Urinary Tract Infections in the Elderly

Urinary tract infections (UTIs) aren't just a nuisance—they can cause serious health problems. A UTI happens when bacteria in the urethra, bladder or kidneys multiplies in the urine. If left untreated, a UTI can lead to acute or chronic kidney infections, which could permanently damage these organs and even lead to kidney failure. UTIs are also a leading cause of sepsis, a potentially life-threatening infection of the bloodstream.

Urinary Tract Infections in the Elderly

The population most likely to experience UTIs is the elderly. Older individuals are more vulnerable for many reasons, not the least of which is their overall susceptibility to infections due to a weakened immune system that comes with age and certain age-related conditions.

Younger people tend to empty their bladders completely upon urination, which helps to keep bacteria from accumulating. However, elderly men and women experience a weakening of the muscles of the bladder, which can lead to increased urine retention, poor bladder emptying and incontinence. These things all contribute to infection.

Typical Symptoms of UTIs

  • Urine that appears cloudy or dark
  • Bloody urine
  • Strong or foul-smelling urine
  • Frequent or urgent need to urinate
  • Pain or burning with urination
  • Pressure in the lower pelvis
  • Low-grade fever
  • Night sweats, shaking, or chills

Lesser-Known UTI Symptoms in Seniors

Elderly people with serious UTIs may not exhibit the hallmark sign of fever because their immune system is unable to mount a response to the infection. In fact, elders often don't exhibit any of the common symptoms listed above – or don't express them to their caregivers.

UTIs in the elderly are often mistaken for the early stages of dementia or Alzheimer's, according to National Institutes of Health (NIH), because symptoms include:

  • Confusion or delirium-like state
  • Agitation
  • Hallucinations
  • Other behavioral changes
  • Poor motor skills or dizziness
  • Falling

These are often the only symptoms that may present in the elderly, so it is crucial to keep an eye out for these sudden changes in mental state.

Why Do the Elderly Develop UTIs?

According to the NIH, the following conditions make the elderly more susceptible to UTIs:

  • Diabetes
  • Urine retention (inability to empty the bladder completely, even if your loved one has just used the bathroom)
  • Use of a urinary catheter
  • Bowel incontinence
  • Enlarged prostate
  • Immobility (for example, those who must lie in bed for extended periods of time)
  • Surgery of any area around the bladder
  • Kidney stones

How to Reduce Risk of UTIs

People with incontinence are at an increased risk for UTIs because of the close contact that adult briefs and other incontinence products have with their skin, which can reintroduce bacteria into the urethra. Some recommendations to help reduce this risk include the following:

  • Change briefs promptly and frequently
  • Encourage front-to-back wiping and cleansing
  • Keep the genital area clean
  • Set reminders/timers for those who are memory-impaired to try to use the bathroom instead of an adult brief

Other ways to reduce the chance of UTIs include:

  • Drinking plenty of fluids (2 to 4 quarts each day unless this conflicts with a physician's orders)
  • Drinking cranberry juice or use cranberry tablets, but NOT if your elder has a personal or family history of kidney stones
  • Avoiding caffeine and alcohol, which irritate the bladder
  • Do not douche or use other feminine hygiene products
  • Always wiping from front to back (for women)
  • Wearing cotton underwear and changing them at least once a day

If you think your loved one might have a urinary tract infection, see your doctor right away to avoid further complications.

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