From the Nurse’s Desk: Infection

It is important to be on the lookout for signs of infection in people with Alzheimer’s and dementia.  A person whose cognitive functioning is intact would tell us if he/she is in pain or doesn’t feel well.  But dementia makes this process more difficult.  Those with dementia can’t always express how they’re feeling.  The key to detecting infection is noticing symptoms and changes in behavior.

There are several types of infections that can cause mental status changes in your loved one. Some of the most common infections include:

  • Urinary tract infections (UTI)
  • Upper respiratory infections
  • Ear infections
  • Sinus infections
  • Abscessed teeth

How can you tell if your loved has an infection?

A person with dementia who is experiencing an infection may demonstrate the following symptoms:

  • Fever – Look for warm forehead, dry lips/skin, or signs of shivering.
  • Increased Confusion –Although it may sound like a challenge to notice confusion in someone who has dementia, an infection can cause significant changes that may include increased disorientation to person, place, or time. Remember you know your loved one’s baseline, so if something seems off, it may be a sign. Mental status changes are your biggest clue.
  • Pain or Discomfort – Watch for non-verbal signs of pain such as grimacing, guarding against touch, crying, refusing to eat, and restlessness. 
  • Abnormal Urine – Check your loved one’s urine for odor, cloudiness, dark color, or blood.
  • Increased Lethargy – Look for out-of-the-ordinary fatigue, withdrawal, and desire to sleep.
  • Decreased Appetite – Some infections can cause nausea and vomiting, and others might just cause someone to feel a little “off” to the point where they just don’t want to eat.
  • Falling – Infections can affect balance and cause muscle weakness.  Repeated falls may be a sign.
  • Paranoia or Hallucinations – If your loved one does not normally experience hallucinations, seeing or hearing things that aren’t there could be an indicator.  Some people become very suspicious of others.
  • Behavior Changes – People with Alzheimer’s and other kinds of dementia may experience some challenging behaviors, but an infection can cause a significant increase in the frequency and intensity of those behaviors.  Your loved one might be somewhat resistant to getting dressed in the morning, but an infection could trigger an extreme reaction of screaming, swearing, hitting and throwing things.

What do you do if you notice these changes in your loved one?

Inform your doctor right away!

It is important to have a great primary care physician involved in your loved one’s care.  Be sure to explain everything you’re noticing that’s different in your loved one’s daily operations.  Remember you are the eyes, ears, and voice for your loved one, so you must advocate for him/her. 

If medication is prescribed, finish all the antibiotic or treatment.  If you do not see any changes within a few days, call the doctor back and discuss further treatment options.