Urinary Tract Infections (UTI's) are common in older people, regardless of gender, especially when they become incontinent and rely on the use of an adult diaper. However, many people with dementia or other illnesses are also to the point that they can not tell you if they have pain anywhere, and so you have no idea that an infection is present. In fact, you can have a UTI without pain. But when an elderly person has a sudden change in cognitive function and actions, always check for a UTI.
Mom had a good Christmas Eve but then on Christmas Day she would not eat, not open her eyes, and she had labored breathing. We could not really get her to respond to us anymore and she also lost her limited amount of speech. After a few days, the hospice nurse had Mom checked for a UTI, which came back positive, and we put her on antibiotics. It has taken many days but Mom has regained some of her self back in the last day. When we visited yesterday her eyes were open, she would say a few words to us, and even laugh at what we were talking about. Her appetite has not really changed much, but at least she was much more bright and cheerful.
When you work in a nursing home or in hospice, you are told to always check for a UTI when sudden changes occur but for those of us taking care of loved ones in our own at home, no one may have told us that. I would insist on checking for a UTI at any time there is a big change. It does not hurt to check and if you are right then you have treatment options. I will caution that if your loved one takes the course of antibiotics appropriate for their UTI (which means do not only have the initial stick test done, ask to have a culture sent out), and they do not get better, do not insist that they still have a UTI. Sometimes people will see marked improvement in their loved one after a UTI and then the next time they have one and do not get symptomatically better, the family wants more antibiotics even when tests show the infection in clear. As long as the UTI tests are coming back negative, they do not need antibiotics and they may truly just be progressing in their disease. I know this can be hard to accept, but repeated courses of antibiotics are not safe for long periods of time and you could cause even more problems in the long run. Also, denying that the disease has progressed does not give you, your loved one, and the rest of your family and friends the ability to grieve the change and mentally prepare for what is going on.