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Atypical Cause of Senior Behavioral Change


Mrs. Rider is an 82-year-old woman and lives in an assisted living community. She suffers from persistent depressive disorder, an illness that often makes her sad and agitated. When the assisted living community staff first noticed a sudden change in Mrs. Rider’s cognitive status and when her daughters commented on her increased confusion and withdrawal from social situations, everyone figured these signs were just a part of Mrs. Rider’s depression. Mrs. Rider's clinical social worker noticed the increased confusion and behavior changes and coordinated with her doctor due to the sudden changes. These symptoms did not seem related to her depression, and the social worker encouraged a medical exam for Mrs. Rider. After a full work-up, her doctor diagnosed Mrs. Rider with a urinary tract infection, or a UTI. "We were shocked that this wasn't the depression,” reports Mrs. Rider’s daughter. "It never occurred to us that the symptoms could be due to an infection. We're glad that her social worker did not just dismiss this as part of her depression." It would be easy to overlook these symptoms; older adults often present different symptoms of a urinary tract infection than younger adults. In fact, signs of a UTI in older adults are often largely behavioral. UTI Warning Signs for Older Adults

  • Cloudy or Bloody urine

  • Strong or foul-smelling urine odor

  • Frequent or urgent need to urinate

  • Pain or burning with urination

  • A new onset of incontinence

  • Low-grade fever

  • Confusion, or delirium-like state

  • Agitation

  • Hallucinations

  • Poor motor skills or dizziness

  • Lethargy

Seeking Treatment for a UTI Typically, UTIs, are easy to cure. If left untreated, however, the infection can spread and develop into far more serious conditions. Knowing that a urinary tract infection can present with non-classic signs and symptoms is the first step in avoiding serious complications. Any time a sudden change in behavior is noted in an older adult, a healthcare provider should be consulted immediately. The healthcare provider can order a urinalysis to test for a UTI and prescribe appropriate treatment. Just like with Mrs. Rider, behavior changes can have a physical cause and not a normal part of any existing mental health disorders. Our skilled clinical social workers are always looking out for any behavioral changes (sudden or gradual) and coordinating with other healthcare professionals to ensure prompt medical attention as appropriate.

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