Week 6

        One of the most frequent triggers of severe delirium episodes in elder dementia sufferers is a urinary tract infection (UTI). A UTI is an infection that enters through the urinary tract via the urethra. If not addressed promptly, germs can migrate throughout the body, damaging the kidneys and the bladder.

        Delirium caused by a urinary tract infection occurs quickly, leaving sufferers and caretakers befuddled. These individuals may be unable to explain how they feel or what sensations they are having, based on their level of disorientation and age. Electrolyte imbalances, dehydration, substance misuse, as well as other health problems can cause disorientation and delirium. 

Additional tests:

        A basic urine examination, and also a urine culture, will be done for this individual to determine what microbe he or she is developing. Complete Blood Count  (primarily to check for White Blood Cells), Comprehensive Metabolic Panel (to evaluate all ions and renal functionality), urine substance screening, thyroid profile, and blood cultures will also be ordered (to exclude sepsis). Based on the sufferer's condition, radiological scans may be ordered.

Treatment plan:

        To prevent additional difficulties, this individual must be managed in a healthcare setting. His age, severe delirium, urine leakage, and other persistent health issues are all major risk factors (Chronic Obstructive Pulmonary Disease, high blood pressure, and dementia). Macrobid is an appropriate medication for this individual in fighting the illness (however this may alter based on the blood/urine cultures). To rectify the osmotic imbalances, Intravenous fluids will be recommended, as well as respiratory therapy to alleviate his difficulty in breathing. The idea is to maintain the sufferer safe, thus a 24-hour sitter will be beneficial till his state of mind recovers. If his disorientation does not alleviate after 3 days of treatment, a brief prescription of psychiatric drugs may be required. Once the individual is no longer in the harmful loop, medical professionals must address the need for regular cleanliness and hydration with the relatives and the individual.

References

Balogun, S. A., & Philbrick, J. T. (2013). Delirium, a Symptom of UTI in the Elderly: Fact or Fable? A Systematic Review. Canadian geriatrics journal : CGJ, 17(1), 22–26. https://doi.org/10.5770/cgj.17.90

Krinitski D, Kasina R, Klöppel S, Lenouvel E. (2021) Associations of delirium with urinary tract infections and asymptomatic bacteriuria in adults aged 65 and older: A systematic review and meta-analysis. J Am Geriatr Soc. 2021 Nov;69(11):3312-3323. doi: 10.1111/jgs.17418. Epub 2021 Aug 27. PMID: 34448496.