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Patients with dementia often cannot clearly express pain or discomfort.
Sudden changes may indicate a medical emergency.
Early recognition and prompt action are critical.


① Suspected UTI (Urinary Tract Infection)

In dementia patients, UTIs often appear as behavioral or mental changes, not urinary complaints.

✔ Common Signs

  • Sudden confusion or agitation

  • Increased restlessness or aggression

  • Hallucinations or incoherent speech

  • Strong-smelling or dark urine

  • Frequent urination or discomfort

  • Low-grade fever or unusual fatigue

✔ Caregiver Actions

  • Check hydration status

  • Measure temperature

  • Observe urine color, smell, and output

  • Notify the nurse or healthcare provider immediately

  • If symptoms worsen or fever is high → Go to the ER


② Sudden Confusion (Delirium)

Delirium is not the same as dementia.
It develops quickly and fluctuates, often indicating an underlying illness.

✔ Warning Signs

  • Sudden inability to recognize people

  • Increased confusion at night

  • Hallucinations or paranoia

  • Alternating drowsiness and agitation

  • Rapid changes throughout the day

✔ Common Causes

  • Infection (UTI, pneumonia)

  • Dehydration

  • Medication side effects

  • Pain or constipation

✔ Caregiver Actions

  • Report any sudden mental change immediately

  • Review recent medication changes

  • Check hydration and bowel status

  • Delirium is a medical emergency


③ After a Fall: How to Assess

Even if the patient appears fine, internal injuries may be present.

✔ Check Immediately

  • Did the head hit the ground?

  • Decreased alertness or excessive sleepiness

  • Vomiting or headache

  • Weakness on one side of the body

  • Difficulty walking or standing

✔ What to Do

  • Do not allow the patient to get up alone

  • Head injury + blood thinners → Immediate ER visit

  • Observe closely for 24 hours

  • Any abnormal change → Seek emergency care


④ Shortness of Breath, Chest Pain & Severe Delirium

Emergency Checklist

If any of the following are present, call 911 or go to the ER immediately:

☐ Severe shortness of breath
☐ Chest pain or pressure
☐ Pale, bluish lips or face
☐ Sudden severe confusion or loss of consciousness
☐ Cold sweats or extreme anxiety
☐ Sudden drop in oxygen saturation

➡ Tell responders:
“The patient has dementia, but this behavior is NOT their baseline.”


📌 Key Takeaways for Caregivers

  • Never assume changes are “just dementia”

  • Sudden changes = possible emergency

  • Keep notes for healthcare providers:

    • When did it start?

    • What changed?

    • How long has it lasted?

 

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