We are trying to help care for a loved one who lives far away. Local siblings reported that she was extremely confused on Father's Day. They thought the caregiver looked awful too. They wonder if it might be time to look for residential care. Some of them do not see her very often (every three months or so) so I wonder if maybe the decline over the past few months has surprised them. However, if this is a rapid change should we ask to have her urine cultured? She was just at her annual physical but my husband confirmed this morning that a urine analysis was not done. She may have just been having a bad day, too. There was a lot of company. When is it appropriate to ask the doctor to do a urine culture? How long can a urinary tract infection go untreated before it causes symptoms other than confusion? What other symptoms should we ask her caretaker to look for? Will she eventually run a fever or something?