Infections and Dementia

What do I need to know about urinary tract infections?

Elderly people are more prone to urinary tract infections than younger people. This is because they are more likely to have bacteria in their genital/urinary areas. They are also more likely to be incontinent, prolonging their urethras to exposure to the bacteria present in urine and feces. Elderly people are also more likely to have problems emptying their bladders, causing urine to stagnate and become a haven for bacteria.

Confusion is often the first and only sign of a urinary tract infection in an elderly person. The bacteria that invade the urinary system can cross over to the circulatory system. Once inside the blood, the bacteria can produce toxic byproducts that get into the brain through circulation and cause damage. The result is confusion or delirium that may or may not be permanent, depending on how quickly the condition is caught.

One of the most common symptoms of a urinary tract infection is painful urination. When you urinate, you may experience an intense burning sensation. You may also experience pain in your pelvic region or lower back. The burning is caused by bacterial inflammation of the urethra, the tube through which urine leaves your body. The pelvic pain is caused by an inflammation in your bladder, while distressed kidneys can cause lower back pain. All these structures are part of the urinary system, but distressed kidneys are a more serious problem than the others. Keep in mind that people with dementia may not be able to tell you that they are having pain, so it is important to pay attention for non-verbal signs.

What else should I do to prevent infections?

People with dementia have an increasing risk of getting sick or getting an infection as the disease progresses. This includes an increased risk of pneumonia and COVID-19. Here are things you can do to decrease the risk of infection:

• As a caregiver, make sure your stay up to date on your own vaccines. Get the flu shot as early as possible every year. If you have not gotten the COVID-19 vaccine you should. If you have gotten the COVID-19 vaccine, check with your provider to see when you should get booster shots. Make sure to tell your provider you are caring for someone that has dementia so they may be immune compromised.

• Keep the vaccines up to date for the person with dementia. Make sure they get their flu shot as early as possible every year. Get them the pneumonia vaccine as directed by their provider to help reduce the risk of pneumococcal pneumonia (a lung infection caused by bacteria). Treat cuts and scrapes immediately. Clean cuts with warm soapy water and apply an antibiotic ointment. If the cut is deep, seek professional medical help.

• Keep the teeth and mouth clean. Good oral hygiene reduces the risk of bacteria in the mouth that can lead to pneumonia. Brush the person's teeth after each meal. If the person wears dentures, remove them and clean them every night. Also, use a soft toothbrush or moistened gauze pad to clean the gums, tongue, and other soft mouth tissues.

• Maintain good hand hygiene by washing your hands or using an alcohol-based hand sanitizer before and after providing care.

• Help the person with dementia with hand hygiene, as they may not wash their hands when they are supposed to (like after going to the bathroom or before eating). You may need to demonstrate proper handwashing or help them to wash their hands. Consider putting up a sign in the bathroom reminding them to wash their hands with soap. Use alcohol-based hand sanitizer as a hand-washing alternative. You may also consider a hand-washing schedule. If you are sick, maintain good respiratory precautions. This includes wearing a mask. If you are unable to wear a mask, make sure to cover your mouth if you need to cough or sneeze, use tissue for a runny nose, and make sure to wash your hands frequently especially after coughing, sneezing, or blowing your nose.