Recently I helped a family find a private care home for their mother who was in her mid 80’s, living in a large assisted living facility and suffering from dementia, depression and loneliness. Her depression and loneliness had come on suddenly and she was talking about not wanting to live any longer.
Her doctor had told the family that her dementia was progressing and made the suggestion that she move to a smaller care home where she would have more one-on-one attention.
During my evaluation with “Mom”, I noticed that she was overly emotional and confused. The family and I realized that it was possible that her medications may not have been appropriately monitored or that she might need an adjustment, but I also pointed out that due to her emotional and mental state at the time of my visit, the family should have her checked out for a urinary tract infection and dehydration. I explained that it is believed that there is a connection to sudden symptoms of dementia or an increase in dementia symptoms and urinary tract infections. They were surprised at my suggestion, but also relieved that there could be an explanation other than a sudden progression of her dementia.
What is a Urinary Tract Infection (UTI)?
It can be difficult to determine if an Alzheimer’s or dementia patient has a UTI because they may not be able to fully verbalize how they feel. They may not understand or be able to express pain, feeling the need to urinate frequently, etc. An infection can cause an imbalance in the substances and salts in the blood and reduce the production of a hormone that contributes to the formation of red blood cells. UTIs in the elderly or people with Alzheimer’s/dementias cannot only profoundly affect their physical health, but also severely impact their behavior such as disorganized thinking, disorientation to time and place, apathy or increased agitation.
Dr. Rajesh Tamp, Director of Psychiatry for Masonicare, feels that the connection between dementias and UTIs is not a widely understood as it needs to be and that people with urinary tract infections are often misdiagnosed as just a sign of dementia.
A significant difference is that confusion or changes in behavior brought on by an infection will come about much more quickly than confusion resulting from dementia.
So, if an older person shows sudden signs of confusion or behavioral changes, it may not be connected to their dementia. The key here is to remember that even if an elderly person has Alzheimer’s or dementia and is exhibiting sudden changes in physical, mental or emotional health, it would be advised to have them examined for a urinary tract infection. With treatment, their symptoms should ease and perhaps reverse altogether.
