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My 70-year-old mother has her second UTI in about six months. Like last time, she has delirium. Though this time it's not as advanced since we caught the UTI sooner rather than later. But it's still been very frustrating because she's partially aware of what's going on, but the paranoia is absolutely taking its toll. She's starting to question her medication more and her appetite is still thin. I can deal with everything but the growing resistance to the antibiotics, as they are supposed to help her get over the UTI and eventually get her back to herself. If she keeps refusing to take the medicine, there's nothing I can do for her at home. I told my brother he'll have to take her back to the ER (we were just there on Tuesday) and let them deal with her if she keeps refusing to take the pills.



Last time she had a UTI, they discharged her after a week, and I had to take her back a week later because the delirium kept her in a hyper-paranoid state where she wouldn't eat or drink or take her medication at all. It wasn't safe for her at home without someone watching her 24/7, which I couldn't do. They put her in Behavioral Health (she's also bipolar), and because she uses a walker and was weak, they kept her bed-bound for 10 days. They didn't even rotate her often and she ended up coming home with a pressure sore on her bottom and even on her head. She lost a bit of muscle, strength, and some things she had gained through months of PT. The fact that she has Parkinson's compounds the situation more (she doesn't have dementia, per her neuro). I don't have any more fuel to help her and only God can convince her to take her pills.

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Dear Nancy, I am very sorry that you and your mother are having such a difficult time. This post is to put what may be an unpalatable truth.

Your mother is 70, which is quite young for all these problems. However:
- She is on her second UTI in 6 months, has become at least partially antibiotic resistant, and is ‘paranoid’.
- She questions and refuses to take her medication, and her appetite is thin.
- She is bi-polar and has Parkinsons.
- Hospital care was not adequate. She needs quite intensive care, which she resists.
- It isn’t safe for her at home without someone watching her 24/7, which is proving almost impossible for you.
- Her own quality of life is low, as is yours, and may not get much better.

It may be that whatever you do, these problems cannot be solved, and your mother’s life may not be as long or good as you were expecting and would like. Perhaps it might be good for all of you to treat this as the beginning of the end. If you have ‘hit your breaking point’, there are limited new resources to put into the mix. And it happens to us all. You both have all our sympathy, Margaret
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Is there any reason she can’t have injections of antibiotics?
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NancyNJ Aug 2023
I don't think so. We're back at ER now and I will ask what other options are available. Thanks.
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Can you crush the pills and mix them in pudding, ice cream or apple sauce?
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NancyNJ Aug 2023
She's refusing to eat so not an option.
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Nancy, I'm so glad you are back at the ER.

I hope she gets admitted. Get her seen by a genito_urologist. There may be a structural problem which makes her prone to utis.

Do you supervise her bathroom hygiene?
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You wrote this in March:; "I had always intended to help my mother "age in place," but dementia adds another level I wasn't prepared for."

Does your mother live with you, or vice-versa? You have a brother and sister, and the brother is local, since you told him to take her to the ER. If your mother is only 70, you are probably still working, yes?

Seems like your mother needs 24/7 care. Are you able/willing to provide that? Since you are at your breaking point, I would say no.

I especially liked Margaret's reply below.
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What a heartbreaking story. I’m so sorry.

My mom had Parkinson’s disease. It’s a very challenging situation.

Wishing you peace as you navigate through this difficult journey.
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Nancy,

Let us know how things are going. We are here if you need to talk.
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Good luck in ER! I hope your mom is not having a psychotic episode (BP), because that would just add 1 more big problem.

I hope it’s “just” UTI (not sepsis), easily fixable with quick antibiotic treatment.

It’s very nice of you to help your mom. I hope soon you can live your life. It’s stressful for you too, and time-consuming, to be in ER.
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