• September 26, 2013 /  Dementia

    Urinary Tract Infections and DisorientationUrinary tract infections (UTI) can cause serious health problems. A urinary tract infection is caused when bacteria in the bladder or kidney multiplies in the urine. Left untreated, a urinary tract infection can lead to acute or chronic kidney infections, which could permanently damage the kidneys and even lead to kidney failure. UTIs are also a leading cause of sepsis, a potentially life-threatening infection of the bloodstream.

    According to the National Institutes of Health (NIH), the population most likely to experience UTIs is the elderly. Elderly people are more vulnerable to UTIs for many reasons, including their overall susceptibility to infections due to the suppressed immune system that comes with age and certain age-related conditions.

    The normal symptoms of UTI’s are urine that appears cloudy or bloody, a strong or foul smelling odor, the frequent need to urinate, painful urination, or low grade fever. A UTI in the elderly can be mistaken for disorientation, confusion, a delirium like state, agitation, or hallucinations.

    I have found that there is a high likelihood that if these symptoms develop suddenly that there may be a UTI involved. I also look for a UTI to develop if there has been a recent surgery, especially on the hips.

    This was true of a case I took on where my client had been declared by the attending doctor to be without capacity, had lost her appetite and the staff was recommending palliative care. I spoke with a couple of people who knew her for a long time and noted that she seemed to have lost her memory and reasoning functions rather rapidly. She had just had a major surgery (hip), and been in a skilled nursing community for a month. As her newly appointed agent for her medical power of attorney, I asked for her records and determined that they had not completed a urine test on her so I ordered one. The next day they reported she had a bladder infection (part of the UTI) and put her on antibiotics. After a full week of medication the UTI was gone and she had significantly recovered memory and reasoning abilities. The doctor completed a reassessment (he used the mini-mental exam) and she passed thus “regaining” capacity.

    Not everything is this easy nor do I always have such a wonderful outcome but it is worth evaluating the patient/family member/friend starting with the simplest things (UTI and/or major surgery) before going to the more complicated treatments.

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