Look Beyond the Behaviour

When someone living with dementia suddenly becomes more confused, agitated, withdrawn or unsettled, it can be easy to assume that their dementia has simply progressed.

But a sudden change can sometimes be a sign that something else is happening. One possible cause is a urinary tract infection (UTI).

For a person living with dementia, an infection or other illness can sometimes trigger a sudden change in thinking, awareness or behaviour. This is why a noticeable change should not automatically be dismissed as "just the dementia."

What Is a UTI?

A urinary tract infection is an infection affecting part of the urinary system. It can involve the bladder or urethra and in more serious cases, may involve the kidneys.

Common symptoms can include:

• Pain, burning or stinging when urinating

• Needing to urinate more frequently

• A sudden or urgent need to urinate

• Cloudy, bloody or strong-smelling urine

• Lower abdominal discomfort

• Fever or chills

• Back or side pain

However, symptoms can be less obvious in someone living with dementia.

When the Person Can't Tell You What Is Wrong

A person with dementia may not be able to explain "It hurts when I urinate." They may instead show that something is wrong through changes in behaviour.

You might notice:

• Sudden increased confusion

• Increased agitation or restlesness

• Becoming unusually quiet or withdrawn

• A sudden change in behaviour

• Increased incontinence

• Changes in mobility or daily activities

• Drowsiness or reduced alertness

• Hallucinations or unusual perceptions

These symptoms can have many possible causes, so they should not automatically be attributed to a UTI.

What Is Delirium?

Delirium is different from dementia,

Dementia generally involves a gradual decline in memory and thinking abilities.

Delirium is a sudden change in attention, awareness or thinking that can develop over hours or days.

An infection or other illness can trigger delirium, particularly in older adults and people who are already living with dementia.

Someone experiencing delirium may suddenly seem very different from their usual self.

What Can Caregivers Do?

If you notice a sudden change:

1. Pay attention to the change

   Think about when it started and what is different.

2. Look for other signs of illness

   Check for changes in urination, continence, appetite, temperature, mobility or alertness.

3. Seek medical advice

   Contact an appropriate healthcare professional if you are concerned. They can assess whether a UTI or another health problem may be responsible.

4. Encourage fluids if appropriate

   Unless the person has been advised to restrict fluids, encourage regular drinking.

5. Keep the person calm and comfortable

   Reassurance and a familiar environment can help while you seek appropriate care.

Don't Automatically Blame the Dementia

A sudden change deserves attention.

It could be an infection, medication effect, dehydration, constipation, pain or another medical issue - not necessarily dementia progression.

Compassion means looking deeper.

At The Memory Nest, we believe that understanding changes in behaviour can help families respond with greater patience and confidence.

If you notice a sudden change in someone's behaviour, thinking or physical condition, seek medical advice rather that assuming it is simply part of their dementia.