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Today after2 days of me thinking she's dying. She's up walking and eating . Boy, what a head game.
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I interviewed several hopsice groups in my area before selecting the one we did - and part of the reason was their comfort care included treating someone with UTI symptoms. I did run into more hospice groups that DID NOT cover it - because they would have to pay for it thru their company - medicare wont cover it.
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I too, am questioning what am I really seeing. The UTI, or shutting down.
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I just called Hospice today. Mom has recurring UTI. She looks horrible. I think she is shutting down. The nurse told me Medicare has strict guidelines with dementia diagnosis. They cover only certain kinds of dementia. I told them I will give the antibiotics a week. I will then call our primary doc and ask her to call them.
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We are in upstate NY, halfway between Albany and Saratoga. My mom had Alz. and was on hospice for at least 2 years (no one expected that!) Toward the end of her life she needed to have a cath inserted and, well, poopy diapers (even though we changed her very frequently) did contribute to her getting UTI's. We received hospice care through our county of Schenectady, and they were brilliant, kind,professional, and they treated each and every case of UTI, plus more. We even had a massage therapist, that came to the house to give my mom massages and she LOVED it. She was bedridden and non-verbal by this time but oh, how she would smile! The even had a wonderful pastor come to our house to pray with my dad and mom then he would stay and talk with my father and listen to what my dad needed to talk about! We cared for my mom in her house until the day she died. I really think, our journey would have been much, much worse without the help received from hospice. Oh, and I forgot to mention we also had a very nice woman that came once a week just to keep mama company so my dad could have some free hours to himself!
Blessings to you, Lindaz.
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I didn't like the way our hospice handled (or rather, failed to handle) UTIs. The doctor in charge resisted doing urine cultures and prescribing antibiotics. When we finally got them to take a urine sample during the last UTI, he didn't want to treat until the culture results came back which was 3 days later, by which time hubby would have surely been dead since he was so sick. I just ignored the doctor & called our PCP who immediately prescribed what turned out to be the correct antibiotic. He's now on a low dose continuously and has had no further problem with UTI and is actually much better overall. He was kicked off hospice subsequently, though. They said it was because he didn't qualify anymore (probably true) but I think it was because the doctor got mad that we went around him (surely true). I get the whole thing about antibiotic resistance but we have to use the tools we have! When it's time for hospice again, I'll be more choosy.
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Doctors should be treating infections because they are painful. In my experience, doctors will only treat the infection of someone on hospice if the family wants them to; otherwise, they won't.
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They must provide measures of comfort.
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Hospice has treated my mom for UTI. They left the decision up to me.
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I would think so, since my personal experience with a UTI was that it was quite painful--and hospice #1 goal is to make the patient comfortable. Maybe old age UTIs are different--I didn't have any delusions with the UTI I had in my 20s.
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My experience with Hospice has been with end of life care only. We only have one provider of Hospice care in our County. So no choice there. What I did learn is not all Hospice care is the same. Different, states, different counties makes it all very interesting to say the least. You can only ask. If the answer is no, then dig into it.
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Could the decision as to whether to treat a UTI in hospice also depend on the general condition of the patient? By that I'm asking whether hospice might not want to treat a patient who is "actively dying" but would treat one having a reasonable chance of living, let's say, at least a few months afterward.
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Absolutely! My dad has recurrent UTI's and the hospice nurse ordered Bactrim right away. No worries. Hospice does not want their patients to be uncomfortable, or hallucinating from UTI infection.
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Yes, just signed up with hospice last week and they had the script in hand the next morning. No tests, just asked symptoms. Hospice has been a GODSEND, if they arent for you I agree with previous posters, get another hospice - AWESOME!!!
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Yes, Hospice is treating my mom for UTI currently.
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Yes....in our experience.
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There are various schools of thought about whether antibiotics actually are beneficial. I've been reading about it and it's not a clear cut answer. Jannie77, I'm going to send you a PM with a link that I found interesting.
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They treated my Husband.
UTI is not the "life limiting" disease that brought them to Hospice.
Hospice will treat for UTI, Fungal issues as well as other conditions.
They may not be able to get a urine sample if the person does not have a catheter or is not using a urinal or commode. (although there are some inserts that can be placed on the toilet to capture urine and fecal matter for testing if necessary. They would probably go by symptoms. Odor, color and the patients change in personality or activity as well as any signs of discomfort.
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Absolutely they should be getting antibiotics for her. It would be no different than if, say, she cut her finger and it got infected.
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Absolutely yes. I am a hospice social worker and hospice regs allow for coverage of diagnosis and treatment for a UTI. If your hospice does not, I would look for another hospice.
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In our experience they did not.
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They should. It is not a "life saving" measure. It is a "comfort measure". Glad pointed out that it also would stop any furthering of confusion due to the infection.
Get the nurse to call and get an antibiotic order.
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Yes, they should treat it as a comfort measure because of delusional behaviors that often develop.
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