Urinary Tract Infections Can Be Very Serious for Seniors

Senior man getting a headacheMy father was in his upper 80’s and I stopped by to see him at his condo. At the time, we were in the process of convincing him to move to an Assisted Living facility, since he was having memory issues and getting weaker. However, I wasn’t prepared for what I found. He was lying in his bed and completely out of it. He also had a broken hip. We’re still not sure how he got back into bed.

So Dad was rushed to the hospital. After being examined, we discovered he had a urinary tract infection. He didn’t remember much about what happened. But in the hospital, he was having hallucinations. He was convinced there was someone peering from the ceiling tiles and it was snowing inside.

Dad was in the early stages of Alzheimer’s so my family wasn’t aware that his exacerbated symptoms were caused by the UTI. It was a scary thing. If I didn’t show up when I did, he probably would’ve died as he was also dehydrated. So it’s important for seniors and those who care for them to be aware of this serious issue. Below is an article from AgingCare.com on urinary tract infections for the elderly.


Marlo Sollito, Contributing Editor, AgingCare.com

Urinary tract infections (UTI) aren’t just a nuisance – they can cause serious health problems. A urinary tract infection happens when bacteria in the bladder or kidney multiplies in the urine. Left untreated, a urinary tract infection can become something more serious than merely a set of uncomfortable symptoms. UTIs can lead to acute or chronic kidney infections, which could permanently damage the kidneys 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. Elderly people are more vulnerable to UTIs for many reasons, not the least of which is their overall susceptibility to all infections due to the suppressed immune system that comes with age and certain age-related conditionsAccording to the National Institutes of Health (NIH).

Younger people tend to empty the bladder completely upon urination, which helps to keep bacteria from accumulating within the bladder. But elderly men and women experience a weakening of the muscles of the bladder, which leads to more urine being retained in the bladder, poor bladder emptying and incontinence, which can lead to UTIs.

Symptoms of UTIs

The typical signs and symptoms of a UTI include:

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

Elderly people with serious urinary tract infection don’t exhibit the hallmark sign of fever because their immune system is unable to mount a response to infection due to the effects of aging. In fact, elders often don’t exhibit any of the common symptoms – or don’t express them to their caregivers.

UTIs in the elderly are often mistaken as the early stages of dementia or Alzheimer’s, according to NIH, because symptoms include:

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

Sometimes, these are the only symptoms of a UTI that show up in the elderly—no pain, no fever, no other typical symptoms of a UTI.

Why Do the Elderly Develop UTIs?

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

  • Diabetes
  • Urinary retention (unable to empty the bladder, 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 more at risk for UTIs because of the close contact that adult briefs have with their skin, which can reintroduce bacteria into the bladder. Some recommendations to help reduce this risk include the following:

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

Other ways to reduce the chance of UTIs:

  • Drink plenty of fluids (2 to 4 quarts each day).
  • Drink cranberry juice or use cranberry tablets, but NOT if your elder has personal or family history of kidney stones.
  • Avoid caffeine and alcohol, because these irritate the bladder
  • Do not douches or use other feminine hygiene products
  • Always wipe from front to back (for women)
  • Wear cotton-cloth underwear, and change them least once a day

If you think your elderly parent might have a urinary tract infection, see your doctor right away.

Elderly people are more vulnerable to UTIs for many reasons, not the least of which is their overall susceptibility to all infections due to the suppressed immune system that comes with age and certain age-related conditions.

“In elderly men and women, bladder muscles have become weaker, which leads to increased residual urine volume, less-efficient bladder emptying, and incontinence. – Nursing Magazine”

According to a recent issue of Nursing, individuals usually tend to empty the bladder completely upon urination, which helps to keep bacteria from accumulating within the bladder. But elderly men and women experience a weakening of the muscles of the bladder, which leads to more urine being retained in the bladder, poor bladder emptying and incontinence, which can lead to UTIs. In elderly men, an enlarged prostate can also lead to obstructed urinary flow and urine stagnation, while in women, bladder prolapse due to the weakness of supporting structures can have the same effect. In either sex, no matter the cause, stagnant urine becomes a breeding ground for the growth and colonization of the bacteria that cause UTIs.

The scariest thing about these infections is that many times the elderly person doesn’t feel a UTI as a younger person would. The only symptom may be that the person is confused, behaviors change, moods change dramatically or they become very hard to reason with.

If you have a senior whose behavior has recently changed and you can’t explain it, have them checked for a UTI, it could be an easy fix!

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