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Is it possible that moodiness, extreme tiredness ( sleeping 18 plus hours a day now) and confusion that have all been there for a long time but are getting worse and worse are due to a UTI?
Doctor seems to think it’s due to dementia progress hasn’t done a urine test.

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Yes, it's definitely possible the symptoms are worse due to a UTI and it's certainly easy enough to perform a urine test to find out!
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Yes - since moms stroke she has had several UTIs and the only thing I notice is cognitive decline - behavior and agitation and lethargy.

If your loved one is living in a facility request a urine test - if home you could ask their dr if you could drop off a sample or if you have home health they can get orders and do the catch for you at home.
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Yes, when I see any change in my dad, I do the strips tests. They are selling in Wallgreens o any other farmacy.
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UTI's can completely alter a person's behavior. we know with MIL that when she gets one she's 100xs more angry and hostile. Usually delusional, too. I'm not involved in her care at all, but when DH sees her and comments that she was worse than usual, we get SIL on board with the OTC test strips. She has fallen 3 times when she has UTI's--spent 2 months in a rehab facility last year b/cshe fell and konked her head badly. I don't think she ever returned to baseline after that one.
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It is possible.
It is possible for both to be happening.
The body fighting an infection can cause a decline.
Contact the doctors office and request a urine test. You can buy test strips at the drugstore and if that shows an infection you could be more instant in requesting testing.
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Can’t imagine why a reasonable doctor would REFUSE a simple non evasive test requested by a loving and concerned caregiver.
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Its possible - but without a proper lab identification test you won't know - and if the "symptoms" have all been there a long time, then simple deterioration and progression of aging and dementia seem just as likely - UTI is not the answer to everything inspite of some people's views. If it is UTI and you have the lab determine the bug(s) good luck with getting the right treatment as most Drs just tinker round with simple dose antibiotics for short courses instead of necessary high dose for double length courses so it just becomes a vicious circle.
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Hello
Cannot tell you how many times I had to suggest myself that a urine test be done for my mom.
Cannot tell you how many times I was told yes, but days and weeks ...would pass before it was done ...and came back positive each time with very very little exception. ( 1% of time...)
Cannot tell you how many times there was a delay in getting the antibiotic...

I learned that a nurse wanted to give her calming medication ..when I asked "why", I was told that for the last two days my mom had suddenly became " agressive" and in a bad mood. ( key word,: suddenly...) I had ( me, the no nursing training one), to suggest a simple urine test and, guess what...Yup...positive UI. She was given an antibiotic, and mom got just as " suddenly" back to her non agressive self. WHERE would we be if I had said yes, drug her up to calm her down, let the side effects kick in and bring the balance and falls issues etc etc. ????
I often went myself to collect sample, ( baught the "hats" to collect sample, and braught them myself to the nurse station). Time is important in getting the antibiotic started and I can tell you that I NEVER REGRETTED insisting for getting testing done.
Of course it had to be asked with five pairs of whites gloves and kind and patient voice, but base line,: it had to be done, period. NOTHING, as in NOTHING to loose for anyone in doing the test, except a few minutes of time to test and cost of testing material , but A LOT, as in a LOT to loose in letting an infection go on untreated.
we will never know how many of our loved ones got on a dangerous and sad path because of the avoiding of starting by doing this so simple test.

NOTE : it is also useful to test AFTER the antibiotic to see if it worked if it is not obvious that things are back to normal. It happened to my mom, had to be given a second treatement that worked. Also, the pharmacist changed the antibiotic after a few infections and once even alerted the doctor that the one prescribed could not be given to her as she was taking another medication (cannot remember what it was) that was incompatible and the interaction was dangerous. He suggested another antibio and all was well.

Re prescription : if loved one living in a assisted facility, to avoid delays in testing and getting antibiotic, an "open" prescription" from md to test when needed, and an "open" prescription" for the antibiotic can be helpful. It avoids the " the doctor has to autorise the testing and she is not here this week-end" or " the doctor is on vacation and her replacement will not prescribe antibiotic unless you bring your mom to see him in person in his office " ( office 20 min drive from where mom lives and middle of winter and flu season...)
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Momheal1 Aug 2021
Agree 100%.

I have wondered how this is not the most basic steps taken automatically in any environment with elder care - wether in-home - facilities and hospitals. Bloodwork and urine I would assume would be the first to be done.
We as family often notice the changes in our loved one first but it does concern me that the first line is “calming meds” before these basic tests are run.

I Also agree as my NP always runs another test approx 10 days after.

It may not be what is causing many to decline but it does cause many and is always worth being the number one to rule out.🙏🏼
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A bad UTI can mimic stroke symptoms and make dementia seems worse. Yes a simple UA will tell you if there is a UTI present.

However, I did not see anyone mention cultures. Without proper cultures done on the bacteria, the UTI cannot be treated properly. There are UTIs that are resistant to most antibiotics.
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A bad UTI can mimic stroke symptoms and make dementia seems worse. Yes a simple UA will tell you if there is a UTI present.

However, I did not see anyone mention cultures. Without proper cultures done on the bacteria, the UTI cannot be treated properly. There are UTIs that are resistant to most antibiotics.
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Hello
Cannot tell you how many times I had to suggest myself that a urine test be done for my mom.
Cannot tell you how many times I was told yes, but days and weeks ...would pass before it was done ...and came back positive each time with very very little exception. ( 1% of time...)
Cannot tell you how many times there was a delay in getting the antibiotic...

I learned that a nurse wanted to give her calming medication ..whan I asked why, I was told that for the last two days she had suddenly became " agressive" and in a bad mood. ( key word,: suddenly...) I had ( me, the no nursing training one, to suggest a urine teat and, guess what...Yup...positive UI, antibiotic, mom back to her non agressive self. WHERE would we be if I had said yes, drug her up to calm her down, let the side effects kick in and bring the balance and falls issues etc etc.
I often went myself to collect sample, ( baught the "hats" to collect sample, and braught them myself to the nurse station). Time is important in getting the antibiotic started and I acn etll you that I NEVER REGRETTED insisting for getting tessting done.
Of course it had to be asked with five pairs of whites gloves and kind and patient voice, but base line,: it had to be done, period. NOTHING, as in NOTHING to loose for anyone in doing the test, except a few minutes of time to test and cost of testing material , but A LOT, as in a LOT to loose in letting an infection go on untreated.
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I was just speaking to a geriatric nurse yesterday about this very same problem with my MIL who we caregive. The nurse said this is all too frequent, and UTI’s in the elderly do not manifest the same way they do to younger people. They manifest in the exact way you are describing.

I would insist on a urine test. Doctor’s don’t know everything (although some would like us to believe otherwise)…
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Yes! UTI must be ruled out! Mom (96) lives with me and has senile dementia and mobility issues. Her only symptom was just increased sleeping for several(?) weeks (I realized in hindsight!) and zero appetite, until one morning she developed severe chills and temp 100. I had to suggest to MD a UA. It was brown and cloudy, WBC 20,000. Also diagnosed with severe kidney infection, which can be the progression of a UTI if it remains untreated. Spent a week in the hospital which severely weaken her further. She rehabbed in a skilled facility for a month with daily PT/OT and now is in a residential board and care home. Don't delay if you notice any change in behavior - it's such a simple test! And yes, by all means, a culture/sensitive MUST be done as well!!
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ABSOLUTELY! My 92 year old mother has had problems with bladder infections for years. She has always been pretty good at telling me that she feels it but as dementia has worsened, she’s either not aware or can’t communicate it to me.

At those times, I’ve only known by the time it’s bad. She’s really confused. Cannot speak, cannot find her words. Irritable, tired.

Her doctor told me that what happens is as she gets older, it’s harder for her body to fight off this bacteria. The body begins to develop an ammonia that affects the brain. Really scary but preventable.
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Untreated uti can kill. Insist on a test today. Go to a walk-in clinic if necessary. It could also be dehydration. Doctors seem to chalk it all up to dementia. It is concerning. Best of luck to you and your mom.
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When UTIs cause a person to go a bit loopy it's usually a more marked, sudden change than you describe; but ruling out a UTI is so straightforward and non-invasive that I don't see how it can possibly hurt to check.

Has the doctor done any routine tests - especially bloods? I shouldn't have thought it would hurt to rule out cardiac or cerebral "events" (as they're rather euphemistically called), either.

There are two reasons for running such checks: 1. If they might result in beneficial treatment or better management. 2. So everyone knows where they stand. Invasive, painful, uncomfortable, strenuous tests might not be justifiable on those grounds, but I hope the doctor isn't averse to basic monitoring that won't subject his patient to any ordeal.
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I would insiist on a urine culture. My mother gets them frequently and displays the same symptoms. I would get this done to rule it out for sure.
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While I agree with all of the answers before, let me add my two cents worth. My late husband was diagnosed with mild cognitive impairment but suddenly he would exhibit extreme paranoia, anger, and confusion for what seemed like no apparent reason. Sure enough, he was battling a UTI upon further screening. However, the UTIs were difficult to treat because as I soon learned there are numerous bacteria that could be the culprit, all requiring a different antibiotic to treat adequately. In order to correctly identify which strain was causing the current infection required an in vitro culture that took days to produce a result. Meanwhile, the infection rages on and the symptoms worsen while we waited for the accurate bacteria diagnosis. The quick strip tests are good for indicating that there is in fact an active UTI infection, but it is useless in identifying the bacterial strain responsible. I hope this information is helpful.
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MariesKid Aug 2021
My Mom has been battling UTI’s for months. In April she got Sepsis. Like you, we have to wait for culture results. It’s hard because she doesn’t complain about symptoms but she gets lethargic and extra confused when she has them.
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Jesskahn: I do not profess to be a medical professional. Ergo, to rule out a urinary tract infection, this individual should have a complete urine analysis, not a simple dip test. If the individual's physician will not perform the test, seek a second opinion physician.
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Sendhelp Aug 2021
So glad that I did not need to come over here and type this excellent advice out!
Especially not the simple dip stick test!

I hope we, as caregivers on this forum, never forget to offer this advice early on, as time is of the essence!

Thanks Llama!
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See a urologist if necessary.
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Infections, low blood pressure, low oxygen levels, imbalances in blood chemistry, low blood sugar, strokes... can all cause worsening of the symptoms you mentioned. If her doctor is not willing to look at physical issues for your loved one's problems, find a doctor who will.
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how long has your loved one had dementia? its possible that they are just progressing in the dementia. Why haven't you requested a urinalysis test be done just to be on the safe side, you can request that. and if you think really bad, take to the ER and they will run a test if you think having serious problems. its an expensive way to get one done, but they should run one. wishing you luck.
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