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Dementia + UTI = Delirium … or Something Else?

hoppeduptortoiseAfter visiting my Mom and noticing a difference in her demeanor and confusion, I contact the nursing station to ask that they check my Mom for a Urinary Tract Infection (UTI). Often, it can present as confusion or delirium. They call me back confirming they have taken a culture and are starting her on a 7-day course of antibiotics. When I visit my Mom a few days later, she seems the same but she is walking in smaller steps today.

When we return to her apartment after lunch, she turns to me and asks if it’s her apartment. I sit down to chat like we normally do, but she won’t sit for more than a few moments. She tells me she is going to take a quick walk down the hallway. She leaves me sitting in her living room. She does this twice more. I sit quietly and just observe my Mom today. She moves slow, but has an edge to her — like a tortoise that drank a pot of coffee. She then pulls off her shoe and complains about her foot.

I suggest we find the corn pads (yes, the glamorous life of a care giver) assuming it’s just her toe bothering her. I ask her to sit on the bed while I find the pads. She pulls off her shoe and her foot is very swollen. I ask her to show me her other foot and it’s also very swollen. I ask the nurse to visit and my mom’s typically very thin calves and ankles are hot to the touch. She says they don’t hurt but tells the nurse to stop poking her foot. I recall that my mom couldn’t really feel the neurologist touching her feet a few years ago and they told me it’s quite common in older people with vitamin B deficiencies.

The put her on the doctors schedule for the day and don’t feel like an ER room visit is necessary. When they call, they tell me that the doctor is taking her off antibiotics, she apparently didn’t have a UTI. They just assumed she did and were going to have her take the medication until the culture came back — it came back today and was negative. Now they are waiting for ultrasound order and will let me know what they find.

I was hoping the sudden decline was in fact because of a UTI. After my post, a fellow blogger and book author shared a link — it is not out of the ordinary to have such a marked decline. Now we have swollen feet. The fact that in the course of a few days, I’ve had to call the nursing station and request help for my mom demands that I recognize we may be at the top of a steep decline. Buckled In. 

7 comments on “Dementia + UTI = Delirium … or Something Else?

  1. Oh, Kay, I’m empathizing with what you’re going through with your mom now. This is not easy for her or for you to go through and my thoughts and prayers are with you both.

    Please keep me posted. The swollen ankles could be blood pressure and heart related (generally the left ankle will retain fluid since it’s on the heart side) or your mom may have had an adverse reaction to the antibiotic (my mom was allergic to penicillin and sulfa-based antibiotics and would have a swelling reaction).

    Hugs, my friend.

  2. Thanks — I realized my Mom is also 10 pounds heavier which makes me think she’s retaining fluid. Called to ask them to look into that as well. It’s frustrating and a little scary that you have to bring these things to the attention of the people who are supposed to be caring for her needs.

  3. I can understand how frustrated you must be. Keep pressing them. You shouldn’t have to be alerting them of these very obvious changes.

  4. It is so frustrating how putting someone on antibiotics before attaining a diagnosis has become standard practice. No wonder we’ve developed so many antibiotic-resistant bacteria. Hope they can find out why your mom’s feet are swelling and they can treat it.

  5. […] She has moderate multi-infarct dementia. Last week I noticed a pretty major change in my Mom and requested that they test for a UTI.  They set her up with a visit with the doctor. They report they tested her and would start […]

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