Behavioral symptoms in Alzheimer’s patients are not always because of the disease. Causes can be UTI(urinary tract infection), constipation, and/or medicinal reactions. If your LO presents unusual, sudden,uncontrollable behavior, increased confusion/distress(see symptoms below) consider any one, or all, of these. Discuss them with their doctor, and insist on the proper testing.

“Urinary tract infection in the elderly or in people with Alzheimer's can profoundly affect not only their health but can have a dramatic effect on behavior such as increasing confusion and/or aggression. Urinary tract infection is in fact the number-one cause of delirium in patients with Alzheimer's disease. They may not be able to verbalize sufficiently well to tell you how they feel or what exactly is wrong. It means it is important to be aware that certain symptoms may mean a person has a urinary tract infection

SIGNS/SYMPTOMS OF URINARY TRACT INFECTION
The urine will look cloudy or milky. If blood is present then the color will be reddish color

Urine can often smell offensive

Nausea and even vomiting may occur in kidney infections

Frequent urge to urinate but often the amount of urine passed is small

Fatigue. You will notice that the person with Alzheimer's may be less willing to carry out tasks or be more reluctant to eat or exercise

Fever (this may mean that the infection has moved into the kidney)

Painful, burning sensations in the area of the bladder or urethra, during urination. The person with Alzheimer's may cry out or show distress when urinating

Back pain. Someone with Alzheimer's may clutch or rub their back


CAUSES OF URINARY TRACT INFECTION
Some people are more likely to get a urinary tract infection than others.
In women the rate of urinary tract infections gradually increases with age. Why women are more prone to urinary infections than men unclear. There are a number of factors that may contribute or cause UTI's. (a)A woman's urethra is short, allowing bacteria quick access to the bladder. (b)The woman's urethral opening is near the anus and vagina and their bacteria. (c)sexual intercourse appears to trigger UTI infection.

People with diabetes have a higher risk of a UTI because of changes in the immune system. Any disorder that suppresses the immune system raises the risk of a urinary infection.

Any abnormality of the urinary tract that obstructs the flow of urine such as a kidney stone or enlarged prostate gland can slow the flow of urine, thus raising the risk of infection.

People who are catheterized or have tubes placed into the bladder are more prone to urinary tract infection. Infection can be introduced when catheters are inserted or bacteria can contaminate the catheter when they are used long term for people who have lost bladder control.”

http://alzheimers.about.com/od/practicalcare/a/uti.htm
http://alzheimers.about.com/od/practicalcare/a/uti_infection.htm

Thanks, maebee. I don't think we can ever be reminded often enough to think of UTI when there's a sudden change in behavior.

I was just telling the caregiver today that I need to call the doc for an order to have DH checked for UTI. In the past few days his insistance on going home, seeing his Mom, etc. have become so profoundly upsetting to him. He literally shakes, and then tells me his stomach hurts. He gets shaky and sometimes pale, appearing like someone in a full blown anxiety attack mode. The last two times the caregiver was with DH he was calm, and quiet, pleasant affect. Today however was a whole different story. Thank goodness she was OK with everything today. She admitted that she was quite taken aback by the difference in him today compared to the past two Wednesdays she's spent with him.

If there is ANY CHANGE of behavior-aggression,melancholy, unsteady on feet, violent, not eating/sleeping, sleeping too much, incontinence, etc., etc., etc., INSIST that a urine test is done. Most of the time, you can drop a sample off at the doctor's office.

This is great advice from Maebee. I have had much experience with both moderate and severe changes in behavior that stemmed from a "silent" UTI.

Very often when Mom's behavior and even sometimes cognition changed, though she did not have any symptoms of a UTI, it was indeed a UTI of the "silent" variety. Once she was treated, she was back to baseline.

CAVEAT: Several times my mother had a course of antibiotic therapy but things were still off kilter. When I insisted we re-check the urine, sure enough; she still was with positive results. Twice she had to receive IV abx followed by a more lengthy course of oral abx in order to quell the nasty organism.

Sometimes it's easy to forget about UTI's, but over the years I finally got to the point where I'd think "UTI" first and then other causes later when things went over the top.

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just went through this with my mom. the only symptoms were anger and aggression and increased confusion. A full trip to the ER with CAT scan etc and it is a UTI. Back on a new antibiotic and everything is improved again.

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Keep in mind, that any unusual behavior or mood changes can be attributed to "silent" UTIs and/or constipation. It can be as minor as an appetite change.

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I have a patient not responding to treatment with medicine. She has agitation and anxiety. She is now on Risperdal and celexa. Every time we try to reduce her meds the agitation comes back. Any suggestions?

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What does TTT mean?

TTT means To The Top. It helps keep an important subject current so that it is listed at the top of the forum, without having to elaborate on the subject.

Thank you. I really need help figuring her out. We have tried everything we know. Thanks

Welcome Chezlynn,
OK, I need to ask this: You state that your patient is not responding to medication, yet that her "agitation comes back" when you reduce her meds. Is she OK then, when she has the full prescribed dose?

Has she had a UA?

Thank you.
Here are her symptoms:
Swinging and hitting, screaming, sometimes just yelling. Wandering, throwing herself to the floor. Will not settle for a nap to relax.
What we have done: we have her on an exercise program three times a day where we walk her, we do music therapy, one on ones, rosaries (she used to say them), pet therapy, children therapy, aromatic therapy, reading to her.
Medically done: Risperdal in the morning and at night, Celexa in the afternoon. Pain meds at night. We have tested her labs (Thyroid, Hgb, etc... even her Vitamin B and Thiamin) tested her UA- psoitive each time- but just finished another round of antibiotics. She is also a diabetic. We have also done Dementia pain monitors, sleep monitors, etc...
Problem: On the medicine she is "dopey" and lethargic, almost zoned. We attempt to reduce the meds and agitation is right back. I want the best for her, to have a good quality of life. Thank you for your help.

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How is everyone doing?

I encountered the Urinary Tract Infection problem with my mother 2 1/2 years ago. It was the most bizarre experience I have ever been through. We were up two nights in a row with her vivid imagination. She saw people in the den who were not there. I kept trying to tell her that I thought we should go to the hospital because she might have had a stroke. "Oh,NO!" she kept saying. Eventually she thought she might be having a stroke because her eye was hurting and she'd previously had a stroke that affected her eye. By the time she got to the hospital all the electrilites in her body were out of balance and she had to stay for 3 days. The longest week of my life.

She is clear from a UTI. Now all she does is scream- and constantly. We are walking her for exercise, music and 1:1. Sometimes still to no avail. We have addressed pain. She is either in a "fog" per se, or she is alert and screaming. When asked why- she said because she can. Don't we all feel like that somedays- ha ha. Anyhoo- the screaming is killing the staff and agitating the rest of the residents. Please help. To scream or not to scream- ha ha, that is the question.

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I don't know how else to bring this to attention, other than TTTing.

Great post. My Mom was acting out and once we got her on a regular BM she is much better.

Thanks for the reminder. We can not have to much of this. Very important especially when LO can not express what they want to say.

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She is still screaming. Any ideas? Pain meds just drug her, we are doing tapes now of church music. Also, we asked her daughter to bring in her hearing aid and a tape of her talking to her that we can play. I just don;t want to give up on her.

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Please, remember that ANY change in behavior(bed/floor wetting, confusion, resistance to care, agitation, loss of appetite, etc.) CAN be attributed to Urinary Tract Infection. The only sure way to test is to insist on a CULTURE.

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My patient died. We did everything we could but had to go Hospice. She is at peace now. I wish the group would have posted more ideas other than check her for a UTI.

Chezlynn,
I am so very sorry, for the loss of your patient. I know you have worked extremely hard to find her comfort. It is possible that the area of her brain affected by the dementia, was the cause of her yelling. I do hope you are comforted and find peace in the fact that you did all you could.

[quote]If there is ANY CHANGE of behavior-aggression,melancholy, unsteady on feet, violent, not eating/sleeping, sleeping too much, incontinence, etc., etc., etc., INSIST that a urine test is done. Most of the time, you can drop a sample off at the doctor's office.[/quote]
If there is ANY CHANGE of behavior-aggression,melancholy, unsteady on feet, violent, not eating/sleeping, sleeping too much, incontinence, etc., etc., etc., INSIST that a urine test is done. Most of the time, you can drop a sample off at the doctor's office.

TTT, once again.
Here are the results of a forum search on "cranberry tablets", which shows members' results with trying this natural preventative. Check with your doctor, of course, first.

http://alzheimers.infopop.cc/eve/forums?a=search&reqWords=cranberry+tablets&use_forum_scope=on&forum_scope=214102241


Here is an article I found, describing using cranberry-with other natural ingredients-as a preventative/cure. Again, check with your doctor.
http://www.adaeveningnews.com/local/local_story_099111349.html

We read here, that UTIs seem to be a common occurrence in our LOs. While focusing on prevention is great, a simple urine culture can reveal the presence of an infection, if that is indeed causing changes in behaviors. Some LOs do need constant checking, especially before medication changes.

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THX MAEBEE...I ASKED THE DR. AT DAYCARE TO PLS CK FOR A UTI WITH MOTHER....SHE DOESN'T GIVE YOU THE TIME OF DAY.....I TRIED MYSELF TO GET MOM TO WIPE THEN [P] IN A CUP....NO LUCK,,, ANY SUGGESTIONS.....THX..ZOEY M

ps: ALSO CK HEARING AND VISION...????

ZOEY,
IS SHE REALLY A DOCTOR? IS SHE THE ONE WHO WON'T GIVE YOU THE TIME OF DAY? MY GUESS IS THAT, BECAUSE SHE IS NOT YOUR MOM'S PERSONAL PHYSICIAN, SHE IS HESITANT TO TREAT HER. I DO NOT KNOW WHAT HER FUNCTION IS AT THE DAYCARE BUT, I WOULD ASSUME THAT SHE WOULD PREFER YOUR MOM HAVE HER OWN DOCTOR.

MY SUGGESTION IS TO EITHER GET YOUR MOM TO A DOCTOR(PERHAPS WITH THE AID OF THE SEROQUEL), OR GET HER INTO A FACILITY, SO THEY CAN HAVE THEIR DOCTOR TREAT HER.

THERE IS ALSO THE CONSIDERATION OF THE PAYMENTS THE DOCTORS RECEIVE. THE DAYCARE DOCTOR IS NOT GETTING PAID TO BE YOUR MOM'S PRIMARY DOCTOR.

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Debbie25 has just encountered the dread UTI in her ADLO, which apparently caused sepsis. Nasty symptoms, panic trip to the ER. (All is well, now.)

She commented that it might be a good idea to have a test for UTI done just before switching meds, so that we have a better idea of whether a change in behavior is due to side effects from the new med.

Which I thought was a great idea!

ttt for maebee, since she's probably too weak to do it herself today...

I feel gooooood today! But thanks anyway, JAB. I am actually 3-4 pounds lighter!

Oh, hey, now that's incentive for getting a colonscopy if I ever heard any!

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My turn!

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Keep in mind, the symptoms in our ADLOs could be drastically different, than in a "healthy" individual.

They can include:
Delusions
Hallucinations
Rage
Frustration
Anger
Confusion
Withdrawing into one’s self
Refusing to eat/loss of appetite
Change the way they walk/inability to walk
Complaining of pain in other parts of body
Bed/floor wetting