I have an elderly client who has senile dementia. She tends to be a bit paranoid, and she has some wild stories about how particular people are trying to take advantage of her, but in general she’s lucid and pretty on top of things.
The last few days she started hallucinating–people in her room, that sort of thing. The RN sent us to the urologist, and when I told the intake nurse there that Client had been hallucinating, she said “Oh, that’s a sure sign.” Sure enough, she had a severe UTI.
So…is there a correlation that I never knew about, or is this a particular feature of my client’s dementia? Just curious.
Best,
karol
WAG, but could it be because of fever? You can run a fever with really bad UTIs, right? So maybe bad fevers in the elderly = hallucinations? 
Acute changes in mental status is one of the most common presenting complaints of the geriatric pt with UTI with or without dementia. In the ER, ‘grampa’s not acting right’ will get us reaching for our urine dipsticks every time.
ETA: I think most of the usu signs and symptoms of UTI are overlooked by the pt or caregiver (frequency, incontinence, burning? we didn’t notice th change)
So interesting. I’ve had kidney/bladder problems all my life, so I just never made the connection. She wasn’t running a fever with this one–forgot to mention in my initial post.
Elderly people often don’t run fevers when they have an infection. Delirium is therefore a common initial presentation of infection in elderly patients (and unfortunately can be confused with dementia by inexperienced care providers).
Anecdote: my wife’s nan was ill over xmas with a UTI, and experienced exactly those type of “stranger in the room” halucinations.
My client is feeling better, and there are no more children taking up all the closet space in her room. 
So what causes the delirium?
i’m figuring on hydration problems. that could send things wonky.
add me to the list of noticing odd thoughts and behaivour during uti of elder relative.