Urinary Tract Infection Delirium Vs. Dementia

Did you know that some hospital and nursing home staff knowingly spread urinary tract infections from patient to patient?

And truth be told, some of these bacteria-spreading nurses may have acquired UTIs, themselves, while spreading the infection around. How are they doing this? By neglecting to wash their hands between patients.

It happened to me.

I had a chronic hospital-acquired UTI that I picked up during my first hospital stay, five years before I died.  It was the worst kind – a super infection that spreads from patient to patient by hitching a ride on the hands of nurses.  Let me tell you how it works.

They may be wearing gloves, but it does no good if they’re putting them on with unwashed hands.

Nurses always wear gloves when inserting and removing patient catheters, and they change gloves between patients.  That is comforting to know, right?  But I wonder how many nurses actually wash their hands with soap and water before they reach for a pair of gloves, and after tossing them in the trash?  

Think about this.  If a nurse does not wash his or her hands before slipping on a fresh pair of gloves, any hand bacteria transfers to the outside of the gloves as they pull them from the box.  And what part of the gloves touches the patients?  The outside, of course.  

Or if the nurse does wash his or her hands before putting on the gloves, but then starts texting on a cell phone before inserting that catheter – well, germs living on the phone march right on in with the catheter, and take up residence.

Hand sanitizing gel is useless for “Super UTIs”.

Here’s something else to think about.  Hand sanitizing gels kill most, but not all, bacteria.  It does not kill the kind that lives in the intestines – such as e. Coli.  Only soap and water can destroy that.  Well, guess what: hospital-acquired antibiotic-resistant super infection UTIs  contain e. Coli bacteria.  

So if a nurse does not wash his or her hands with soap and water, prior to putting gloves on, voila! the infection gets passed to the next unsuspecting victim.

All nurses know this. They learn it in nursing school.

There’s more bad news, in addition to all that.

Once a patient acquires this type of infection, it is next to impossible to cure because it is antibiotic-resistant.

There is only one oral antibiotic I know of that can completely destroy the bacteria: Nitrofurantoin (Macrobid).  But if you’ve got reduced kidney function, as I did, it can kill you, along with the infection.  So yes, my final UTI was destroyed, alright, but so was I.

An antibiotic called Macrobid caused my death.

There is an IV Antibiotic that works better, and less likely to kill you – but Medicare won’t pay for the full number of inpatient days required to complete treatment.

The antibiotic is called Meropenem.

So . . . the hospitalist generally starts you on the antibiotic IV wonder drug, then sends you home in a couple of days (sometimes same day) with an oral antibiotic to finish the course.

But the oral antibiotic does not destroy the infection remnants, at least that was true 100% of the time in my case.  Interestingly, they never sent me home with Macrobid. It was usually some other type that was not even labeled for antibiotic-resistant UTIs.  Maybe Macrobid is too strong to use in conjunction with the powerful IV antibiotic.  I’m not really sure.  But the point is – the UTI is usually not fully treated, stays alive in trace amounts, and eventually flares up again.  

I’ve been through this scenario more times than I can count. In fact, I tested positive for UTI each time I went to the hospital.

The hospital got in the habit of routinely checking me, as a precaution. 

I became a “frequent flyer” patient

I was in and out of the hospital and different rehabs for post-hospital therapy more times than most.  Hospital staff recognized me upon arrival, if that tells you anything.  My admissions were for repeated falls resulting from medication effects, hospital-acquired Cellulitis flareups, and a couple of times because I was simply acting crazy from UTI infections that hadn’t been adequately treated in the past.

But it was not my fault.

Every single one of my hospital admissions was directly or indirectly related to medications given me by doctors, and flareups of super infections acquired from the hospital.  They referred to me as a frequent flyer – yet they were the reason I kept coming back.  How’s that for irony. 

These UTI flareups caused me to have delirium.

One month before I died, the memory care facility I lived at transported me to the emergency room for evaluation and treatment because I was developing significant mental and disruptive behavioral symptoms they had not seen in me before.  They didn’t know if my dementia had suddenly taken a turn for the worst, or not; but were quick to get me in the hands of medical professionals who could evaluate me.

I went to the hospital.

The facility called Janet to let her know they were transporting me, and Janet left work to meet me at the hospital.  

She found me in a state of delirium.  I wasn’t making sense.  But I was trying hard to communicate.

They discovered a raging UTI – which had flared up numerous times in the past, but this was the worst case of it.  

They started me on Meropenem, a very powerful IV-administered antibiotic used for serious antibiotic-resistant UTI infections.

The delirium went away next day as the antibiotic started to work on my UTI.


Rehabs and nursing homes often mistake cases of UTI for dementia.  As a result, they use antipsychotic drugs without even checking for UTI. It happened to me more than once.

Haldol, Resperidone, or Seroquel (antipsychotic drugs).  Hospital doctors also use these drugs for delirium.  And my UTIs were no exception.   Janet had to put it in writing to stop use of these drugs with me, as they only made matters worse.

And sadly, many people with UTIs are given these drugs while the UTI goes undiagnosed.  

Mental, emotional, and behavioral signs are often the only UTI symptoms in elderly patients.

Symptoms experienced in younger people, such as fever, burning sensation, or physical discomfort do not always manifest in elderly patients.  

A UTI can also masquerade as dementia in persons who don’t even have dementia.  In fact, that was happening to me.  I was getting “temporary dementia” or “pseudo dementia” due to UTIs, off and on for a few years before my “real dementia” began.  My actual dementia did not truly begin until maybe a year or less before my death – which is about the time I began to think my plush toy Kitty Cat was real.  That is not to say that people didn’t assume I had dementia when I did not – because they often did.  Yet it always seemed to disappear with treatment of the underlying UTI.  That said, I did eventually develop “real dementia.”

If you take away only one thing from this post, let it be to think “UTI,” first, when there is a quick, significant, and unexplainable change in mental, emotional, or behavioral state.

It is not always dementia or worsening dementia. And it does not have to be permanent.  Have it checked out before jumping to incorrect conclusions.

Things are not always as they appear.


Must-read links from Susan Macaulay:

12 UTI symptoms experienced by the elderly and what they’re like in real life

if only they had listened to ciaran


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