How To Tell If Someone Is Confused
If a person is confused, they may:
- not be able to think or speak clearly or quickly
- not know where they are
- struggle to pay attention or remember things
- see or hear things that are not there
Try asking the person their name, their age and todayâs date. If they seem unsure or cannot answer you, they probably need medical help.
What Damages Brain Cells And Nerves
Damage to brain cells can occur in many ways, including:
- Alzheimers disease the most common cause of dementia in seniors. For yet unknown reasons, victims develop clumps and tangles of proteins in their brain.
- Frontotemporal dementia nerve cells associated with behavior, language, and personality have degenerated.
- Lewy body dementia clumps of protein called Lewy bodies damage the victims brain. Lewy bodies are also part of Alzheimers and other diseases.
- Vascular dementia damaged blood vessels are no longer able to supply the brain with nutrition. The blood vessels can be damaged in a variety of ways, including from a stroke.
- Certain diseases such as Parkinsons.
Confusion Is A Common Sign Of Uti In Seniors
Common medical conditions can cause seniors to suddenly show dementia-like symptoms or cause existing dementia symptoms to worsen significantly. One of the most common is a urinary tract infection .
Seniors are the most likely group of people to have a UTI. Theyre also the group thats least likely to have the usual symptoms like pain during urination, fever, or a frequent urge to go.
Instead, many caregivers find out their older adults have a UTI because theres a sudden change in behavior. Someone who suddenly cant do something they could a week ago might have a UTI. Falls, recent incontinence, or loss of appetite can also be signs of an infection.
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Unresolved Utis Can Cause Dementia
The connection between urinary tract infections and dementia isnt common knowledge among the majority of doctors and health care workers. Fortunately, some nursing home professionals have started to make the connection. Still, I would be shocked if there werent hundreds of thousands of misdiagnosed elderly patients either being treated with antipsychotic medications and/or institutionalized because of the brain-related side effects associated with unresolved UTIs.
UTIs are fairly common, resulting in more than eight million doctor visits a year. If youve ever had one, most likely you remember it. The painful burning during urination and difficulty emptying the bladder certainly leave a lasting impression. Half of all women will develop a UTI during their lifetime, along with a large percentage of men. Some of the most common causes include:
- Sex
- Constipation
- Dehydration
- Diabetes
- Delayed bladder emptying
- Birth control
- Unlubricated condoms
- Estrogen deficiency causing an alkaline pH
- Feminine hygiene products
- Pregnancy
- Antihistamines or drugs that decrease urination
Until recently, most UTIs could be easily cured with a round of antibiotics and by abstaining from irritants and drinking plenty of water. In about 20 percent of women, UTIs are chronic and recurring. This is usually due to an underlying bacterial imbalance.
Along with behavioral changes, other indications of a UTI include falling, general discomfort, being overly tired, bloody urine, and a loss of appetite.
Goals Of The Investigation
Although prior research has examined diagnostic patterns of UTI among older adults in the ED,5 little is known about the prevalence of UTI diagnosis specifically in older people living with dementia who visit the ED. Given the challenges of UTI diagnosis posed by cognitive impairment in acute care, our objective was to examine the association between dementia and UTI diagnosis in the ED.
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What Causes Cramps After Sex
In most cases, you do not need to worry about having a cramping sensation after sex, but there are situations when you should see your doctor. Here are some common causes of feeling some discomfort after sex.
1. You Are Not Sexually Aroused
You are likely to feel pain or cramps during and even after a sexual intercourse when you proceed with vaginal penetration even when you are not fully aroused. When you are not sexually aroused, your vagina is likely to be dry. In the absence of enough lubrication, you are going to feel irritated due to penetration. It can cause pain during and after sex. If that is the cause of your pain, you may communicate better with your partner and consider using some lubrication or spend more time in foreplay to have enough lubrication for easy penetration.
2. You Have an Orgasm
Sometimes, you enjoy your sex session so much that you end with a strong orgasm. It is possible to feel bad cramps in your lower abdomen when you climax, and this orgasmic pain may continue even after you are done with the act.
3. You Have Pelvic Inflammatory Disease
You may experience cramps after sex when you are suffering from pelvic inflammatory disease . Usually caused by a sexually transmitted disease called Chlamydia, PID leads to the inflammation of the fallopian tubes and uterus. This can cause pain during and sometimes after sex.
4. You Have Endometriosis
8. You Have Cysts or Fibroids
9. You Are Pregnant
10. You Have Bladder Infection
Are Utis A Sign Of Dementia
Urinary tract infections can exacerbate dementia symptoms, but a UTI does not necessarily signal dementia or Alzheimers.
As the Alzheimers Society explains, UTIs can cause distressing behavior changes for a person with Alzheimers. These changes, referred to as delirium, can develop in as little as one to two days. Symptoms of delirium can range from agitation and restlessness to hallucinations or delusions.
Further, UTIs can speed up the progression of dementia, making it crucial for caregivers to understand how to recognize and limit risks for UTIs in seniors.
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Confusion Linked To Acute Cystitis Or Pyelonephritis
Studies including hospitalised patients are likely to also include patients with pyelonephritis, a condition likely to result in confusion in a fragile elderly person. However, the typical nursing home situation usually involves the suspicion of confusion caused by a lower UTI in an afebrile patient.
The primary aim of this review was not to evaluate the association between pyelonephritis and confusion. The primary question was if lower UTI with no fever in residents without a urinary catheter, with or without localised symptoms such as acute dysuria, urgency or frequency, is associated with confusion. This review concludes that current evidence does not provide a clear answer to this question.
Hospice And Palliative Care
The primary goal of hospice and palliative care is to provide a higher quality of life for the patient. Many of the infections that can lead to the death of a person living with dementia are treatable. However, when reviewing treatments for a person with dementia, its important to consider their quality of life. In the late stage of dementia, the side effects of many drug therapies can outweigh the benefits, as individuals can be frail and infections often return.
Managing pain and other symptoms helps a patient remain comfortable. Hospice teams can also provide helpful suggestions to family and friends on how they can continue to connect with their loved one during the late stages of dementia. Hospice and palliative care also benefit families by offering caregiving assistance and emotional support.
Read:Hospice Care for Advanced Dementia: When Is It Time?
Although dementia progresses slowly, care and end-of-life wishes can be a challenge to discuss when a person is first diagnosed. However, exploring in-home care, memory care, and hospice before the individual can no longer make important decisions is essential, says the National Institute on Aging. AgingCare offers several tools and resources, including an online caregiver forum, to help families connect with others who share similar experiences.
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Home Health Care Specialists Understand Urinary Tract Infections
Infections, including urinary tract infections, can damage nerves and brain cells. That can lead to temporary mental disorientation. The disorientation can be mistaken for the onset of dementia by those unfamiliar with the interaction between it and UTIs.
Temporary dementia can be successfully treated and potentially reversed if the cause is removed. Reversible dementia has much of the same symptoms as irreversible dementia, so testing is necessary to determine the cause.
Dementia due to infection may occur rapidly, which is a telltale difference between a reversible and an irreversible condition.
Home health care professionals are trained to observe and evaluate any changes in patients. Individuals with dementia arent always able to express whats happening in their minds and bodies. Pegasus caregivers have the ability to elicit information and understand what is or isnt significant.
If the individual already has dementia, a UTI can worsen it. That makes it even more important to find the cause for any disorientation. Treat the infection, and dementia may improve.
Choose The Proper Care
Due to the increased risk with dementia and infections, you may want to consider help in caring for your loved one with dementia. Many families want to give their loved one the best but simply cannot do it all on their own.
Dementia requires a watchful eye as it progresses, and the risk is great. Look into our dementia care for an approach that centers on your loved ones best interest.
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Risk Factors For Utis
It is more common for women to get UTIs because the urethral opening is close to the vagina and anus. Poor hygiene and wiping back to front after going to the toilet can enable bacteria from the bowel and vagina to enter the urethral opening to the bladder more easily.
Sexual intercourse can also lead to UTIs in some people, though the risk is much greater for women.
As dementia progresses, it may be harder to maintain personal hygiene . This may increase the risk of developing a UTI.
Washing and toilet problems
Personal hygiene and toilet problems can be sensitive topics. Read more about how to assist people with dementia with these issues.
Urinary Tract Infections And People With Alzheimer’s Disease Or Dementia
Synopsis:Urinary tract infections can cause confusion in older people and those who experience dementia or Alzheimers disease. A UTI infection in Seniors or people who experience Alzheimer’s or dementia has the potential to profoundly affect not only their health, but dramatically affect their behavior through increases in aggression or confusion. While some people who have a UTI do not experience any symptoms, most people do experience a certain amount of discomfort. Caregivers need to be aware of the signs and symptoms of a urinary tract infection.
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How Do People Die From Dementia
Pneumonia is cited as the most common cause of death for people living with dementia, according to a study published in the European Journal of Neurology. Other conditions that can cause death as a result of dementia may include:
- Injuries that result from a fall
- Blood clots
- Stroke
Immune function weakens naturally with age, but some studies suggest that dementia can affect the immune systems ability to respond to infections as cited in a 2021 article in the research journal Frontiers. In addition, bacteria and viruses may more easily infect a person with dementia, because the condition has been found to cause a weakening of the barrier that protects the brain, according to an article in the Journal of Alzheimers Disease.
Difficulties with eating and drinking are also common for people living with dementia. Complications can be severe and may even lead to death if a person becomes dehydrated or malnourished. Eating challenges like dysphagia can cause accidental inhalation of food particles and may result in a potentially deadly infection: aspiration pneumonia.
A disease or medical condition that exists with others, called comorbidities, can create additional complications and may lead to death for dementia patients. Examples of these include conditions such as heart disease, kidney disease, or cancer.
Risk Factors For Urinary Tract Infections
1. Urinary tract infections are more common in elderly people. This is because urine tends to sit in the bladder for longer as we age, increasing the likelihood of bacterial contamination.
2. Urinary tract infections are more common in women than men around 50 per cent of women will have a UTI in their lifetime. This is because the opening to the urethra is much closer to the anus, which can increase the chance of bacteria entering, particularly if you dont wipe front-to-back.
3. Poor personal hygiene can be a risk factor for UTIs. This is a particular challenge for people with dementia, particularly if they have incontinence and need to wear pads.
4. As men get older, prostate problems can make it harder for them to empty their bladder. This can mean urine is held in there for longer and is at risk of developing bacteria.
5. Having a catheter inserted can increase the risk of developing urinary tract infections.
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Does Cranberry Juice Help
Research has come up with different results on this question. Some studies have found a slight benefit of cranberry juice in reducing the risk of UTIs. Others have not found a difference when cranberry juice was ingested. You should check with your healthcare provider first before adding cranberry juice to your diet on a regular basis because it can interact with other medications such as Coumadin .
Addressing Urinary Retention Or Urinary Obstruction
Conditions such as prostate enlargement in older men and neurological damage due to diabetes, stroke or multiple sclerosis may lead to urinary retention. When this happens, a senior is unable to completely empty their bladder. Urine will accumulate and stagnate within the organ, eventually resulting in bacterial colonization and possibly UTI.
Urinary retention is diagnosed by measuring a seniors post-void residual, which is the amount of urine that remains in the bladder after urination. To obtain a post-void residual measurement, a catheter is inserted through the urethra and into the bladder after urinating to drain any leftover urine. Sometimes an ultrasound machine can be used to take this measurement. A residual of 100 mL or more indicates that the bladder is not emptying properly.
Another cause of incomplete voiding is urinary obstruction caused by a kidney stone stuck in a ureter . This blockage can contribute to recurrent UTIs and even kidney infections. Diagnostic imaging, such as an ultrasound or CT scan, can be used to diagnose a ureteral stone and treatment must usually be provided by a urologist.
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Delirium And Urinary Tract Infections
A urinary tract infection can cause significant and often times distressing change in a person’s behavior commonly referred to as, ‘delirium,’ or, ‘acute confusional state.’ Delirium involves a change in a person’s mental state or consciousness and often develops of a period of a day or two. There are different types of delirium. The symptoms can include:
- Difficulty concentrating
- Hallucinations or delusions
- Sleepiness or withdrawal from others
Family members, caregivers, and friends need to seek medical help for the person if they witness a sudden change in the person’s behavior to make sure the person gets the help they need. If the person’s delirium is caused by a UTI, treatment with antibiotics can help to ease the symptoms. In some instances, short-term treatment with an antipsychotic medication might be considered if other types of treatment are unsuccessful.
Delivering Quality Care For People Living With Dementia
Its important to understand that there are no clear steps to avoiding some causes of death for individuals living with dementia. However, support and close supervision can help prevent falls, bedsores, and even certain infections.
Consult with a doctor to consider a course of action that provides the best quality of life for your loved one. If youve reached a point where you recognize you need additional help caring for them, the following care options are a good place to start.
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Should Catheters Be Used
Catheters historically have been thought of as a way to respond to problems with incontinence, but their use is not recommended unless absolutely medically necessary. The insertion of a catheter can introduce more bacteria into the urinary system and this increases the risk significantly for UTIs. A UTI that develops in someone using a catheter is called a Cather Associated Urinary Tract Infection , and the medical community has worked hard to reduce these preventable infections.
Catheters are appropriate for some conditions such as urinary retention, where someone is unable to completely empty their bladder, but they are not recommended without a specific medical condition that makes the necessary.
Preventing Utis In Older Adults
Women are more likely to get UTIs than men, which is important to know so you know to stay aware of sudden changes in behavior or the appearance of other UTI symptoms. According to the National Institute of Diabetes and Digestive and Kidney Diseases, at least 40 to 60 percent of women develop a UTI during their lifetime, and 1 in 4 women is likely to have a repeat infection. Not only do women have a shorter urethra, making it easy for bacteria to get into the bladder, post-menopausal women face a higher risk of UTI because they have less estrogen to help prevent the growth of bacteria in the urethra.
Having diabetes, kidney problems, or a weakened immune system increases the risk for UTIs in both women and men.
Many of the prevention tips listed in our UTI Prevention article apply to older adults too. If you are caring for an older parent or loved one, take note of the three tips emphasized by the Cleveland Clinic:
- Drink plenty of fluids
- Promote genital and urinary hygiene
- Ask the doctor about low-dose estrogen vaginal cream for postmenopausal women
Good hygiene includes showering or thoroughly washing the body each day and using the bathroom several times a day, wiping front to back each time.
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