Dear Sir/Mam, I totally understand your concerns about your mother s health. The following points should be taken into consideration for a full assessment and a complete management of this case. 1- Confusion and lethargy are known to be one of the symptoms of infection in elderly. UTI can cause this in your mother. Regarding inability to stand this might be due to her confusion but also can be due to orhtostatic hypo-tension that results from dehydration due to the infection itself. In order to detect this you have to take the blood pressure of your mother in a sitting position then in a standing position and if there is a decrease of the systolic blood pressure by more than 20 mmHg or the diastolic blood pressure by more than 10 mmHg you have your diagnosis of orthostatic hypo-tension. 2- The fact that she is elderly, especially if confused, patients have difficulty expressing their thirst which makes the dehydration worse, and cause more confusion. 3- Other conditions also must be taken into consideration such as electrolyte abnormalities due to dehydration, and certain medications side effects. But the most important concern in this case is urosepsis, that can present as such, that is why blood pressure most be taken in her condition and if the systolic blood pressure is less than 90 mmHg than an immediate transfer to the ER is needed. 4- The following steps are recommended: a- monitor your mother s vital signs : blood pressure, temperature, respiratory rate and pulse. b- electrolytes and CBCD needed to evaluate her case. c- check the medications she is taking that might cause confusion d- keep her hydrated. e- make sure the antibiotic she is taking is adequate for the bacteria on urine culture. I hope she will get well soon. Best regards.