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I often hear families say their mom or dad suddenly got dementia or they state their loved one with dementia declined rapidly over just a couple of days. Sometimes families will explain a loved one’s behavior as being so bizarre and out of the ordinary that they cannot understand what happened. I always ask if they have a history of UTI, or if they have been recently checked for a UTI. Families are shocked when they find out that their loved one had a urinary tract infection that caused their increased confusion, fatigue, falls and unusual behavior.  


Dementia is a blanket term for many different types of cognitive impairments. Dementia is a chronic mental status change that happens over a significant amount of time, usually months and years. This change can be slow enough that the change over time can be hard to notice.  


Delirium is a short-term mental status change, usually over a span of hours or days. Delirium is typically caused by a reversible condition such as infections like UTI’s. It is possible for a person with dementia to also suffer from delirium, in which you would notice a sharp decline in the person’s mental status in a short period of time. If a person suffering from dementia has delirium, it would be most noticeable by a family member or caregiver that knows that person’s typical baseline cognition status.  


Urinary tract infections are a common reason we see in-home care for delirium. The elderly, especially those with dementia, may not have noticed the typical signs we think of with a UTI such as: urinary burning, increased urge, or lower abdominal pain or back ache. This leaves it up to the family member or caregiver to be aware of the signs of a UTI and notice the changes in the person’s behavior. Usually, once a family or caregiver experiences delirium from a UTI with a loved one, they then know what to do once they start seeing signs of another. If a family member or caregiver is not aware of these signs, they often end up taking their loved one to the emergency room. Emergency rooms can be costly and very upsetting for an elderly person, especially if they have dementia. A better choice would be contacting your primary care physician or your home health care agency, if you suspect a UTI. With a doctor’s order, your home health care agency can do a urine analysis from the home and you could potentially avoid leaving the home over this type of infection.  


If you or someone you know has had a sudden change in their cognition status, call Western Illinois Home Health Care 1-800-228-5993. Our skilled staff could help you determine the plan of action and support you or your loved one in remaining at home.


Amanda Powell, BSW, is a Senior Care Manager at Western Illinois Home Health Care


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April 2018

by Amanda Powell

Delirium, Urinary Tract Infections, and the Elderly