Urinary tract infections (UTIs) aren't just a nuisance in the senior population—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 vital organs and even lead to kidney failure. These common infections are also a leading cause of sepsis, a potentially life-threatening infection of the bloodstream.
Seniors Are Prone to UTIs
The elderly are particularly susceptible to urinary tract infections. Older individuals are more vulnerable for many reasons, including their overall susceptibility to infections due to a weakened immune system. “As you get older your immune response changes; it’s part of normal aging,” says Anna Treinkman, a nurse practitioner at the Rush Alzheimer’s Disease Center in Chicago and president of the National Conference of Gerontological Nurse Practitioners. Elderly men and women also experience a weakening of the muscles of the bladder and pelvic floor, which can lead to increased urine retention (incomplete emptying of the bladder) 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 during urination
- Feelings of pressure in the lower pelvis
- Low-grade fever
- Night sweats, shaking or chills
Lesser-Known UTI Symptoms in Seniors
Older individuals with UTIs may not exhibit any of the hallmark signs listed above because their immune systems are unable to mount a significant response to the infection. On top of the lack of noticeable symptoms, many seniors do not or cannot express their discomfort to their caregivers.
Since elders’ bodies respond differently to infection, it is important to look for different signs and symptoms. One tell-tale symptom of UTIs in the elderly is often mistaken for the early stages of dementia or Alzheimer's disease, according to National Institutes of Health (NIH). Indicators of infection in seniors include the following:
- Confusion or delirium
- Other unusual behavioral changes
- Poor motor skills or loss of coordination
Acute behavioral and /or functional changes are often the only symptoms that present in the elderly, so it is crucial to keep an eye out for these sudden changes in behavior and mental state.
Why Do the Elderly Develop UTIs?
According to the NIH, the following conditions make older individuals more susceptible to UTIs:
- 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
- Urinary 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
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. While these products can help to contain messes and prevent embarrassment associated with accidents, they can also introduce bacteria into the urethra. Below are some recommendations to help reduce this risk.
- Change briefs promptly and frequently.
- Encourage front-to-back wiping and cleansing.
- Keep the genital area clean.
- Set reminders/timers for seniors who are memory-impaired to try to use the bathroom instead of an adult brief.
How to Reduce the Risk of UTIs
- Drink plenty of fluids (2 to 4 quarts of water each day unless this conflicts with a physician's orders).
- Drink cranberry juice or use cranberry tablets, but NOT if your elder has a personal or family history of kidney stones.
- Avoid or at least limit caffeine and alcohol intake, which irritates the bladder.
- Do not douche or use other feminine hygiene products.
- Always wipe from front to back (for women).
- Wear breathable cotton underwear and change 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. An urgent care clinic is a viable alternative if you cannot get an appointment with your loved one’s primary care physician soon enough. If caught early on, a simple course of antibiotics typically clears the infection in no time.
Source: National Institutes of Health; 1. https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-infection-uti-in-adults?dkrd=hiscr0045 2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3878051/