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How many of us caregivers have experienced this phenomenon?! I can remember this was more often than not the cause for behavior swings and increased confusion and excitability with my Grandmother while she had dementia. I can recall, while she was on hospice, before I was her full-time caregiver, that the nurses would find her on the floor, having crawled out of her hospital bed (because her legs were so weakened from her battle with viral encephalitis, which exacerbated her dementia). She would either be next to the bed or be trying to crawl down the hall to get wherever she thought she was supposed to be. What usually followed, was cloudy urine in her catheter bag and a subsequent Urinary Tract Infection.
I experienced the same phenomena when we were able to bring her home. When she went through extreme swings in behavior and especially the need to be somewhere, we could be sure to expect cloudy or dark urine and the start of a UTI and a call to her doctor to get an antibiotic prescription.
A UTI is an infection of the urinary tract, most commonly the bladder. For most people, the need to urinate frequently and/or urgently are two key symptoms of a UTI. So is a burning sensation when you go, and urine that is an off color or has an odor. Sometimes, a small amount of blood in the urine is visible. But in older adults, those symptoms are often missing. Instead, older adults may suffer from unexplained incontinence, vague fatigue or significant changes their behavior and mental status.
"Older people can get markedly confused, agitated, or sleepy," says Dr. Smith. "Sometimes they can see things that aren't there, like bugs crawling on the ceiling. They can have false beliefs and become paranoid."
In my grandmother's case, eventually we learned that she wasn't as able to communicate that she had discomfort urinating, so we had to be more proactive about maintaining better hygiene and toileting. It meant more work for me, to get her to the toilet more often, to ensure better cleanliness (instead of taking her word for it that she wiped appropriately), to try and get her a little more physically active (which was difficult because she really had severe limitations with mobility), but it was worth it because we were able to decrease the prevalence of UTIs, and to not just help her physically, but to help her emotionally by warding off more bouts of confusion and anxiety. A lot of effort, but well worth it!
What are symptoms that you experienced? How did you treat it or help with prevention?
Please read on to understand how UTIs can really affected mental status of the elderly. I always say, start simple and work from there. So, if your loved one is starting to show irrational or altered behaviors, investigate the possibility of a simple Urinary Tract Infection.