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Mother with mild/moderate Alzheimer’s. Can dress with assistance, feeds herself, no mobility issues wakes up delirious one morning August 27 aggressive with memory care staff. (She’s 5’ 1”) broke the finger of a big tall man! Hospitalized, under restraints, no uti, no infections, no stroke, she will drink, doesn’t want to eat much. she’s in her own little world and fighting any interaction with this one. Why, how? Will she return? What’s going on? This is not what I’ve seen in other AZ people nor when I’ve researched it.

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The antibiotics should help. My dad is in the hospital after becoming EXTREMELY confused and violent over the weekend. Very much out of character from his 'normal' dementia. He had been doing so much better but the SNF and myself noticed a huge difference over a few days time. He was sent to the hospital. Tested negative for UTI. Dad continually deals with cellulitus infections in his legs and the hospital said the one he currently has is not doing very well and they felt his agitation was caused from the infection that was not responding to oral antibiotic treatment. They put him on IV antibiotics and yesterday when he called, he sounded like his old self. He said he was anxious to get back to the SNF but does not remember how or why he was put in the hospital.
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Although a UTIs are a common cause of a rapid change in behaviour, another infection could have a similar result. Have they done a complete blood panel?

Has she had a recent change in medication, as in within the last month?
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I want to second the idea of re-doing the urine culture.

Has a psych consult been requested? Many years ago, my father in law had altered mental status. It was the psychiatrist who figured out that he had had a stroke.
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For now your mother is a mystery. My first vote would have gone to checking for a UTI and I would still caution be certain that a culture was done. Not all UTI will show on regular urine exam amazingly enough, and I found this out the hard way. Also do know that not all strokes show up easily. Bleeds do, on scan, but strokes don't always. I think right now you are in the hands of neurologists. Anything we say is guesswork. What you are seeing, to happen so suddenly, is, -yes--rare. I hope you will update us as diagnostics continue.
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Karen51 Sep 2020
She didn't have a UTI when she went in, but a few days later did. Is now on antibiotics. She's spent over a week in restraints. She is now unable to feed herself, not sure about her ability to walk. She was more like her normal cheerful self yesterday and today. So, I'm hopeful. her dominant hand is weak now, either too much straining at the restraints or a mini-stroke, I lean towards a stroke. With my late husband they didn't see the mini-strokes on the scan until he had his massive one.
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