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do I hate you today or is it another UTI?
Posted: Thursday, January 28, 2016 5:32 AM
Joined: 9/12/2013
Posts: 3608

Time for an AT HOME UTI test. 

google at home uti test, different types available. is what I am ordering.

....Another reason that when someone GOES OFF to not start slinging mud or retaliate. But we can not tell in words later in illness that something burns when we pee, or wet the bed, or have NO symptoms you can see, nor can we drive ourselves to some place for help. Women have many  more infections than men, but not to exclude men from being checked.


From Alzheimer's reading Room Blog:

"If your loved one living with dementia is a woman the odds are over 70 percent that you are going to experience the wrath of the dreaded urinary tract infection. 

You read that right


Gut wrenching. Sadness. Confusion. Anger. Challenging behavior, Heartbreak. Or, worse.

Is your loved one mean? Have you had a thorough blood culture ordered by your doctor? Did you ask for or request it as a normal course of events?

No you answered.

Did you know that as we age our core body temperature drops? Did you also know that during your loved one's ten minute doctors appointment if their temperature is taken and it is 98.6 or lower they will be deemed just fine and dandy.

Well, when my mother's temperature was 98.6 she had a ragging urinary tract infection. Do you want to know why?

Because her core body temperature was 97.6.

Custom Search - The Connection Between UTI and Worsening Dementia

Here are some real life examples:

  • At least five readers of the Alzheimer's Reading Room had loved one's die as a result of an untreated urinary tract infection that escalated into a sepsis infection.
  • Carole Larkin had a client that woke up speaking gibberish. She advised the caregiver to take the patient directly to the emergency room. She instructed the doctors to check for a UTI. That was the problem. Gotta love Carole, she is diligent and always ready to take action. Read this - Dementia Patients in the Emergency Room - Think UTI First
  • My own mother, Dotty, woke up completely disoriented. She wanted to know when we were going to go home. She was home. I immediately took her temperature and then called the doctor. Result she had a UTI and we caught it fast.
  • More than 100 readers of the ARR ended up in the emergency as a result of an infection that had gone untreated and had escalated.

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.

Posted: Thursday, January 28, 2016 5:37 AM
Joined: 9/12/2013
Posts: 3608

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.

Undetected UTI |

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.

Custom Search - Urinary Tract Infection

Alzheimer's Reading Room

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 theworse

Custom Search - What's the Difference Between Alzheimer's and Dementia

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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.

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 5,000 articles. Bob lives in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room

Posted: Thursday, January 28, 2016 6:07 AM
Joined: 4/7/2015
Posts: 482

Good points Alz+. I'm crossing over from the spousal board

Let me add, in the 25 years I worked as a hospital RN  I have seen the protocol for urinary catheters change. Long ago, everyone seemed to get one. Now, they are used much less. Catheters cause UTIs very frequently. No longer (or shouldn't) are catheters used "just because the patient is incontinent". Hospital personnel must perform good catheter care daily to prevent bacteria from colonizing and traveling up the tube to create a UTI. 

If PWD is in hospital I would hesitate if a catheter is recommended. Is it for convienence (have to change patient less) or is it needed (patient has heart failure or kidney disease and output measurement is needed). I worked cardiac floor so often we needed to know exactly output to watch for heart failure. We gave many medications to promote urination. 

If anyone is in hospital and incontinent be very careful with skin breakdown. The staff can use special creams to give a skin barrier to help with this. Diapers promote skin breakdown. They keep the patient not only moist but warm and moist. We didn't use diapers. The beds were padded well. Staff must check patients every 1-2 hours to offer to go to bathroom/bedpan or check for wetness. Unfortunately this doesn't happen. Lastly, if skin breakdown occurs a wound nurse can be brought in to asses. They have ways to help heal the skin sometimes. Urine is just so damaging to the skin. 

Sorta got off topic I think but as stated, UTI are very dangerous. 

Posted: Thursday, January 28, 2016 6:15 AM
Joined: 9/12/2013
Posts: 3608

thank you for additional info.

I  getting in home test kit today. 

Women  can also benefit from the aloe wipes, and a hand held shower spray can be used to rinse yourself clean when needed. 

I remember the story of LoneStray on boards who wrote a book about how he took over care of his wife and brought her back to life. He built her a "wet room" for the purpose of easy complete cleaning. 

Think there should be a booklet "Ideal home set up for care of dependent people".

Iris L.
Posted: Thursday, January 28, 2016 1:45 PM
Joined: 12/15/2011
Posts: 18719

This is why I love these boards.  The caregivers post about "silent" UTIs in PWDs with sudden changes, all the time.  

This is why we do need some interaction between patients and caregiver boards, so that we patients can know what the caregivers know about us.

Thank you for sharing the good information above, Alz+.

Iris L.

Posted: Thursday, January 28, 2016 5:12 PM
Joined: 12/5/2011
Posts: 795

Thanks for sharing all this invaluable information.

These boards are full of wonderful caring people who want to help.

Peace and Hope,


Posted: Thursday, January 28, 2016 10:03 PM
Joined: 5/20/2014
Posts: 4408

Love the title of this post! Hopefully it is not another UTI. I've had multiple UTI's over the past 2 years and sought tx. Alz+ I hope the home UTI test is sufficient. Let us know how it works? I guess it's time to track core body temperature. All this is so important to know. Thanks for sharing this information.
Posted: Friday, January 29, 2016 6:59 AM
Joined: 5/20/2014
Posts: 4408

For some reason I could not start a new topic. This is off track but here's from Dottie herself:

Alzheimer's and Dementia

Alzheimer's Reading Room

Dotty's Ten Tips for Communicating with a Person Living with Dementia
  1. You know what makes me feel safe, secure, and happy? A smile.
  2. Did you ever conside this? When you get tense and uptight it makes me feel tense and uptight.
  3. Instead of getting all bent out of shape when I do something that seems perfectly normal to me, and perfectly nutty to you, why not just smile at me? It will take the edge off the situation all the way around.
  4. Please try to understand and remember it is my short term memory,my right now memory, that is gone -- don't talk so fast, or use so many words.
  5. You know what I am going to say if you go off into long winded explanations on why we should do something? I am going to sayNo, because I can never be certain if you are asking me to do something I like, or drink a bottle of castor oil. So I'll just say No to be safe.
  6. Slow down. And don't sneak up on me and start talking. Did I tell you I like smiles?
  7. Make sure you have my attention before you start blabbering away. What is going to happen if you start blabbering away and you don't have my attention, or confuse me? I am going to say No - count on it.
  8. My attention span and ability to pay attention are not as good as they once were, please make eye contact with me before you start talking. A nice smile always gets my attention. Did I mention that before?
  9. Sometimes you talk to me like I am a child or an idiot. How would you like it if I did that to you? Go to your room and think about this. Don't come back and tell me you are sorry, I won't know what you are talking about. Just stop doing it and we will get along very well, and probably better than you think.
  10. You talk too much -- instead try taking my hand and leading the way. I need a guide not a person to nag me all the time.

Mimi S.
Posted: Friday, January 29, 2016 8:55 AM
Joined: 11/29/2011
Posts: 7027

Bob De Marco was a very perceptive guy. He thought about what was going on between his mom and the world. He gradually learned to be part of her world. He learned when to ignore her nos.

I love his story of taking her to the pool with er saying no every step. Continuing the no as he gently led her into the pool. And then her broad smile as the water encased her body.