Tuesday, March 5, 2013

Urinary Tract Infection, You Can Learn From My Experience


When a UTI goes undetected in an Alzheimer's patient they can become mean, delusional, dull, disoriented or worse. Undetected UTIs are common in Alzheimer's and dementia patients.

By Bob DeMarco +Alzheimer's Reading Room

Urinary Tract Infection

Yes, there is such a thing as a silent urinary tract infection. Silent means no clear cut sign of physical pain, no burning sensation, and no discernible odor.

This explain in part why a person who is living with Alzheimer's cannot tell you they have a urinary tract infection. On the other hand, most of the women I know that get a UTI can tell you what is wrong before they go to the doctor.

There are discernible symptoms of a UTI in dementia patients, but the symptoms are rarely connected to UTI by caregivers. This is especially true of "new" or "less experienced" Alzheimer's  caregivers.

In addition, UTIs often go undetected for long periods of time in memory care facilities.

What usually happens when a person living with dementia has a silent UTI? They usually evidence a change in behavior, a sudden change for the worse.

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Behavior change for the worse can mean challenging behavior, mean spirited behavior, dullness, or it can appear that the memory of the person with the UTI is declining fast. In other words, all of a sudden they seem to be deteriorating fast -- one way or another.

Here are a couple of examples of how Dotty acted when she had a urinary tract infection that was undetected by me. I wrote,
My mother seemed completely disoriented. On Monday morning, I woke up when I heard my mother yelling, Bobby, Bobby, Bobby. She came down to my room and asked me if I was in bed for the night. It was 6:45 AM. When I tried to explain to her it was morning, she started whimpering, and started telling me about how she was losing it.
The cause of her behaviors. Another UTI.

Another time,
Like I said she was just "out of it" in a way I had never seen before. On one morning she asked me where we were. I told her home. Her response, is this where we live?
Cause of behavior, another UTI.

The point I am trying to make here is that Dotty did act: out of it, disoriented, dull, moody, delusional, mean, and did evidence behaviors that can best be described as "disconcerting to me" when she had a UTI that had not been diagnised.

All of this happened before I learned how to detect a UTI immediately.

How to catch a UTI, infection, or illness before it gets out of hand, and worsens.

Five years ago, I started taking Dotty's temperature every morning. The first thing I learned surprised me. Dotty's morning temperature is 97.6, not 98.6. Her core body temperature is about 97.8. I did a little research and learned it is not unusual for an elderly persons' core body temperature to drop as they age.

Tip number one. You can go to the doctor. The doctor can take a persons temperature and conclude that nothing is wrong when they get a reading of 98.6.

Don't go fooling yourself into thinking that doctors know about or even consider that a person's core temperature is lower and 98.6 might indicate a fever. The typical doctor appointment in the U.S. is scheduled for 10 minutes (more like 7-9 minutes in New York City). How thorough can a doctor be?

My mother had at least 10 urinary tract infections that went undetected at a doctor's visit, and were only detected when they worsened to the point that her temperature soared above 99. For Dotty, a temperature that is equivalent to over 100 degrees.

What was happening? That nasty E coli bacteria was breeding and getting stronger. As this happened, Dotty's behavior got worse and worse. There were times when things got so bad that I thought we were at the beginning of the end for Dotty. Take a look at the image at the top of this article that is E Coli. Imagine that stuff breeding fast inside the body.

I suggest that you take an Alzheimer's dementia patients temperature every morning. Learn the core body temperature. If it goes up by .8, get to the doctor immediately, that day.

Tip number two. A person who has a UTI will probably start peeing constantly. They might start peeing all over themselves. If they wear inontinence wear it might get "wet" faster than usual. Do not assume that this is being caused by dementia. Yes, it is easy to explain away just about anything by blaming dementia. When you see a change think, UTI, or infection, and become a detective and an inspector. Get on top of it. If you get behind the circumstances will worsen and you will end up paying a heavy emotional price.

Tip number three. When a person who is deeply forgetful makes a sudden behavior change think UTI or infection. Don't think, oh my goodness, things are getting worse and it is the dementia that is making this happen. Common mistake, believe me, I did it.

Tip number four. An undetected infection, including a urinary tract infection, can get so bad that it leads to death. That is right. Infection is one of the leading causes of death in Alzheimer's patients.

You can not rely solely on doctors.

Doctors miss infections and this sometimes happens in the emergency room. Most doctors are in a hurry in medical settings. It is a simple fact of life.

You have to take some real responsibility when caring for a person that is living with Alzheimer's.

Tip number five -- don't be how I was before I learned these lessons, learn these lessons now and avoid heartache, or worse.

I suffered great emotional pain over a 4 year period in part because I didn't know how to spot and detect a urinary tract infection. Dotty suffered great physical and emotional pain because I didn't know how to detect or spot a UTI.

More than once I thought this is the end. Dotty won't be able to function much longer. Only to learn that when we finally got rid of the dreaded UTI she bounced back and started acting "nice" again.

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BobDeMarco
+Bob DeMarco is the Founder of the Alzheimer's Reading Room (ARR). Bob is a recognized expert, writer, speaker, and influencer in the Alzheimer's and Dementia Community worldwide. The ARR Knowledge Base contains more than 4,000 articles. Bob lives in Delray Beach, FL.
Original content Bob DeMarco, the Alzheimer's Reading Room