People with dementia often get infections. In fact, infections are a common cause of death among people with dementia. Many different kinds of infections can occur. The most common are infections in the lungs, urine, or skin.
Lung Infections (Pneumonia)
Lung infections are called pneumonia (nu-MON-ya). Pneumonia happens when germs from the nose, mouth, and throat spread down into the lungs.
When people with dementia get pneumonia, they often have a cough and may have a fever. They may also just be sleepy, not want to eat, or be more confused than usual.
The way to know for sure if someone has pneumonia is to get a chest x-ray. The picture below shows what pneumonia can look like on an x-ray. Sometimes it may be bigger or smaller than on this picture, or be in a different place in the lungs.
Pneumonia can often be treated with antibiotics, either as pills or through an IV. Some kinds of pneumonia can be prevented with a vaccine.
Before treating pneumonia in someone with advanced dementia, it is important to decide if the person would want to be treated or not. Many times, people with dementia would want to be allowed to die from the pneumonia. They just get sleepy and slip away to death without pain. In fact, there is a saying for just that situation - that "pneumonia is an old man's best friend."
Urine infections are also common in people with dementia. They happen when germs from outside the body spread into the bladder and kidneys (see picture). Urine infections are most common when people have catheters (tubes) put into their bladder, to collect urine. They can also occur without catheters.
People with dementia who get urine infections may have pain when they go to the bathroom. They may also have a fever. Or, you may notice changes in their behavior, like being more sleepy, more confused than usual, or even angry.
The way to tell for sure if someone has a urine infection is to run lab tests on the urine. If there is an infection, it can be treated with antibiotics. Just as with pneumonia, for someone with advanced dementia you need to decide if the infection should be treated.
Many people with advanced dementia lie in bed for long periods of time. When that happens, they can get "bed sores." The sores most often occur on parts of their body that have constant contact with the bed, like the lower back or the hips (see picture).
Bed sores can get infected with germs, causing redness, pain, fever, and other problems. They are very hard to treat. Bed sores can get infected with germs, causing redness, pain, fever, and other problems. They are very hard to treat.
The best way to deal with bed sores is to prevent them from happening in the first place. That means making sure that the person with dementia does not lie or sit in the same position for long periods of time. Even if they are in bed or in a chair all day, they should have their position changed at least every two hours.
Written by: Barry D Weiss, MD, University of Arizona College of Medicine