UTI - urine test positive but no infection??

[Gigglemore]

Mum is in a nursing home but I visit every day and get involved in her personal care. About a week ago she suddenly deteriorated and was complaining of tummy pains so I suggested she might be constipated (she suffered from impaction in Sept but the carers didn't pick it up until I insisted she had a problem). Nurse said she would have bowel movements monitored and treat if necessary, but they said she is OK.

So as strange behaviour, including frequent bedwetting, continued I asked her to be tested for UTI. Was told urine sample was "positive" and being sent for analysis so I thought great, a course of antibiotics and she will improve again. But when I enquired tonight was told that there was no UTI. Don't really understand this - maybe someone can explain, as I assumed the analysis was just to indicate what type of infection? I couldn't ask the nurse for a clear explanation as I was taking Mum to bed and didn't want her to pick up on my distress.

Her dementia is progressing rapidly and I find it hard to believe how much she has changed in last 12 months. But her understanding has really crashed this last week - I am desperate for there to be an explanation other than an irreversible downturn. I think I don't believe that there is no UTI but don't know how to ask for another check without offending the nursing staff.

 

[lin1]

Hello . Sorry to hear
I think you need to find out if the sample was sent to the Labs for testing or did the nurse at the home just do a dip stick test .
If it was a dip stick test , these are not always accurate.
When my mum had a UTI, her urine did not smell very nice, often a bit fishy.
Horrid though this may sound, if you get a chance to smell her urine do so, this may give u a guide .
I hope the cause is found soon .
Please don't fret about offending the nurses , she is your Mum and you are worried about her as I would be if I were in your shoes .

Just had a thought , you can arrange to talk to mum's GP about your worries for your mum.

Please let us know how you get on.

 

[frogman]

As lin1 said, a dip-test may be quick but may not always be accurate. The MSU sample (Mid Stream Urine) is normally sent to a lab for cultures to be grown to determine which infection it might be. I would suggest a new MSU sample (make sure it is fresh) and sent off asap to the lab.

However, we have had a similar issue where the mental impact of a UTI (or other infection) lingers for some time after the infection has cleared. Ask your GP for the urine test and a blood test. The GP should also check her stomach for compaction, bloating or bladder enlargement for urine retention.

 

[Lindy50]

Thanks for the posts on here

Mum had a urine test last week that came back from the lab as negative, although her urine was similar to treacle in its colour and thickness. Also she has had some loose bowel movements (’accidents' where she cannot get to the loo in time....it's about 4 yards from her chair).

We have a Memory Clinic appointment on Monday - the first one after she had a brain scan, as she refused it before. On reflection, I think a GP appointment is necessary within the week as well. Mum is eating and drinking very little and randomly, so this may be the main cause of her stomach problems.....but I'll definitely get her checked.

Thanks again x

 

[Gigglemore]

Many thanks for the advice. The sample was sent off for testing but I don't know how long this took. I've been thwarted in my urine sniffing attempts today as she has done small sticky b.m. both times I took her to the toilet earlier in the day which were a bit fragrant.

Started to raise UTI issue with another nurse who was on duty when I visited today but was quickly told Mum doesn't have one. So will wait until one of my favourites is on duty and ask for her opinion on the reason for the sudden decline, and suggest GP visit. Unfortunately Mum is in a large group GP practice and the nice doctor who I got to know when taking her for medical appointments left the practice over 18 months ago so I don't really have a relationship with a particular GP (happily don't often have to go on my own account!) What baffles me is that care staff must surely be having problems and noticing the change - a couple of evenings ago I was helping her at tea-time and she kept taking the lid off the pepper pot and trying to empty it onto her bread. Also kept offering the vinegar shaker to another resident to "have a nice drink" - thankfully the offer was rejected! If we carers didn't laugh we'd cry - but so often do both.

Lindy50 - coincidentally I have just chased Memory Clinic for results of a scan Mum had last month. Description of your Mum's urine sounds a bit worrying.

 

[tinap]

Please get them to recheck urine, I was in exactly same situation 2 weeks ago. Mom was in hospital but it was me who noticed the change in her mental state and swelling of her abdomen, so I asked the nurses to test her water the dip test showed positive, they then sent sample off which came back negative. She seemed to be getting worse and no one did anything until she was sent to another hospital due to chest pains, they did all routine tests but the only thing that showed was a UTI and constipation.

 

[Gigglemore]

Many thanks tinap - have e-mailed the manager to try to tactfully prompt another test as the nursing staff seem a bit defensive and I have been a bit tearful since someone asked Mum her name yesterday and she just couldn't remember it. Getting her to bed tonight was a nightmare - tried to keep instructions like "please stand up" really calm and simple but it's like someone has unplugged her.

I do hope that your Mom is improving.

 

[Nebiroth]

The dipstick test looks for things that indicate an infection, things in urine that shouldn't be there. However, there are other things that can cause false-positives.

If the urine is sent to a laboratory, they actually do a culture to identify the presence of bacteria - and to identify which sort.

The dipstick is very good, but not perfect.

Also, all tests rely on having a proper sample to test and it is quite easy to contaminate these.

Lastly, UTI infections can develop very fast with no obvius symptoms, so it is possible there is one now but wasn;t before.

 

[Lisajk]

Hi there,
Sorry to read of your mums progression. Could mum be a little dehydrated? I've noticed that MIL's confusion seems worse when she's not been drinking. Shes had many UTI's, but sometimes there's no infection present, and an increase in fluids seem to help.

 

[Gigglemore]

Eventual 2nd test now on antibiotics

Well they eventually did another urine test and Mum has been on antibiotics since Tuesday. She had got much worse and thank you for the tip re dehydration. Was startled to find her fast asleep with a piece of toast lying on her lap and a cold untouched cup of tea on her table when I visited late morning yesterday. However, I have now discovered which carer was responsible for giving her breakfast and I'm not really surprised.

I stayed to hand feed her lunch - they brought a 3 course meal but only a small glass of juice and a cup of tea - not much for someone who's had nothing to drink since 6pm last night apart from whatever she was persuaded to drink to wash down her morning tablets. I emphasised to the senior nurse last night that I spent much of the day trying to get Mum to drink, as she would only accept a couple of sips at a time. Putting a drink beside her and telling her to drink is pointless - she was often forgetting to drink even a few weeks ago. I phoned this morning as there will be a different shift on duty, was told she is again unable to do anything for herself and that staff have now been allocated to feed her. I again made the point that as Mum isn't underweight I am really more concerned that the staff ensure she drinks plenty to help flush out the infection. If no improvement in the next couple of days I'm going to ask them to keep records of her fluid intake (thanks TP, I would never have thought of this before my education here). Housekeeping staff remove unwanted drinks once they've gone stone cold, so there is no proper monitoring of Mum's intake at present.

I am scared that if she has another few days without walking, it will become very difficult to get her moving properly again.

Can't believe the change in her since last Christmas, when she was home with me and could dress and shower herself without assistance and make her own morning coffee whenever she wanted it. We have been lucky this year as I have been able to bring her out of the nursing home for nice drives and back here for meals and to sit in our own lounge to watch the birds in the garden, but am now crying as I know she will probably never be able to come here again. Supposed to be my Christmas card writing day before visiting to feed her at tea-time, but really not in the festive mood.

 

[cragmaid]

I'm lucky because the staff in my Mum's CH are on the ball with fluids. I keep a supply in Mum's room of 330 ml bottles of fizzy fruit flavoured water, the peach is her favourite, and she has the sippy cups ( child's lidded spouted cups) so that she can hold them and not spill them, neither can she drop bits into the cups as her sight is non existant and scraps get dumped anywhere. Mum's fluid intake is monitored and whenever she goes past the door there is one carer in particular, who will come in and check the status of Mum's cup and top it up if needed.

 

[LYN T]

I am scared that if she has another few days without walking, it will become very difficult to get her moving properly again.

.

My OH used to get loads of infections; sometimes through UTI's/chest but also constipation.

In between the infections he managed to find his legs again. I used to massage his legs/feet to keep the circulation going. Any lotion will do-but if it's herbal based just check with the staff first as aromatherapy can react with AB/other meds.

Take care

Lyn T X

 

[Gigglemore]

Thanks

Dear Lyn thank you so much for taking time to reassure and advise me despite your great sadness.

Cragmaid - your Mum's home sounds so good. Although nothing will make watching your poor Mum's current existence easy it must be such a comfort to know she gets kind care.

 

[Gigglemore]

And now a pressure sore

Doesn't look like Mum is going to recover much after the UTI. She now needs 2 staff to transfer her - she didn't recover her mobility and became scared when asked to stand, even when well supported.

She has strength to grip a cup but just puts it down without drinking if it is put into her hand. She is still being spoon fed - she accepts the food but doesn't seem able to understand how to feed herself. I did a lot of crying before Christmas when I had to stop going to the home to put her to bed at night, as I simply could not safely move her and very much felt that I was in the staff's way, and it was time to step back. She is now totally incontinent.

Was shocked today - I asked about an airflow mattress that had appeared in her room. It appears they have been treating a pressure sore for days. Last week I had mentioned to a nurse that Mum had been complaining about her sore bottom and that nurse said the carers would have reported any problem, but said she would check it. A bit annoyed that no-one was going to mention the sore to me. I got the full story by asking to read her notes today.

At least the sore is being addressed at what I hope is the very early stage - but as I can no longer take Mum to the toilet I have not seen the skin for myself. Came home in tears doing the guilt-trip thing - if I had stayed more hands-on could I have stopped it etc. But I have done a search on TP for pressure sores and see they can happen very quickly.

There is nothing in her notes about turning Mum at night - even pre-dementia she only slept on her back. If they do try to turn her at night I worry it will distress her, she usually sleeps very well. Hopefully the mattress will help.

 

[Sue J]

Hi Gigglemore,

Sorry to read about your Mum's pressure sore, they can develop quickly but in my view that should be anticipated in someone who is incontinent and an airflow mattress put in place sooner but please don't blame yourself (although I still blame myself for a friend I nursed who got sores when admitted to a home, I'd nursed her in bed for 6 months and she had not one sore and was never incontinent) I was not well enough due to carer breakdown to keep them on their toes.

Hopefully as you say the airflow mattress will allow her to sleep as she is used to and also allow healing of the sore, hope its better soon.
love
Sue