How UTIs in Elderly Nursing Home Patients Can Lead to Delirium

How UTIs in Elderly Nursing Home Patients Can Lead to Delirium

Jill visited her elderly mother in a local Illinois nursing home at least every other day. Her mother appeared to be adjusting to the facility and was generally in good spirits. One day, Jill went in to see her mother and was stunned to find her extremely agitated, confused, and combative – to the point the staff had restrained her in her bed. Nothing Jill said calmed her mother down. It was almost like her mother had advanced dementia or Alzheimer’s – but whatever was wrong with her had occurred virtually overnight.

Jill had no idea what was wrong with her mother and was unaware that sudden confusion (known as delirium) is common among elderly people who have an untreated urinary tract infection (UTI). Delirium from a UTI can develop quickly, usually resulting in agitation, restlessness, and delusions. The symptoms can vary in intensity throughout the day and may look different from one person to the next.

While agitation is the most common manifestation of UTI delirium, some patients may seem unusually withdrawn and drowsy. Either way, a patient with UTI delirium is less responsive and alert to what is happening around them. Since UTI delirium is the result of an untreated infection, it could be that the nursing home staff are guilty of abuse or neglect. If you suspect your loved one is suffering from UTI delirium, you need assistance from an experienced Peoria, IL nursing home abuse and neglect attorney.  

How Often Do UTIs Occur in Nursing Home Patients?

While the numbers vary, the number of UTIs in older adults increases significantly compared to middle-aged persons. More than ten percent of women over the age of 65 reported having a UTI within the past twelve months, and that number jumps to 30 percent in women over the age of 85.

Although women are much more likely than men to have UTIs, elderly men, in particular, are more susceptible to this type of infection, especially those with a catheter. Elderly patients in nursing homes who are bedridden or spend much of their day in a wheelchair may be more susceptible to UTIs. Even more important, nursing homes that fail to practice good hygiene and infection control will have more patients with UTIs.  

Which Nursing Home Patients Have the Highest Risk for UTIs and UTI Delirium?

Overall, UTIs are the second most commonly diagnosed infection among long-term care residents, comprising more than a third of all nursing home-associated infections. Some patients will have a higher risk of developing a urinary tract infection and UTI delirium. The factors that increase risk include:

  • Changes related to aging, including a weakened bladder function, can cause urinary retention, which in turn increases the likelihood of bacterial growth and the development of a UTI.
  • A natural decline in immune function that accompanies aging makes elderly patients more likely to have a UTI.
  • Alzheimer’s disease and dementia are more common among the elderly, making it more difficult for them to communicate symptoms of UTIs. Left undiagnosed and untreated, complications can arise, including delirium.
  • Those with limited mobility have an increased risk of UTIs.
  • Patients with an indwelling catheter have an increased risk of UTIs, especially when caregivers fail to follow approved protocols for handling catheters.
  •  UTIs among the elderly may present in an atypical fashion, making it more difficult for caregivers to diagnose and treat the infection promptly. Staff members who are unaware of UTI delirium may believe the patient is showing cognitive decline, so they may not suspect a UTI.
  • Many UTIs are the direct result of neglect in the form of unsanitary conditions, chronic dehydration, inadequate assistance when going to the bathroom, poor hygiene, and improper catheter care.

What Are the Symptoms of UTIs and UTI Delirium?

The “classic” symptoms of a UTI include:

  •  Pain, discomfort, or burning during urination
  • Strong-smelling urine
  • Cloudy, dark, or bloody urine
  • The frequent or urgent need to urinate
  • Pain in the lower abdomen
  • Pressure in the abdomen
  • A feeling of incomplete bladder emptying

When an elderly person has UTI delirium, he or she may be less alert and less responsive. The person may be disoriented, seemingly unaware of where they are or what time it is. They may virtually overnight be unable to do something like walk or eat and may struggle to follow a conversation. You could see sudden mood or behavior swings, and the person may even hallucinate, have delusions, or become paranoid. There are three main types of UTI delirium among the elderly, including:

  •  Hyperactive delirium causes agitation and restlessness, an aggressive response to staff and caregivers, an unusual wariness of other people, delusions that cause the person to think someone is trying to harm them, and hallucinations – seeing someone who is not there.
  • Hypoactive delirium may seem sluggish and withdrawn and may stop interacting with others. The person may struggle to focus when he or she is awake. The patient with hypoactive delirium may eat or drink much less than usual and may appear to have little pleasure in people or activities they usually enjoy.
  • A patient with mixed delirium can swing abruptly from hyperactive delirium to hypoactive delirium throughout the course of a day, being extremely agitated one moment and drowsy and withdrawn the next.

The Differences Between Dementia and Delirium

Although dementia and delirium can have some of the same symptoms, they are not the same. Dementia develops slowly, over months or years, while delirium develops suddenly – within one to two days. Dementia worsens over time, while delirium will get better quickly with the right medical treatment, like an antibiotic for UTI. Dementia symptoms tend to be consistent from one day to the next, while delirium symptoms can change from hour to hour. While dementia is a long-term health condition, delirium is an urgent medical issue.

How Are UTIs Treated?

UTIs are treated with antibiotics, but when left untreated, sepsis can develop. Sepsis occurs when the body releases chemicals into the bloodstream in an effort to stop an infection. This flood of chemicals can damage multiple organs. Sepsis can lead to septic shock, a dangerous drop in blood pressure, and even death.

Untreated UTIs can cause permanent kidney damage, and a patient who has two or more untreated UTIs in a six-month period can face a lifetime of recurring UTIs and UTI delirium. General preventative measures for UTIs include drinking cranberry juice and lots of water. This keeps the urinary system flushed and clear of bacteria buildup.  

Recovering From UTI Delirium

For most people, UTI delirium symptoms will improve within a few days once the underlying infection is properly treated. However, some elderly people will not make a quick or full recovery. You may notice your loved one still having memory and thinking problems weeks or even months after the UTI delirium episode. Prolonged or severe delirium from an untreated UTI increases a person’s risk of dementia. The individual may have trouble doing the ordinary things they were able to do before the UTI, and this may or may not resolve with time.

Contact a Peoria County, IL Nursing Home Infection Lawyer

If your loved one has frequent UTIs or has developed UTI delirium, it is important that you look carefully at the nursing home to determine whether there is abuse or neglect occurring. When you have an experienced Peoria, IL nursing home infection attorney by your side, your loved one can get the justice he or she deserves.

Our firm is a small division of a large law firm. This allows us to ensure our clients have the resources and benefits of a large firm while receiving highly individualized attention and care. Contact Nursing Home Injury Center at 309-524-6900 to schedule your free consultation. 

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