This month, a much-loved relative of mine, who lives with dementia, had a fall and was admitted for tests to a hospital – not a Butterfly Scheme one, but this is still a very relevant story. After a few days, her son mentioned to me on the phone that she’d become very confused, thinking she was at a railway station. I was immediately concerned that she had a delirium on top of her dementia; I asked him to contact the senior nurse on the ward, explain how unusual this behaviour was for his mum and ask that she be tested for a urinary tract infection. This was done and she did indeed have a urinary tract infection, so antibiotics were started and the confusion (caused by the infection) was soon gone.

This is an absolutely classic situation, especially when people with dementia become dehydrated during a hospital stay. Prevention is far better than cure, so hydration should always be a priority – but the point of telling this story here is to emphasise to carers how crucial their knowledge of that person is. If someone you care for is more confused than usual, please always act quickly to ask healthcare teams to check whether infection is causing a delirium. Apart from trying to ease the distress to the person with dementia, getting on top of it is important because someone with a delirium is, for example, more likely to fall – and suddenly the hospital stay starts to extend way beyond what ought to have been necessary, possibly with prolonged consequences.

Working in partnership with the hospital team – communicating with them about what is and isn’t normal for the person you usually care for – is extremely valuable and should be welcomed by the team. Changes in cognition (someone being more confused, agitated or lethargic than usual) may not be recognised by healthcare teams who may only just have met a patient, but carers can offer their expertise to help everyone towards the best outcome.

In my relative’s case, the team was very grateful for the information given and the lady in question is now home and well.