How to prevent UTI in very elderly?

Wipe front to back. Very hard for the older, especially with back problems.
I just took my mom to doc yesterday and they put her in observation for a day, coming home this afternoon. On keflex. Once they get them it's hard to control and they keep coming back.
I do give her cranberry juice and try to keep the water flowing. Also lying in bed makes it easier to catch them since women's urethra is shorter.
I wish I knew the answer.

My mom almost died from an undiagnosed UTI, even just after a trip to the ER because she had fallen, dazed and confused, with gait issues. It was only after discovering the most severe and serious symptom of blood in her urine were we able to get a diagnosis and treatment, and JUST in time as she was becoming incoherent and we were considering emergency transfer to the dementia ward in her assisted living community. The idea of wiping from front to back is very important, but the elderly sometimes either can't reach that far, have no coordination nor strength, so we have introduced flushable wipes to help- you can get them at Costco in bulk. We are also giving 100% cranberry juice each morning with which to take her pills. It is tart, so you can water it down or add a bit of honey, agave, etc. However, it is extremely important to use the 100% juice and not the "blends." Another thing we've learned is that mom was dehydrating herself by not using the air conditioning when the sun rays would stream into her window making it to sometimes 90+ degrees! Of course, to exacerbate the problem, she was not drinking enough water regularly, so we have placed the smaller spring water bottles (easier to handle) all around her apartment with notes like in "Alice in Wonderland," saying "DRINK ME!" We would make it a game. . . .

My 93 year old mother was constantly haveing UTI's. The doctor put her on antibiotics for 90 days and within a week she would have another one. Her # 1 problem was cleaniness. She had forgotten how to bathe and clean herself. Even the Dr. told her she needed to bathe because she smelled like urine. Getting her in the shower for even once a week is a challange. In her mind she takes sponge baths every morning but there is no evidence that she does. I bought the thick wash cloths that comes in a package. It's like the wipes but only thicker. One day she in the bathroom I went in and gave her one of those wash clothes and told her to wash herself evertime she went to the bathroom. I also made her change her undrerpants. She wears depends and when they get wet she doesn't feel the wetness. I bought her the "TENA" undergarments. They pull the water away from the body. I also bought her some cranberry juice. Do not buy the regular cranberry juice. It is loaded with sugar and does not work. It's called "Jus Cranberry". It's a little expensive but well worth it. I have found it at Food Lion and the Super Walmart stores. Do not drink it straight for it's very bitter so I mix it 3/4 juice and 1/4 with water. (Some people may need half and half mixture). Mom would not drink water except for a sip this way she drinks her water and her cranberry. She gets a glass with every meal and she also gets the Cranberry pills three times a day with her meals. This has helped a lot. It has been three weeks without an infection. The big challange is getting her to shower and keep herself clean. She says she sponge bath every morning but I don't think she does. The fact of having someone bathe her is be-littling and embarrassing to her and she has gotten violent when someone tries to help her. I have told her I let her wash herself if I could just get her in the shower. I have a chair and everything but we have to arguing with her. I keep telling her it is Dr. prescribed and it would actually help her arithritis. I keep having to remind to clean herself and to change her undergarments. It's quite a challange.

Thanks. Are the probiotics and estrogen creams a waste of time?

Very important to keep water intake up. My MIL refuses a lot of fluids because she has to get to the bathroom frequently and she can't do it herself and has to call someone in the nursing home to help her. Often they take too long and she wets herself. Her response is to cut back on water intake so she won't have to 'bother them'. Very bad judgement on her part but it's hard to blame her. She is 91 and was quite independent for so long. It's sad but regardless she must keep drinking water. A lot. Frequently.
She also hates to spend money on pull up type pants and the pads just don't get the job done. These are constant battles - as are the almost continuous UTI's. Not easy.

Probiotics replace the good bacteria that antibiotics kill off. They just help your digestive system, good for everyone. Kids and dogs included.
Don't know about estrogen creams for UTIs.

Thank you very much. She has a prescription for Cipro prophylactic now, which is another problem, and it causes diarrhea. Added in cranberry pills, probiotics, and have pinneapple juice (read on the Dr OZ site). She is dramatically better after clearing this infection up. She went from probably dementia and unable to balance to really nothing wrong. This will certainly be difficult, but the quality of life difference is amazing. Thank you so much

Just a warning about cranberry juice if your loved ones are on Warfarin/Coumadin. It interacts and creates longer bleed times, so if you start cranberry juice or extracts, it'll be necessary to check their INR more frequently to make sure their Coumadin dose remains at the proper amount. Also, from what I understand, cranberry and D-Mannose only help prevent e. coli infections (which do comprise something like 90% of UTIs), not other types. My mom's had three UTIs since I moved in with her and only one was e. coli bacteria, so cranberry/D-Mannose would have helped her only in that once case. Now, hard to say whether preventing that first one would have prevented the others - I'm convinced she doesn't ever really "clear" her UTIs completely, so I suppose it's possible.

The cleanliness issue is a difficult one; but it did prevent further UTI's for my MIL. She wore the depends as well. I had her change them frequently and wash her private area throughout the day. Fortunately, she did cooperate to wash herself with my assistance. It is a challenge and not all will cooperate.