“He couldn’t recognize me as his wife.”

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Bethany had noticed that her husband’s condition was declining. Samuel was much more confused than he’d been before, and his word-finding abilities were getting worse. He had an Alzheimer’s diagnosis and was being followed by both a psychiatrist and a geriatrician, which was helpful.

Still, it didn’t seem like the disease had progressed that quickly—until they went on vacation. The couple had had a difficult plane trip. It was long, it was cold, and there was a layover. To make matters worse, the flight was also happening in the evening. By the time they arrived at their destination, Samuel was clearly confused. 

It was 2:00 in the morning, and things just weren’t right. Suddenly, Samuel turned to his wife and yelled, “Who are you!?” Understandably frightened, Bethany called their daughter, who was staying in a different hotel. 

The next morning, everything was back to normal. Samuel recognized his wife again, and there were no other issues.

When I first heard this story, I suggested that Samuel might have a urinary tract infection, as those are common in causing delirium. Bethany noted that she’d had him checked for a UTI, and the test was negative. Once she explained more about the stressful plane right, though, it made sense: the plane ride, the exhaustion, and the stress had caused this sudden onset of extra confusion.

While dementia does not often get “suddenly” worse (unless there is a fall or other medical incident) there are times that people with dementia may experience delirium, which is a sudden onset of confusion. Delirium can be caused by a lot of things, namely UTIs, sleep deprivation, medication mishaps, strokes, falls, and more. 

Fortunately, this episode passed very quickly, but if a friend with dementia undergoes bizarre and fast changes like these, it is best for them to see a doctor as soon as possible. 

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Rachael Wonderlin has a Master’s in Gerontology and is the author of two published books with Johns Hopkins University Press. She owns Dementia By Day, a dementia care consulting company.

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