformickey Nov 2020
Mom's medical record doesn't indicate type of dementia. Praying that things will calm down and it's more gradual. That will give me a chance to slowly break into the full on caregiving. Thank you for taking time to respond to my SOS.
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Sadly you had to sit through 10 hrs to find the simple cause! I was a skeptic when I first joined the forum and read so many posts suggesting tests for UTI... That is until mom had her first MAJOR sun-downing episode in MC. She used to get UTIs, one or more/year, but she knew it and dealt with it. It had been quite some time since she'd had one. Unfortunately it was Friday evening, no access to doc until Monday (unless someone wanted to sit in the ER for HOURS!) In her case, she got Rx for mildest dose of Lorazepam (anti-anxiety) to take the "edge" off, until the UTI was treated.

While briefs can contribute to UTIs, mom was still wearing undies at that point. It wasn't until maybe a year later that we switched her to briefs. She really didn't need them, but we did it anyway (she still will use the toilet, if taken in time - she's in a wheelchair now, so dependent on their schedules.)

ANY sudden change in behavior or demeanor should trigger a test for UTI. They do sell test kits OTC. They aren't as trustworthy, but can give you a heads up to call the doc for an Rx. If it's negative, it wouldn't hurt to get the better testing done at the doc office or outpatient lab. They often use the dip sticks, but cultures are the best test of all - the bacteria causing the UTI can be better treated with antibiotics specifically for that bacteria.

Although mom's first UTI resulted in sun-downing (she was out of control!), the ones she has had since then (only 2, total 3 in 4 years) resulted in night-time bed wetting. SOAKING everything, despite having a max brief with a pad inserted. Sure, she's had some accidents, but these were major soakings!

So, be aware that UTIs can result in some bizarre goings-on for elders, esp those with dementia. Hopefully once the infection is treated, she will revert back to how she was prior to the UTI. Once she resumes more normal toileting, be sure to encourage regular trips. She may still soil her briefs between trips, but she might be able to go again AND it's an opportunity to ensure she gets cleaned up and has clean briefs.

If she continues to have issues with taking pills after the UTI is treated, ask the pharmacist if there are alternatives to the pills - perhaps they can provide it in liquid form or have it compounded. Sometimes swallowing becomes an issue. For the most part, my mother has been okay taking her meds for almost 4 years in MC now (MANY years prior on her own or with a dispenser), but she recently had a stroke. We eliminated the eye vitamins the Mac Deg doc recommended, as they aren't critical and she was spitting them out. I also cancelled future treatments as it is too difficult to transport her and put her through the long process involved for each appt. I haven't explored options yet for her BP meds. Waiting to hear from staff or hospice (for those who have seen my previous posts, yes, they were asked to come back and evaluate again - oh, look, she's lost some weight) - if she can't take those, I will inquire about alternatives. Monitoring her BP would be key as well. With dementia and stroke, keeping her BP in check is important.
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careformickey Nov 2020
Seems you also have gone through a lot with your mom. Thank you for sharing. I tried telling mom to go to restroom but that got her upset because she didn't need it. She is still having trouble taking pills. She has to drink so much water that her tummy hurts. I will ask doctor which pills mom can omit. Thank you.
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Something has just gotten worse due to her medical condition. And it will get even more bad given time. Can you get a caretaker to relieve you? If not, you must make arrangements to remove her so you are safe and can live in peace. It is truly beyond my capacity to understand why people allow those with dementia to live with them and have their own lives destroyed. She has to be moved out of your presence no matter how you do it. End of statement.
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careformickey Nov 2020
Unfortunately, there are not enough funds to pay for AL, and too much to qualify for medi-cal to get into AL. I have hired a lawyer to help apply for medi-cal but there is a waiting list (1 yr plus) . Once qualified, will have to start with getting a caregiver to come to the house, until AL opens up. I've been told that an emergency hospilization where I can't take care of mom if released, would be the only way mom would be placed in AL. At that time, a social worker would step in.
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Care, I think that perhaps you might want to get a plan in place if mom develops these symptoms again that DOES NOT involve an ER.

Talk to her doc about home test strips, urgent care and other alternatives.
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careformickey Nov 2020
We have a phone appointment coming up. I will definitely ask about test strips. Thank you. I wish the doctor had us go to urgent care instead of ER.
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I would consider the effect of drug interactions. Combining pharma meds used for osteoporosis, anti-depression, statins, blood pressure etc - there is no book that can accurately predict how these drugs will blend together.
We decided the “risk” of cholesterol was much less than the terrible effects of cognitive decline caused by well-intentioned prescription meds.
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Speak to her doctor about this, and also try to get in touch with a social worker or elder care expert who can counsel you. Her doctor or the office may be able to recommend one.
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careformickey Nov 2020
Thank you for your response. I have spoken to mom's doctor and social worker. Not much help. Currently working with elder lawyer.
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careformickey: I did see your update that you have a care plan in place. My late mother suffered from many U.T.I.s. Prayers sent for things to improve.
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careformickey Nov 2020
Thank you for your prayers.. So many challenges with aging.
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