Is there a connection between Sundowning and Urinary tract Infections (UTI)? UTI’s are uncomfortable for some, bothersome for many but can have severe consequences for the elderly or those with diseases in which dementia is symptomatic.
Sundowning is not a disease but is a symptom of diseases such as Alzheimer’s, Parkinson’s or dementia related diseases. Sundowning causes a patient to become super charged or super active at night. It can begin anytime after dinner and continue well into the night.
Sundowning Symptoms And Sundowning Syndrome
Common symptoms of sundowning or sundowners syndrome include: confusion, agitation, anxiety, aggressive behavior, restless behavior, inability to sleep, pacing, combative behavior. This presents a duo fold problem as a patient needs monitoring and attentive care during sundowner episodes; the sundowning tends to occur at the end of the day for the caregiver when the caregiver is the most tired.
Patients with progressive neuromuscular diseases and an already compromised ability to walk or balance are at a physical risk of falling during sundowning episodes which causes safety concerns for the patient. While the cause of sundowning has not been found, the internal clock is disrupted and the consequences for the patient and caregiver can be profound physically, emotionally and financially.
Urinary Tract Infections
One often overlooked cause of sundowning are Urinary Tract Infections (UTIs.) In a healthy individual a UTI is uncomfortable, but considered a minor infection. However in individuals battling a serous disease with a compromised immune system and frequently being prescribed brain altering medications, a UTI can bring on sundowning episodes without warning.
An undiagnosed UTI is many times diagnosed after investigation into a sundowning episode in an individual which has not exhibited tendencies to sundown prior. Caregivers may notice increasing symptoms of sundowning and should investigate any underlying medical causes which may cause the sundowning. Along with UTI’s, low blood sugar, dehydration, hospitalization, fluctuating electrolyte levels can also trigger a sundowning episode.
Patients with dementia symptoms are particularly susceptible to sundowning. Sundowning can present itself more severely with a wider fluctuation of moods, aggressiveness, confusion, and delirium.
UTI’s are always a threat for the elderly and can affect the bladder, kidney, ureter or uretha. Common symptoms are fever, nausea, chills, vomiting, pain caused when bacteria enters into the urine and multiplies. Nursing facility residents and hospitalized patients or home care patients with catheters are also highly susceptible.
UTI’s Should Always Be On the Radar In Connection With Sundowning
All caregivers for the seriously ill should keep urinary tract infections on the radar as a possibility should a sudden change in mental condition occur. UTI’s are the second most common reason people seek medical help in the United States. UTIs are easily diagnosed and generally a regime of antibiotics is prescribed once a diagnosis is confirmed. If a patient is confined at home due to illness, dipsticks aka urinalysis kits can be easily purchased over the counter for an immediate result. This should not take the place of medical consultation; however, if a patient is an invalid with a tendency toward urinary tract infections, the dipstick/ urinary strip is wise to have immediately available.
At home hospice patients can also benefit if a caregiver has access to a urinalysis kit. Caregivers have immediate access to the hospice nurse via phone; however, it can be helpful for the hospice nurse or doctor to have a home analysis as the symptoms are investigated over the phone and prior to a home visit where a professional will also perform a urinalysis.