Why is Grandma Suddenly Confused?

Confusion in Seniors Can be a Result of a Urinary Tract Infection (UTI)We recently got a phone call from caregiver “Sherry,” who was concerned about one of her clients.  She was concerned because her client “Inez” was acting, in Sherry’s words, loopy.  Inez was disoriented, wasn’t making good decisions, and was lacking her characteristic lucidity of thought.  Sherry was very concerned that Inez had mis-monitored her diabetes.

Carol Hauser, our community relations liaison, had a similar experience in her own life.  Although her mother-in-law Marilyn has advanced Parkinson’s disease, her mental state has always remained intact.  After a phone call with Marilyn one evening, Carol’s husband was concerned.  His mother’s conversation was disjointed, jumping from a variety of disconnected ideas.  She wasn’t making sense at all, and it was frightening.

Having worked in eldercare in Minnesota for over nine years, Carol knew what was up.  After a trip to the doctor, her mother-in-law—as was Inez—was diagnosed with a urinary tract infection (UTI).

To help you through any potential UTIs with your parents, Carol, who has a Master’s degree in Gerontology, offers the following:

If an elderly parent seems suddenly confused, it’s tempting to fear the onset of Alzheimer’s disease.  Sometimes people also just chalk it up as a normal attribute of aging.  These, however, may not be the correct assumptions.  If your elderly parent is exhibiting signs of confusion, it’s a good idea to seek advice from a healthcare provider.  If the onset of confusion happened quickly, don’t be surprised if the doctor orders a urine specimen.  And a urine specimen would be a good first step since UTIs are a common cause of delirium in the elderly.

Urinary tract infections, with or without symptoms, are quite common in the elderly:

  • According to a 2005 article in Drugs Aging entitled “Asymptomatic Bacteriuria in Elderly Patients,” 20-25% of women and 10% of men over the age of 65 have bacteria in their urine without symptoms, also known as asymptomatic bacteriuria.
  • People over 80 years are even more likely to develop asymptomatic bacteriuria—over half of women and over a third of men.
  • According to The Merck Manual of Geriatrics, as many as 10% of all elders have symptomatic UTIs.

If you are taking care of elderly parents, note that a senior who is experiencing signs of cognitive difficulties should also be closely monitored for other signs of a UTI, such as:

  • Urine that appears cloudy
  • Bloody urine
  • Strong or foul-smelling urine odor
  • Frequent or urgent need to urinate
  • Pain or burning with urination
  • Pressure in the lower pelvis

The most common treatment for a UTI in the elderly, once properly diagnosed, is an antibiotic regiment. UTIs can be prevented or their recurrence minimized by:

  • Not using douches or other feminine hygiene products
  • Not drinking fluids that tend to irritate the bladder, such as alcohol and caffeine
  • Drinking cranberry juice or taking cranberry supplement tablets, but only if your parent or your family does not have a history of kidney stones
  • Drinking lots of water
  • Keeping the genital area clean. If wearing adult incontinence products, see that they are changed regularly.
  • Always wiping from front to back (for women)

—Carol Hauser, M.A. Gerontology


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