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An UTI can mimic dementia and cause other unusual behaviors in older people, especially common in women. The test itself is easy, pee in a cup. If the test comes back positive, antibiotics are prescribed.
If there is severe denial you may have your answer that she is already noting failure and in denial, fearful. You may then have to await the incident severe enough that you call EMS and request testing once at the ER.
Is there a POA? Who is closest to this woman? Would family consider intervention to approach together? What are you seeing that could represent DANGER to her? What is in place already or needs to be (POA, Wills, plans and etc).
Other things you can consider is telling her MD what you are seeing and asking for his intervention to ask to see her or to carefully examine for need for neuro eval at next appointment. Calling APS and telling them of your fears for her and asking for welfare check and putting it on them is one more option.
MJ's approach is certainly another option for you, and I agree that if this is a sudden change you need to consider dip sticking the urine at home to check for evidence of bladder infection, or taking a specimen to her doctor for testing.
If she does have dementia, you should weigh carefully if this is something helpful for the person to hear, or if it will distress them (as well, they may not remember the information, but may remember the distress caused).
My mother was diagnosed with 'Dementia, probably Alzheimer's' at age 91, when she started being unable to follow her daily routines (meds, showers, food prep).
She had been experiencing some memory loss, that had gradually grown worse, since about age 88.
I took her to her PCP, telling Mom it was for her annual Medicare wellness check. I handed the office staff a note for the doctor when we checked in, detailing the changes I was seeing, and that I was concerned. At that visit we were referred to a neuropsychiatrist for testing.
I gave the neuropsychiatrist a copy of the note too, and noted that my mom would find a diagnosis of dementia scary-she watched it affect a dear friend to the end. The doctor talked about her test results in terms of what areas she tested well in and where she was less strong. She forgot the doctor's discussion by the time we reached the car.
And that was that.
My mother is aware that she has some difficulties retaining information, but it seems kinder to not reiterate that she has Alzheimer's.
This is helpful reading:
https://www.alzconnected.org/uploadedFiles/understanding-the-dementia-experience.pdf