If you're caring for someone with dementia, it's important to understand how UTIs may present and what actions you should take if you suspect one. This quick guide covers the key signs to watch for, how infections can impact dementia symptoms and when to seek medical help.

Why People With Dementia Are at Higher Risk for UTIs

Older adults with dementia can be especially vulnerable to urinary tract infections. A combination of physical and cognitive factors can make it harder for them to maintain good urinary health — and easier for infections to take hold. Some of the most common risk factors include:

• Incontinence or hygiene challenges. Difficulty managing personal hygiene can allow bacteria to spread more easily and lead to infections.
• Limited mobility. When someone isn't able to move around easily or use the restroom independently, it can increase the risk of UTIs.
• Cognitive changes. Memory loss and confusion can cause someone to ignore or misunderstand the need to urinate or the signs of an early infection.
• Dehydration. People with dementia may forget to drink water or may not recognize thirst, leading to concentrated urine that makes it easier for bacteria to grow.
• Side effects of medications. Some medications used to treat dementia symptoms, blood pressure or other conditions can increase the risk of urinary retention or infection.

Recognizing UTI Symptoms in a Person With Dementia

Recognizing a UTI in someone with dementia can be tricky. Instead of typical signs like burning during urination, a person with dementia may show changes in behavior or overall well-being. Some possible signs include:

• Increased confusion or disorientation. A sudden worsening of memory or communication skills can point to an infection.
• Agitation or restlessness. Someone who's normally calm may become easily upset, angry or combative.
• Sudden lethargy or withdrawal. They may seem unusually tired, uninterested in activities or less responsive.
• Loss of appetite. Eating habits may change drastically, sometimes leading to rapid weight loss.
• New or worsened incontinence. Accidents may become more frequent, even if the person was fairly continent before.
• Fever, chills or shivering. These physical symptoms can sometimes accompany behavioral changes but may be overlooked if not closely monitored.

How UTIs Can Worsen Dementia Symptoms

A urinary tract infection can worsen dementia symptoms. Even in the early stages of dementia, a UTI may trigger sudden confusion, disorganized thinking or memory lapses that seem more severe than usual. This can be frightening for both the person affected and their caregivers.

In some cases, the infection causes a rapid onset of delirium — a state of extreme confusion that can include hallucinations, paranoia or difficulty speaking. These symptoms often appear suddenly and may be mistaken for permanent dementia progression. However, once the infection is treated, many people return to their previous cognitive baseline or close to it.

What Caregivers Should Do If a UTI Is Suspected

If you think your loved one might have a UTI, taking quick and thoughtful action can help prevent serious complications. Here’s a simple step-by-step guide for what to do:

1. Watch for sudden changes in wellness or mental status. Keep an eye out for unusual behavior, confusion or physical symptoms like fever or incontinence.
2. Document what you’re seeing. Make note of what’s different and when it started — this can help medical professionals make a faster, more accurate diagnosis.
3. Encourage hydration. If the person is willing and able to drink fluids, offer water or favorite beverages to help flush the urinary system.
4. Use at-home test strips, if available. These can give you an early indication of a UTI, but they’re not a substitute for medical care.
5. Contact a health care provider. Call the doctor or care team to report your concerns and request a urine test if needed.
6. Follow through on treatment. Make sure any antibiotics are taken as prescribed, and keep monitoring for symptoms during and after treatment.

Preventing UTIs in People With Dementia

While not every UTI can be avoided, small daily habits can help reduce the risk. Encourage regular hydration by offering water often — especially with meals and medications. Even a few sips at a time can make a difference.

Maintain a bathroom routine. Prompting someone to use the restroom at regular intervals may prevent accidents and reduce infection risk. Gentle hygiene support also goes a long way.

Encouragement for Caregivers

Caring for someone with dementia can be incredibly rewarding — and incredibly challenging. When sudden changes in behavior or health happen, it’s easy to feel overwhelmed or unsure what to do next. Remember, you don’t have to navigate it alone.

At Autumn View Gardens in Creve Coeur, our memory care team is trained to recognize subtle signs of infection and other health concerns. We work alongside families to ensure residents receive compassionate, attentive care every day. Whether you’re a full-time caregiver or exploring supportive living options, we’re here to help every step of the way.