Quote from njmomstudent
I just want to say, I'm only a nursing student and this is NOT a medical question. It is regarding my grandfather. I guess my question is, have any of you experienced delusional patients because of a UTI?? Is that a common side effect for geriatrics that you've noticed? For the past 8 months he's been in assisted living and was doing quite well until recently. He gets bad when he doesn't eat or drink enough. It started one weekend when he didn't make it to dinner, and if he misses one meal, he goes downhill fast. Anyway, he also contracted another UTI. Thats when he started hallucinating. Since he was weak from not eating/drinking, he would hallucinate then get up and fall. He's been admitted to the hospital now and is being treated accordingly, but he is not getting better mentally and its been about a week being treated for the UTI. I don't think the assisted living will take him back, so he will be nursing home bound unfortunately. A few other nurses commented that for some reason, when geriatric patients get UTI's, they tend to get crazy like this. Of course when he is like this he is very difficult to handle. He's always trying to get up and do things he can't, etc. I feel terrible for the nurses honestly. And my mother is beside herself because the nursing home will be the 4th place he's been, and at times, he remembers his modular and asks her if he can go back, and asks her "I don't have to go somewhere else now do I?" None of the nursing homes here are comparable to the wonderful assisted living that took him (the assisted living was GORGEOUS), so its going to be really depressing. The man is 95 and just keeps on going. We would love for him to be able to go home, but his social security income will not cover in home care unfortunately and he needs it 24/7 now. My mom is feeling extremely guilty. Her brother sends his wife and she could care less. And her sister lives 1000 miles away and does nothing but call and harass the nurses/physicians and tell them they are lying about his condition.
Mental status changes certainly can be a sign of UTI. It's so common, in fact, that, when we get a geriatric patient in the ER with this problem, one of the first things we do is collect a urine specimen. And, yes, elderly patients (UTI or no UTI) can get confused and disoriented in the hospital, especially at night. (From my days of floor nursing, I recall that confused elderly women would say, "I have to call my daughter RIGHT NOW" ---at 2:30 am--- "because she's going to be wondering where I am." Confused elderly men would get up in the middle of the night----some of them forgetting that they hadn't been ambulatory for months or years----arguing, "I have to go start the car!" And no amount of reassurance or explanations will convince them otherwise.
Sometimes the confusion and restlessness clears up as quickly as it started: one evening the patient will be climbing out of bed and cursing the staff for putting him/her back in, and the next morning s/he'll be his/her old self. It's hard to say what causes it----fluid imbalance? Infection? Adverse reactions of medications? Being in an unfamiliar environment? or all four?----but it's quite common. Most nurses who have spent time caring for geriatric patients have similar stories.
Unfortunately, there are no easy answers, regarding future long term arrangements for your grandfather. All you can do is choose whichever option seems best, and visit him as often as possible to make sure he doesn't feel that he's been forgotten. Maybe some of the long term care nurses here will have some good suggestions to offer.