Guide to Understanding Elderly UTI

A caregiver's guide to recognizing the symptoms of urinary tract infection and understanding the impact of UTI in older adults. Get expert advice and caregiver tips for signs of UTI in the elderly as well as prevention and treatment recommendations from the experience of other caregivers.  

What is a Urinary Tract Infection?

A UTI is an infection caused when bacteria enters the urinary tract through the urethra. According to the Mayo Clinic urinary tract infection can occur at any point in the urinary system- kidneys, ureters, bladder or urethra, but most infections involve the lower urinary tract.

Symptoms of a UTI

  • A persistent urge to urinate
  • A burning sensation when urinating
  • Passing frequent, small amounts of urine
  • Urine that appears cloudy, red, bright pink or cola-colored 
  • Strong-smelling urine
  • Pelvic pain, in women — especially in the center of the pelvis and around the area of the pubic bone

Understanding UTI in the Elderly

UTIs are very common and can happen at any age; nearly 20% of women will experience a UTI in their lifetime. Possibly due to incomplete emptying of the bladder or the hygiene challenges that present with incontinence, urinary tract infections account for for as much as 25% of all infections in the elderly. The difficulty in recognizing urinary tract infections in older adults is that they may not present with any of the physical symptoms represented in the list above. Instead, UTIs in the elderly usually present as fever accompanied by sudden changes in cognition, delusions, hallucinations, or other behavioral symptoms of UTI

Delirium and UTI

Caregivers of older adults commonly cope with witnessing a loved one experience age related declines in functioning, therefore it can be challenging to rely on changes in cognition and orientation as signs of UTI. Oftentimes, those who are familiar with the baseline level of functioning of an older adult notice a decrease in reasoning that initiates panicked questions as to how their parent could have developed dementia overnight. Diagnostic appointments are made to determine the reason for this sudden shift in thinking and behavior. Delirium- the mental state represented by confusion and disorientation, however, is a common symptom of UTI in the elderly. In fact, many family caregivers in the Caregiver Forum point to this sudden change in mental state as the primary indicator that their elderly care recipient has a UTI. The good news for caregivers is that UTIs are treatable, and with treatment cognition usually returns to previous levels.

Unfortunately, recognizing the changes in behavior or cognition that point to UTI become more complex when caring for an older adult with an existing dementia diagnosis. Although dementia is a progressive disease, changes do not usually occur in a sudden manner. Consequently, rapid changes in thinking or behavior should always be a sign that a dementia caregiver should seek medical advice to rule out other medical conditions, especially a UTI. >> Dementia and UTI

UTI Treatment and Prevention

If your loved one is exhibiting signs of a urinary tract infection, a urine culture will determine the cause of the infection and proper course of treatment. Most UTIs are treated with antibiotics.

The AgingCare Caregiver Forum is a valuable resource for family caregivers looking for advice and tips for dealing with recurrent UTIs in an aging loved one. Caregivers offer tips on prevention, advice from their own experience and information on treatment that has helped them cope with caring for an elder with UTI. 

Read more : UTI Questions From Caregivers

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