UTIs and Dementia: What are the signs?

UTI and dementia are two terms that may not seem directly connected at first, but they often overlap among older people—especially when someone already has memory issues. Urinary tract infections (UTIs) are among the most common infections in older people. Unlike in younger adults, UTIs in older individuals often do not cause typical symptoms like pain or burning when urinating. Instead, they can trigger sudden confusion, agitation, or even hallucinations—symptoms that are sometimes mistaken for dementia progression. 

When someone already has dementia, spotting a UTI can be even more difficult. The person may be unable to express discomfort or recognise something is wrong, making it crucial for family members and carers to be aware of the signs. Recognising the early warning signs and ensuring prompt medical treatment can significantly prevent further health decline. In this guide, we’ll explain UTIs and dementia, the symptoms to watch for, how families can help prevent infections from occurring, and how Tiggo Care’s home care services can help.

What is an Urinary Tract Infection (UTI)?

Urinary tract infections (UTIs) are infections that occur anywhere within a person’s urinary system. This system includes the kidneys, ureters (the tubes leading from the kidneys to the bladder), the bladder itself, and the urethra (the tube that carries urine out of the body). Bacteria, most commonly from the bowel, can enter through the urethra and then multiply rapidly in the urinary tract.

When an infection stays in the urethra or bladder, it’s often referred to as a “lower UTI.” If it travels upward to the kidneys, it’s considered an “upper UTI,” which is more serious. Upper UTIs can lead to kidney damage if not addressed quickly. Some doctors may call a bladder infection “cystitis” and a kidney infection “pyelonephritis.” While these terms can sound complicated, what matters most is identifying symptoms quickly so your loved one can call their GP for advice as needed.

Bacteria thrive in warm, moist environments, so it’s important to support proper hygiene. It’s also crucial to encourage enough fluid intake. Dehydration can increase the chance of infection because your loved one won’t flush out bacteria as effectively. Even though older people can be more prone to UTIs due to weaker urine flow, simple changes can often help, such as making sure they drink regularly and use the toilet on a schedule.

What are the symptoms of a UTI?

Common UTI symptoms include the following. However, keep in mind these can differ or appear subtle in older people:

1. Burning or pain when urinating.
2. Frequent urge to urinate but passing only small amounts.
3. Cloudy or strong-smelling urine.
4. Lower abdominal pain or a feeling of pressure in the pelvic area.
5. Needing to urinate urgently or leaking urine before reaching the toilet.
6. Blood in the urine (often visible as pinkish or reddish streaks).
7. Fever or raised temperature—in older people, this may not always be present.
8. Sudden confusion or disorientation—referred to as delirium, particularly noticeable if it appears unexpectedly.

When an infection travels to the kidneys (an upper UTI), you may also see:

• Higher fever (above 38°C or about 101.0°F).
• Lower back pain, sometimes on only one side.
• Shivering or chills.
• Nausea or vomiting.

If you suspect your loved one has these symptoms, you should contact their GP for advice or call NHS 111. Early intervention can prevent more serious complications down the line.

UTI symptoms in people with dementia

When a person has both dementia and a possible UTI, spotting symptoms becomes more complex. They may not be able to say, “It burns when I pee,” or “My tummy hurts.” Instead, they might appear restless, pick at their clothing, or visit the toilet more often than usual. 

In people with dementia, a UTI can manifest as delirium, which is a sudden state of intense confusion. You might notice that your loved one has completely lost track of time or can’t recognise once-familiar surroundings. This shift can be quite rapid—sometimes in a day or two.

Confusion and changed behaviour are not always tied to infection, but it’s a clue worth investigating. If you notice quick mood swings, irritability, or a sudden withdrawal from conversation, think about whether something physical might be causing it.

Another sign could be a new or dramatic memory lapse. The person might struggle more than usual to find their words or to remember the faces of people they see daily. Because dementia is already present, it can be easy to dismiss these changes as disease progression, but a UTI could be behind the scenes.

A higher risk of dehydration can also show up in ways you don’t expect. For instance, your loved one might be touching their mouth more frequently or refusing meals because swallowing feels uncomfortable. If they’re not taking in enough fluids, their risk of a UTI spikes.
In severe cases, the person might see or hear things that aren’t there (hallucinations) or develop false beliefs (delusions). These symptoms are unsettling for everyone. If you notice them, reach out to a GP for advice as soon as possible.

Careful observation is key. You know your loved one’s habits, expressions, and daily routines. If you see them struggling with toilet tasks or suddenly resistant to personal care, there might be an underlying infection or discomfort they can’t quite describe.

How to prevent UTIs in people with dementia?

Prevention boils down to a few core areas: hydration, regular toilet use, personal hygiene, and prompt attention to any new or unusual behaviour. You don’t need medical training to help with these practical measures at home.

1. Stay hydrated

• Encourage your loved one to drink six to eight glasses of fluid per day if possible.
• Offer drinks they enjoy (tea, squash, or juice) to make it more enticing.
• Use a bright or clear cup so they can see the liquid and remember to drink it.
• Watch for signs of dehydration, such as dark urine or infrequent urination.

2. Encourage good toilet habits

• Prompt your loved one to use the toilet regularly.
• Try to prevent them from holding urine too long.
• Make the toilet easy to find, possibly by adding a sign on the bathroom door.
• Consider a toilet seat in a contrasting colour if they have trouble seeing it.

3. Maintain good hygiene

• Help with daily washing around the genitals using unperfumed soap.
• Avoid talcum powder, which can irritate sensitive areas.
• If you’re assisting a female loved one, remember the “front to back” rule to minimise introducing bacteria.
• Keep wet wipes handy in the bathroom for easier cleanup.

4. Prevent constipation

• Provide a fibre-rich diet, ample fluids, and gentle exercise if they can manage it.
• Regular bowel movements make it easier to fully empty the bladder.
• If constipation persists, talk to a GP for advice on possible remedies.

5. Address continence aids and catheters carefully

• Change absorbent pads frequently, as lingering moisture encourages bacterial growth.
• If a catheter is needed, make sure a qualified nurse fits and cares for it properly.
• Prompt attention to any signs of infection is crucial, as catheters can hasten bacterial spread.

When these supportive measures are in place, you give your loved one the best chance to stay infection-free or reduce the risk of recurrent UTIs. While no one can offer a guarantee, simple daily routines make a difference.

Conclusion

Caring for a person with dementia can already feel like a juggling act, and layering in the threat of urinary tract infections raises the stakes further. However, by staying alert to the common signs of UTIs—such as sudden confusion, unusual agitation, or more frequent toilet visits—you can make sure your loved one’s treatment is arranged quickly. That small window of quick action can help them return to their typical daily rhythm, reducing stress for both you and them. If you notice these signs or have any concerns, contacting the GP for advice is the next logical step.

If you feel you could use more support at home, Tiggo Care can help make life easier. We offer a personalised approach to your loved one’s dementia care, aiming to maximise day-to-day comfort and quality of life. We assist with personal care tasks, medication routines, household chores, meal preparation, and more, all while respecting your loved one’s dignity and doctor’s instructions. 

If you’d like to organise home visits or dementia home care services, reach out to Tiggo Care. We’re here to help you create a safer, more comfortable environment where your family members can continue managing dementia with added support, helping them feel more at ease and less isolated day after day.