My dad continues to express bafflement about why we thought he was close to death in 2020. My sister asked if he remembered the day all the grandkids called to say goodbye and he said no. She also asked if he remembered the two musicians who came to his house to give him a “final” concert as part of hospice and he said no (and he was definitely conscious and responsive during it). So my sister explained how severe his heart and lung issues were and he just doesn’t remember any of that period. I should also remind him how many times he was intubated.
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It is probably better for him not to remember. Sometimes, our brain deliberately forgets stuff that is too hard to think about. I would not remind him of these difficult times.
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After about 24 hours of calls from my father, including several at 4 am Saturday morning, telling me to please help him, the calls have stopped. I assume this means that the antibiotics kicked in and he is no longer delirious. The good news is that the nursing home can treat him for his UTI. When he was in assisted living, it would have led to an ER visit, a hospital stay, possibly followed by rehab, turning it into a month long process.
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Why do UTI’s cause so many severe random symptoms including wacky mental health? Seriously, I need to look this up. Just found out yesterday that a previous neighbor - early 60’s and a history of lung cancer/brain of several years - has a UTI, fell and broke a vertebrae, and is in ICU vented and having seizures, it’s not looking good.
I feel like there needs to be more attention to screening quickly for UTI’s. 
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MIL has had numerous UTIs, all diagnosed & treated at her AL facility. They have an NP who treats.
I have looked around online and also spoken to some health care professionals about the UTI and delirium in the elderly. One issue is that a UTI is often left untreated for longer than it should be due to the older person not being able to communicate efficiently or early symptoms like cloudy urine going undetected. Add to that adult diapers, catheters, and lower immune systems, making elderly more prone to these infections.
There doesn’t seem to be a clear understanding of why the UTI leads to this delirium, but it is pretty common occurrence. I was once speaking over the phone with an attending physician at my father’s hospital bedside. She was treating his UTI and he was basically hallucinating (saying he was somewhere else, speaking gibberish). She told me not to worry about it, he would be fine once the infection was under control, and he was.
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The AL my father was at did not have a doctor on site. If he had a fever or low oxygen level, they called 911 and shipped him out. They could also not do some simple things like change a catheter (called in visiting nurse service to do that).
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Wow, good point, thanks.
My mother did not have dementia. During the course of her terminal illness, she had several UTIs that were only evident by her confused thoughts. She did not experience the pain or burning that frequently accompany these infections. Her AL was on top of it and tested her immediately if she wasn’t making sense. Her cognition went to baseline very quickly after initiation of antibiotic treatment. I was told an older frail body fighting a systemic infection involves inflammation and stress that may impact the brain’s functioning. Additional research has been done since then.
People with frequently recurring UTIs are sometimes put on a sustained low-dose antibiotic for prophylaxis. This could be worthwhile to discuss with a urologist, especially if the cognitive rebound is slow or illness is painful and disruptive.
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I have been on a low-dose antibiotic to prevent UTIs for at least 20 years now. The urologist told me that a small percentage of women have a condition where bacteria cling to our urinary tracts like velcro. It doesn’t matter how much water, cranberry extract, etc. I take, I will get UTIs unless I’m on this antibiotic. I’m very thankful for it! I’ve had two kidney infections after getting UTIs when I was younger, and I never want to go through that again.
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Sounds like it’s not available in the US.
I’m not worried about becoming resistant to the daily antibiotic. My urologist is one of the best in Maine and he said over many years, he hasn’t had that happen to a single patient.
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I find myself being worried about my sister. We both have familial risk as far as dementia, our dad died of severe dementia, mom has mild dementia, which will likely get worse. My sister is only 63, but she seems so scared of everything, her world has gotten so small. Terrified to travel, doesn’t want to drive a car more than a short distance, only going a small number of things. I am concerned that when you limit your life to just a small number of activities, dementia could be right around the corner. I don’t want to say it, though.
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My sympathy and empathy, @busdriver11. Are there alternatives she can use to get around?
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Yes, she always had her husband drive, if it’s of any distance. He is very accommodating, but I feel this is unhealthy for someone so young, and limits the things she does in her life. It’s not good to be so fearful of everything, you have to keep expanding your world as you get older, not shrinking it.
Is it possible that she may already be experiencing some symptoms of dementia and is retreating from the world as a result?
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You should be saying it though very loud and clear and often. Not that someone is headed towards dementia but encouragement to expand their horizons. Fear is a huge factor in moving forward. It doesn’t mean dementia is around the corner. But people get stuck. Literally stuck in a quicksand of wrong thinking that things can’t improve or what they do won’t improve a situation they are in.
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Easier said than done on the part of the fearful loved one.
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Of course it’s easier said than done. That’s why you never stop encouraging the move forward at any opportunity. Never stop chiseling away.
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