When a person living with dementia seems suddenly more confused than usual, it is easy to assume the dementia is simply progressing. Sometimes that is not what is happening. In older adults, a urinary tract infection, or UTI, may show up as mental-status changes or confusion rather than the more familiar symptoms people expect.
This matters because persons living with dementia may not be able to clearly describe pain, burning, urgency, or pressure. What families and staff may notice first is a sudden shift in behavior: more restlessness, withdrawal, agitation, fatigue, or increased disorientation.
A person-centered response starts with curiosity rather than assumption. Instead of asking, ‘Why is this person acting this way?’ it is often better to ask, ‘What might this person be experiencing that they cannot explain?’ That shift matters. Person-centered dementia care focuses on seeing the whole person, not just the diagnosis, and on responding with empathy, individualized support, and practical observation.
Possible signs that should prompt a medical call include a sudden increase in confusion, new incontinence, unusual sleepiness, nausea, foul-smelling urine, fever, flank pain, or a sharp change from the person’s usual baseline. A sudden change should not automatically be dismissed as just dementia.
For professionals and organizations, this is one reason dementia education matters so much. Teams need to recognize that behavior may be communication, and that communication may point to pain, illness, infection, dehydration, or another unmet need. NCCDP’s ADDC Seminar is designed to build that foundation, and NCCDP’s certifications support professionals who want stronger, evidence-based dementia care skills across settings.
