Jun 1, 2016

Alzheimer's Care Case Study Sudden Memory Loss or Disorientation in a Person Living with Dementia

When a person living with Alzheimer's has a sudden drop in memory, or all of sudden seems disoriented, the caregiver assumes this is being caused by Alzheimer's Disease. But more often than not it is being caused by a bladder infection.

When a person living with Alzheimer's has a sudden drop in memory, or all of sudden seems disoriented, the caregiver assumes this is being caused by Alzheimer's Disease. But more often than not it is being caused by a bladder infection.
By Bob DeMarco
Alzheimer's Reading Room

Urinary tract infections are the bane of patients living with Alzheimer's and their caregivers. UTIs in dementia often go undetected. It happens to all of us.

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.

Bane -  a source of harm or ruin, curse, death, destruction

One of the biggest problem caregivers face is the undetected urinary tract infection. Dementia patients don't tell us they have an infection, and most times they don't even say they feel sick. They suffer from from what I call the silent but potentially deadly urinary tract infections.

Most of the women I know can self diagnosis themselves when they have a UTI. They know they need to go to the doctor immediately and get an antibiotic. The infection normally goes away pretty quick.

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Case Study #1

My mom woke up and I immediately noticed she had a very dull look on her face. She asked, can we go home. I responded, we are home. I then asked her, where do you think home is? She gave me address of where we lived when I was growing up. She had not lived their in 28 years.

During the day she was very dull, almost listless. She didn't want to eat and barely said a word.

At the time I was very new to caregiving. I admit I was full of anxiety and thinking this is it. This is it meaning - my mom was going to worsen very quickly. I blamed it on Alzheimer's disease. My mom lived another 7 and a half years after this episode.

The next day my mom woke up and it was obvious just by touching her that she had a fever.

I took her to the doctor and he diagnosed her with a urinary tract infection. After a day or 2 she was back to normal. No disorientation, no listlessness, and they very dull look on her face was gone.

Case Study #2

A few months later a take my mom to a regularly scheduled doctors appointment. The patient assistant took her temperature and blood pressure and pronounced all was well. Her temperature was 98.4. Next the doctor pronounced all is well.

I then said to the doctor, is there any chance my mom is dehydrated. He asked why I was thinking this. I said, her eyes have been really glassy, and she felt warm to the touch. He said let's find out.

We went and got a urine sample and waited for them to test it. The doctor came back in and said the good news is she is not dehydrated; but, she does have a urinary tract infection.

A couple of days later all was fine.

The Light Bulb in My Head Goes On

After  five more UTIs, I went home and decided to read up on core body temperature. Sure enough I learn as we age, all of us, our core body temperature tends to drop. So we might have been normal at 98.6 but if our core body temperature drops we have a lower new normal. This means you can actually have a fever at 98.6.

I then decided to buy a cheap digital thermometer. I started taking my mom's temperature every morning. Pretty soon it became clear that my mom, Dotty's, core body temperature was 97.6.

Then I started taking her temperature twice a day. It was around 97.8 in the afternoon.

How to talk with someone who has dementia

Case Study #3

By this point my mom had already had a bunch of UTIs. The day came and my mom's temperature was 98.4. I called for the doctor appointment and was told because her body temperature was only 98.4 I would have to wait 2 days for an appointment. Well in 2 days my mom was "sick as a dog".

Yes, she had a UTI. After a quick discussion with the doctor he told me that from that day forward if my mom's temperature reached 98.4 I should call and inform the front desk that we were entitled to a work in appointment. This meant they would work us into the schedule that day. As it turned out it was usually right after lunch most times.

Can you believe every time I called in the person answering the phone would resist. I had to ask them to tell the Doc -  Bob DeMarco is on the phone asking for a "work in". And every time, we were worked in. Sooner rather than later I should add. We had the best doctor.

Case Study #4

I kept on reading. I soon learned that as women age, men also, they start to "leak". These little urinary leaks can lead to a bladder infection. These leaks are pretty common at night when a person living with dementia is sleeping. I bet you already knew this.

My solution. I went out and bought 24 pairs of panties for my mom. Every time I took her for a pee I gave her a fresh pair of underwear. I didn't even bother checking. So like 6 changes a day.

I think I can safely say that I washed more panties at home that any man that every lived. Wash wash wash em, wear em out, get new one's.

Are you ready for this? I nearly eradicated the urinary tract infections in my mom.

All the work was well worth it. Those urinary tract infections made me feel so sad, filled me with anxiety, and honestly, in the beginning made me feel like the end was near.

It was so bad I actually can feel what it felt like right now.

I beat the dreaded urinary tract infection. I hope you can do it also.

Lets face it - it is not easy being one of Us. Sometimes we just have to seize the bull by the horns.

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Bob DeMarco is the Founder of the Alzheimer's Reading Room (ARR). The Alzheimer's Reading Room contains more than 5,000 articles and has been published daily since July, 2009.

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