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My mother originally went to the hospital for shortness of breathe. She came out with 17 different medications. The she went to rehab for two weeks. We picked her up on a Friday and that Saturday she was talking with a slur so we took her to the hospital again and was told it was another urinary tract infection. My brother feels that the hospital over medicated her. Now is is always weak and slow to speak. Has this ever happen to any of your parents?

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Start with her PCP or yours. Make an appt and take her with you. Bring a list of all her drugs and any instructions as to when to take them and w or w/o food. Have a UTI done and if there is no infections, get her off all the antibiotics unless they are necessary for another reason.
Get a list the dr. wants her on and if she tolerates those, ask if any others are necessary. Bring her in once a week at minimum until she stabilizes.
Make sure she checks off the drug as she takes it. You might need a care taker until you have a system in place.
Prepare for that or find a place for her to live where she can get help.
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Yes! This happens to my senior patients frequently. UTIs can cause these problems because of the toxins released by bacteria as the immune system fights the infection. There can also be other reasons for these symptoms. The best option is to have your parent fully evaluated to investigate all causes and treat appropriately.
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Yes…do you know what all 17 medications are for? My suspicion is that she is over medicated also. When you are evaluating the medications, look at the side effects and see if there is another drug that addresses the side effect. A lot of times, the hospitals will give the drug that “MOST” people can tolerate and are hesitant to use a different drug thinking the patient can just work through the side effect. It’s a miserable time.

If you have a good relationship with her PCP, I would take her there and get his take why she needs all the medication and he can order the test for UTI. The slur in speech could be due to a stroke also, so he can order X-rays and MRI to help make that determination.

As for the UTI, see if you can introduce cranberry juice into her diet. That might help break the cycle of UTIs. I’m assuming she took ALL the pills as prescribed for the UTI.
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multee63: U.T.I.s can wreck havoc on the body.
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Check meds also.

i went to urgent care with uti over a thanksgiving weekend and np prescribed a new med which was better than my old med.

started having balance problems and was unable to read. I knew that each word was a word but what did each mean ? I couldnt understand them.

called regular doc who prescribed old med which is not supposed to be good for heart but …

urgent care np/er doc i talked to another time/pharmacist said new drug was good.

maybe it was for other people but it wasnt for me !

so maybe theres a drug she cant take either.
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Yes! Our mother was hospitalized for shingles. She was in hospital for two weeks getting more and more confused with serious symptoms of dementia. Leaving out details, after several months of home care she is back to her happy and bright 90 year old self.
What I learned is this is very common when the elderly are hospitalized. There is a name for it. Look up "hospital delirium" on the internet. I don't think they really know what causes it, but we all need to be aware of it!
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Similar issue: My mom had pneumonia and was treated with antibiotics. She ended up getting c. Diff (presumably from antibiotic usage juxtaposed with a stay in rehab) and ended up getting sepsis. She was sort of breath, speech was not normal, lots of confusion… She was treated with antibiotics again and the infection came back with a vengeance and she ended up with septic shock. I found out about a repeated infection through asking her doctor to test her blood, test her for UTI, and they ended up running another c.Diff test. She was also on two pages worth of medications after her hospital stay.

i would have her doctor do lab work on her/do a UA test with knowledge of previous UTI symptoms, bring up your concerns and go from there. She may be having recurrent infections but it’s super important to catch that. 17 medications also seems insane. Definitely talk to her PCP and ask him to evaluate her.
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It's not uncommon for the elderly to come out of the hospital worse than when they went in- especially if there is some dementia. 17 medications is ridiculous - she needs to be re-evaluated from a private doctor experienced in elder care. Can you imagine taking all those meds yourself??? Also, just being in different settings is extremely disorienting to our elderly parents. IF at all possible, keep Mom home and hire a caretaker who will make sure she is hydrated and well cared for. It's not easy - but it's worth the fight for peace of mind, safety, and better care.
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My mom went into the hospital last October with UTI. She then went to Rehab, then back to Hospital, then back to rehab, then we took her to Boston area hospital because her WBC and her confusion kept escalating. We were very concerned about the delusion she was experiencing. They did as many tests as they could to try and track down an infection to see what was causing it and finally couldn't find anything. Ultimately, we took her home with the advise that familiar surroundings, routine, and people would help. They also planned a "Senior Consult" doctor team that looks at elderly persons meds and whole history to try to figure out and consult with PCP to determine what she should really be on. She has so many doctors prescribing so many things, she had multiple pain relievers and other sedating drugs that likely contributed to her confusion. It took 2 months of hospital and rehab time and then a good 3 weeks at home before she gradually became herself again. Now she is as alert as ever. Definitely have PCP go over meds with you.
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Actually any infection can cause someone to be confused and extended hospitalizations can add another level of confusion.
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My mother, 97, gets UTIs several times a year and has been in hospital 4-5 times for weeklong stays. Symptoms can be misleading and not what you’d expect. In her It begins with frequent trips to the bathroom followed by confusion, disorientation and agitation followed by weakness and vomiting. Symptoms escalate quickly and can be life threatening. She has never developed a slur, but she gets agitated to the point she needs to be in restraints to keep her safe. At this point she can be incredibly strong and kick, bite and scratch. The slur your mother has developed may be due to some of the drugs she received in hospital. Your doctor should be able to tell. Infections are common as the immune system starts to fail. It’s definitely something to watch out for.
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Agree that UTI is likely causing her issues.

But so are the meds. Our insurance offers consultation about prescriptions. Perhaps mom's does as well. Of course get the PCP visit as soon as possible and have that doctor review the meds.

And you can also check meds yourself by going to one of the sites like drugs.com or webmd.com and using their Interactions Checker. You might find that some drugs need to be taken several hours apart from other drugs. And some drugs shouldn't be taken together at all.
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Grandma1954 Apr 2023
All pharmacies are required to give information and answer questions about medications. They always ask if this is a new prescription, they always ask if there are any questions. I bet 99.9% of the time people just say no, or ignore the question.
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YES! UTIs are so very common and can cause lethargy, confusion etc in the elderly. They need to be handled quickly via antibiotics in the hospital...
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Talk to her Dr
We are not doctors
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NorasDaughter Apr 2023
Yes of course, but this is a forum to share personal experiences and get support from others who are going through the same thing.
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This is common for dementia patients. My mom came back in a deeper dementia and after 4 months it has not resolved. She had pneumonia. We feel the hospital visits have damaged her quality of life….No more ER visits for her..her geriatric MD agrees. Ps. Look up elderly and hospital delirium..my mom takes 250mg Keflex daily to stop the UTIS….she had 12 in 16 months. Works to suppress Utis.
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Beatty Apr 2023
Pneumonia can cause delerium in the elderly just as UTI does. Add strange & stressfull hospital environment. Add Covid probably at some stage too.
Adding it all together, just too much 😥
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When this happened to us the cause was severe overmedication.

In our situation, every other doctor on rounds had added another Rx or increased a dose. This, along with an accumulation of what was too much medication already over the course of several years was too much for Mom’s body to process. Some of the meds had terrible interactions. Mom’s symptoms and new problems aligned with the warnings and (some of the most severe) side effects, yet none of the medical professionals noticed. The doctors in the hospital refused to acknowledge a change or any problem, attributing Mom’s sudden disorientation and downturn to her age. (It’s surprising the hospital’s pharmacy warning bells and whistles didn’t catch the problem). When Mom was released (newly in a wheelchair), even the drug store pharmacy alerts were not triggered. Further, Mom’s dosages were appropriate only for someone twice her size. (Don’t be fooled by claims of advanced technology and computerized charts-now all the doctoring time is spent inputting data with only a couple minutes left for patient examination, listening to concerns and actual care).

After discharge, Mom’s primary care provider refused to reduce the overwhelming list of medications when approached by concerned family. The new pill box was large and administering was difficult, meds 6x throughout the day, some with food, some without, some at rising, others at bedtime). Mom was diagnosed with dementia. My dad was leading the charge in finding a resolution. He was telling her doctor that he believed mom was over medicated. (When we later obtained the medical records we saw the primary care provider had included in the records nothing about our suspicions of overmedication, but rather, “Husband has dementia” (not true) and “Daughter is in denial about patient’s general health condition.”

We decided to change providers and Mom was weaned slowly under close medical supervision. We went to a cardiologist because her prescribed drugs were predominantly heart medications. Weaning too quickly can cause additional problems and damage - do not attempt this without the help of a medical professional).

Mom returned to normal- a miracle! Actually even better than normal, she said she hadn’t felt so good in years. She got out of the wheelchair and resumed exercise, cooking, gardening, other hobbies… many activities that had grown difficult or impossible in preceding years.

I have shared my story widely and have learned that this problem is widespread. (A visiting nurse at the time was able to help 2 of her other patients (at that time!!!) after witnessing mom’s positive transformation).

Look up all the meds, the dosages (frequency and relevant to her weight), drug warnings, interactions and chart them out. This information is readily found online and will give you a roadmap to identify any potential problems.

Wishing you the best.
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betskand Apr 2023
This is a really useful story! Thanks for posting it. I am going to get hubby's urine tested right away and also check his meds against each other (although our PCP is genuinely very careful about this and when he was released from the hospital immediately starting making careful changes and reductions.)
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Good Morning,

These UTI's can mimic other things. You need to clear the UTI with medication, lots of water and a shot of Cranberry juice in the morning--per your doctor's recommendations.

Also, once the UTI clears, this is your mother's "baseline". Basically, what you are left with. My mother during the Pandemic was in a similar situation. The medications now are streamlined but they are keeping her up and running. Mother has Lewy Body Dementia and wears hearings aids which causes another issue when the hospital staff wakes you up at 2AM and ask you who is the President of the United States?

Follow-up also with home services--physical therapy, occupational therapy, good walking shoes, not sitting for too long.

Also, white cotton underwear. An UpWalker Lite far surpasses the gray aluminum one's that are passed out upon discharge.

It takes a while for the elderly to regain their strength (or what's left) upon a hospital stay. The short-term rehabs you really can't sleep. They have their own doctor and pharmacy who prescribes or oftentimes overprescribes.

Some of the medications--heart, blood pressure, anything that sends serotonin to the brain are required so they won't be lethargic are important. The more I read, the more I realize the brain inhibitors are crucial and also the importance of the "executive functioning skills" to be maintained as best as they can.

At one time my mother didn't even know how to brush her teeth. Your brother is going to need a "team" of people. Ask the primary care doctor to send a nurse out the house for an assessment. Write orders for p/t, o/t and home blood draw.

I agree with Burnt Caregiver the medications can also have side effects. It's hard to find out in the early stages what is doing what. I could not get over the medication list my mother came home with. They are now streamlined and I have gone through every area of her life to give her quality of life--medications, physical appearance, home cooked meals, flowers on the table, studied the health insurance and know what is available out there for help, fresh air, exercise, socialization, Church people visit on a Sunday.

Know what each pill does and why. Read the side effects, follow up with doctors and get a Geriatrician if you can find one. Check out ALL your mother's doctor's on your State Board website. Some of the Psychiatrists for the elderly, well put is this way, people pick their profession for a reason. This is important, don't assume anything.

A hospital bed with 1/2 railing can be covered by insurance. It's adjustable and they will be safe. Clear the pathways in the house and change the light bulbs and buy more lamps if needed.

Half of the elderly population is on a blood thinner--Warfarin (Coumadin) was a nightmare since the INR was all over the place due to the UTI antibiotics. Anything can set that off (too many greens), etc. I switched my mother to Eliquis. There are no blood draws but it is more expensive but well worth it.

Good walking shoes, throw out all step-in slippers with no backs and long nightgowns are trouble too. Also any type of blanket that can trip over at nighttime needs to go. Usually after a hospital stay the elderly's shoe size changes.

I buy the SAS Tripad Comfort Soft Step Mary Jane with adjustable strap in case of Edema which usually happens during a rehab and/or prolonged hospital stay. A trip to the Podiatrist every 10 weeks for toe-nail clipping is usually covered.

This is important--the booster seat for the toilet do NOT use because you can't wipe yourself as good and can lead to further UTI's. I recommend the railings around the seat so they can push off getting up. A shower chair and nozzle will suffice. Make sure you control the water temperature not your mother.

As you can see, I have been in trenches. I'm seasoned at this. At first, when I was a newbie to this I prayed to the Lord everyday to help me. Now I can help others. You will learn on the job...Amen.
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Yes and it took 2 years for the brain fog to clear and the medication to get out of her system.
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17 different medications? That's ridiculous. What does your mother's primary doctor say about this?
Why was your mother put in rehab? She may very well have had another UTI. That happens all the time when an elder goes into the hospital or rehab or any care facility.
Her strange slurred and slow speech could also be cause by different medications or different dosages of ones she has taken for a long time. Or a stroke.
The hospital did a urine culture and it came up positive for infection. Okay. That may not be the only reason for the slurred and slow speech.
Is your mother diabetic? Did they tinker with the regular doses of diabetes medications she takes. Or change them? This will certainly cause the slurred and slow speech too.
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As others have recommended, she now needs to have a regular primary doctor for her medical needs so that there is continuity of care. Hospitals are necessary in emergencies but work against patients in terms of connecting the dots for most accurate diagnoses and treatments. The primary doctor can look at her "big picture" and has time to ponder causes.

What did the hospital doctor conclude was causing her shortness of breath? That is only a symptom of a bigger problem.

Did she really come away with 17 prescriptions? To treat what? Thanks for the extra info.
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I am sure some type of follow-up is required. Check to see if you have a urogynecologist near you. If not a geriatrician. Not a family doc.

Seventeen?! Really?
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I would take her to her doctor and evaluate the need for all the meds.. and of course, the UTI.
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sometimes of course one MUST go to the hospital.
but remember, it's always a risk to go to the hospital (and even more so, if you're elderly) (and EVEN more, if there's dementia; one isn't aware in hospital; one can't defend oneself.)

sometimes you:
go in with 1 problem, come out with 10 new problems.

(yes, it's totally possible your mother was over-medicated. every time my LOs go to the hospital, i oversee every step. i ask questions. and sometimes, i don't give my consent for whatever they want to do. i research/investigate/ask/decide.)

(yes, UTIs can cause disorientation/slurred speech.)
(also, UTIs can be CAUSED sometimes by hospitals, rehab...)

please make your mother drink lots of water. try to wash out the side-effects of medicine; try to help wash out the UTI. whatever the cause, sometimes one is lucky and with time (some days/weeks), the slurred speech/disorientation goes away.
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bundleofjoy Apr 2023
by the way OP, sometimes hospitals give patients drugs so they stay quiet, sleep, don't bother staff.
:(
some of these drugs also cause slurred speech.

also:
not every UTI needs to be dealt with in hospital.
there are different degrees of UTI:
...mild: can be washed out by drinking lots of water (anyway, whatever level of UTI, drink lots of water daily: it helps to recover & it helps to prevent future UTIs).
...medium: needs anti-biotics.
...severe (bordering on sepsis): needs hospital asap. every hour counts. the sooner one arrives in hospital, the more likely one can survive, and prevent permanent organ damage.
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I think hospitals are wonderful for treating an acute crisis but I would not trust them to choose the wisest course for long term problems because their knowledge of the person is superficial. If her regular doc isn't helpful then I would try to find a gerontologist that can review those medications and also work toward eliminating the recurring UTIs (D - Manose is often recommended)
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YES UTI can causes disorientation & confusion.

So could 17 meds, eek!

I'd want a review of those meds, stat. Also a good medical checkup to rule out other causes (? stroke).
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