Tuesday, October 4, 2022

Preventing Urinary Tract Infections In The Elderly

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A Pharmacist Can Help With Utis

Urinary Tract Infection (UTI) In The Elderly

You can ask a pharmacist about treatments for a UTI. A pharmacist can:

  • offer advice on things that can help you get better
  • suggest the best painkiller to take
  • tell you if you need to see a GP about your symptoms

Some pharmacies offer a UTI management service and can prescribe antibiotics if they’re needed.

Why Are Urinary Tract Infections Common In Older Adults

Seniors 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 its part of normal aging, explains Anna Dowd, APN, a gerontological nurse practitioner in the greater Chicago area.

According to the National Institutes of Health , the following conditions make older individuals more susceptible to UTIs:

  • Diabetes

Drink More Cranberry Juice

There is some evidence that drinking cranberry juice or consuming cranberries could help with preventing the recurrence of UTIs.

A study looked at 150 women who had urinary tract infections and the effects of cranberry juice on preventing urinary tract infections. The women were divided into three groups. One group drank cranberry-lingonberry concentrate juice for 6 months. Compared to the control groups, the researchers found there was a 20% risk reduction in the recurrence of UTIs when the women drank the cranberry-lingonberry concentrate.

Another study found that cranberry juice could disrupt UTI-associated bacterial biofilms.

Take these simple steps to keep UTIs at bay.

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Regular Urination Schedule And Utis

Urine consists of bacteria and, if held in the bladder for an extended amount of time, can lead to an increased risk of infection.

It is important to have a regular urination schedule throughout the day. This simply means, get up and use the restroom often. Dont hold it for too long.

Some elderly people may not be able to mobilize as well and get to the bathroom, so it is important for caretakers to ask frequently if they need to go.

Nursing Home And Resident Characteristics

What causes burning urination? Causes and treatment

Forty-four nursing homes with a total of 1473 residents were included. The institutions were situated in central and northern parts of Norway in five out of 19 Norwegian counties. Data collection was performed by 11 consultant pharmacists. The average nursing home had 33 residents . 19% of the residents lived in dementia special care homes, 43% in long term somatic homes and 38% in mixed institutions. In 26 nursing homes all residents had single rooms one nursing home had no single rooms while in the remaining 17 nursing homes the majority of the residents lived in single rooms. 81% of the residents prescribed prophylaxis were females and 61% were above 80 years of age.

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Prophylactic Agents And Antibiotics For Therapy

All possible agents used for prevention of UTIs noted in the residents medical records were included, i.e. medicinal agents, vitamins and herbals, and they were recorded by name, daily dose and route of administration. Agents were classified according to The Anatomical Therapeutic Chemical system . Cranberry products represents a heterogeneous group of agents but were coded together. The indication for UTI prophylaxis by the nursing home physician was accepted without further details of treatment criteria. Furthermore, length of treatment was recorded in days. Prophylactic treatments are expected to be long-term and if no date of evaluation or withdrawal was assigned by the physician in the medical record, the treatments were recorded as continuous in the study.

Factors That Contribute To Getting Utis

There are some factors that make it more likely for one to get a UTI and they include:

  • Reduced estrogen levels
  • Sexual contact
  • Catheterization
  • Estrogen: this is a hormone that occurs naturally and it helps in the prevention of UTIs in women. When women reach menopause, the levels of this hormone drop significantly and this is together with some other good bacteria that live within the vagina.

    It is such good bacterium that helps in the prevention of intestinal bacteria thriving within the vagina. It is such things that make elderly women more prone to contracting UTIs.

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    Why Are Seniors Susceptible To Utis

    Older individuals are vulnerable to UTIs for several reasons. The biggest culprit is an immune system weakened by time that increases susceptibility to any infection. Also, the elderly may have a diminished ability to take care of themselves. Reduced cognitive abilities and lower energy levels are issues that cause decreased hygiene and increased bacteria in seniors too. Becoming less communicative, often due to the same diminished cognitive capabilities, can be a contributing factor as well.

    Urine overstaying its welcome in the bladder is common in elderly populations, and can foster bacteria that spreads and turns into a UTI. There are several reasons this may occur. One is that seniors may lower fluid intake during the day to avoid the embarrassment and inconvenience caused by bladder control issues. This leads to less frequent urination and a pool of urine being held in the bladder much longer. Also, aging men and women undergo a gradual weakening of the muscles of the bladder and pelvic floor, or a prolapsed bladder, leading them to retain more urine and to experience incontinence.

    Why Are The Elderly So Vulnerable To Urinary Tract Infections

    Elderly Care: Preventing UTI for Patient with Adult Diapers

    There are many reasons seniors are more vulnerable than the general population. Gerontologists often cite a weakened immune system, which is a part of normal aging.

    According to the National Institute of Health , these situations and conditions also make seniors more susceptible to UTIs:

    • Diabetes
    • Poor motor skills or loss of coordination
    • Falling

    There are often only acute functional or behavioral changes in the elderly, making it vital for family caregivers to watch for these sudden changes in mental state and behavior.

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    Why Do I Keep Getting Uti

    UTIs are a common cause of doctor visits and it happens to be more rampant in women because of where the female urinary system is located. If you happen to have 3 or even more UTIs within a year, then you have what is called recurrent UTI and it has to be addressed as soon as possible by a qualified doctor.

    Adequate Fluids And Utis

    Adequate fluid status is important as it helps aid in urination, which can help flush bacteria out of the urinary system.

    How much fluid the elderly needs greatly depends on current body size, weight, medications, activity level, and the environment.

    Commonly used calculations for estimated fluid needs in the elderly include:

    • 1 mL fluid per calorie
    • Urine output + 500mL/d

    You can learn more at our article Dehydration in the Elderly.

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    Uti Symptoms & Prevention In Elderly Adults

    Urinary tract infections become more common as you age, particularly for women. According to one study, more than a third of all infections in people in nursing homes are UTIs. Over 10 percent of women over age 65 report having a UTI in the past year and that number increases to almost 30 percent in women over 85 with half of all women experiencing at least one UTI within their lifetimes.

    Despite how common these infections are, the symptoms are not always obvious in older adults which means a UTI can often be missed or misdiagnosed. When caught early, UTI treatment is usually a straightforward course of antibiotics. If left untreated, however, the infection can spread leading to sepsis or other complications requiring hospitalization and increase your risk for falls or injury.

    One of the biggest problems with urinary tract infections in the elderly is that it can mimic the symptoms of other issues like dementia. In younger adults, a UTI is often painful and quite obvious, but these symptoms change as we age and an older adult may not experience pain at all. Elderly patients may present with changes in behavior like confusion or difficulty performing regular tasks that can be misdiagnosed.

    Provide Proper Catheter Care Including Excellent Hand Hygiene

    UTI

    Patients with urinary catheters are at an increased risk for a UTI. Providing appropriate catheter care and lots of hand washing can decrease the chance of the patient getting a UTI. This also includes ensuring there are no kinks in the urinary catheter, and ensuring that the collection bag is below the level of the patients bladder.

    Give us a call at 510-452-1100 to learn more about our continuing education courses. Our courses will help prepare you for whatever being a CNA throws your way. CNA courses are available at our Oakland and Sacramento locations and are approved by the California Department of Public Health .

    You can also see whats next in our CNA programs by enrolling in our continued education courses. Or you can give us a call at 510-452-1100 x 0 and we can sign you up today.

    And remember, all SEIU CNAs can take any of our continuing education units for free through the amazing SEIU Education Fund

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    What Is The Difference Between Lower And Upper Uti

    Generally speaking, a UTI isn´t dangerous, although it is painful. It is most commonly treated with antibiotics by prescription from a doctor, but if left untreated, the infection can spread from the lower urinary tract to the upper urinary tract and the kidneys. Such an infection can potentially cause kidney damage or even kidney failure. If that happens, the symptoms will get considerably worse with e.g. back pain, nausea and fever. From the kidneys the infection can enter the blood stream and spread to other parts of the body, which is a serious medical condition that requires intensive care.

    Senior Toileting Tips For Preventing Uti

    A senior could be having problems emptying their bladder. If possible, when they urinate in the toilet, count to thirty once they have finished and then encourage him to give it another push. In potty-training my disabled son, an autism specialist told me that after the initial urge is gone, the brain can stop/reduce the message that they still needed to go. I know Ive tried it myself and I am always amazed at how much Ill go again after the count. Sorry if thats TMI! Lastly, if they are wearing adult diapers, you may need to be changing them more frequently since they are bacteria sponges. Rainmom

    Encourage/help older folks get to the toilet at least every 2 hours. Sometimes, older folks dont feel thirsty, sometimes they forget to drink, but sometimes, they are afraid of urinary accidents and avoid drinking enough fluids. Its very important to keep going to the bathroom to empty that bladder. MomDaughterRN

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    What Causes A Uti

    A UTI occurs when bacteria, usually from either the anus, kidney stones, or from backed-up urine, is trapped in the urethra and allowed to grow. Research tells us that there are various causes for UTIs and urinary infections , and causes tend to change as we grow older. For example, in older women, a decrease in estrogen can lead to UTIs. Other factors that contribute to UTIs and UIs include:

    • Living in an environment with someone that has a yeast infection or UTI
    • Wearing incontinence supplies for an extended time
    • Sexual activity, especially unprotected sex that can expose you to bacteria and STDs
    • Kidney stones or other issues affecting the urethra, trapping urine and bacteria

    How Long Does A Uti Last Untreated

    URINARY TRACT INFECTIONS IN THE ELDERLY (TWO MINUTE TIP)

    If an elderly woman has nonspecific symptoms, it is important for the clinicians to encourage such persons to drink more water until more tests are done for proper diagnosis. When a delay is made, usually the women dont need to use antibiotics in the long run.

    Even with no antibiotics, some positive results can be witnessed if adequate amounts of fluids are taken in a weeks time. However, it is important to assess other criteria because UTIs can be deadly and can spread if not treated on time.

    It is important to be very careful when you are administering antibiotics to seniors. The dose and the duration of use should also be carefully thought out. It is important to aim at the organism that is actually causing the infection so that the side effects can be minimized.

    There are older adults in long-term facilities who may have renal insufficiency and this makes it necessary to make some adjustments to the most common dosages by using a glomerular filtration rate which is estimated.

    Ask your doctor how to relieve UTI pain at night.

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    Preventing Utis In Elderly Men

  • 1Urinate regularly and avoid holding it when you have to go. If you don’t wear adult diapers or use a catheter, focus on urinating regularly to flush your urinary tract. Additionally, do your best to use the toilet whenever you feel the urge instead of holding it.XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source
  • The main causes of UTIs in older men are blockages , prostate issues, and catheter use. Staying hydrated and urinating regularly can help flush the urinary tract and prevent blockages.
  • 2Discuss your prostate and kidney health with your doctor. In older men, UTIs are usually associated with kidney or prostate issues. If you develop an infection, your doctor should test your kidney function, check for prostate enlargement or infection, and look for other underlying conditions.XTrustworthy SourceNational Institute of Diabetes and Digestive and Kidney DiseasesHealth information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of HealthGo to source
  • Your doctor might recommend medication to manage any underlying issues.
  • To diagnose the problem, your doctor may recommend a cytoscopy, where they insert a scope into your bladder.XExpert Source
  • Implications For Research And Practice

    Based on the data we analysed, a pragmatic approach is required when considering prescribing long-term antibiotics in older patients with recurrent UTI. Although long-term antibiotics may reduce the risk of UTI recurrence in women, this benefit diminishes on cessation of treatment. Little is known about optimal prophylaxis period, long-term effects on health, risk of antibiotic resistant infections, effect in older men, effect in frail care home residents or impact on important patient-centred outcomes. These unknowns must be balanced against benefits and patient preferences.

    Future research efforts on recurrent UTI should focus on improving the design and reporting of trials and developing a core set of outcomes to allow better synthesis of trial data. Antibiotic prophylaxis should be compared with non-antibiotic prophylaxis with some evidence of efficacy rather than those with little or poor evidence of efficacy. Researchers should address unanswered questions regarding long-term effects, duration of use, adverse effects and antibiotic resistance.

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    These Are The Steps To Take When Youre Trying To Ward Off Utis

    If you havent experienced a urinary tract infection before, take note: while the infections are uncommon in older men, they can be common in older women, occurring in 10% of women ages 65 or older, and in 30% of women ages 85 or older. For up to a third of women who have a UTI, the infection comes back within six months.

    E. coli bacteria cause approximately 80% of all recurrent UTIs and continue generating microbe strains that are resistant to antibiotics. The ability of the bacteria to stick to the urinary tract can sometimes make them very difficult to eliminate,” says Edward Doherty, who spent 10 years working on potential vaccines for recurrent UTI and other conditions at Harvards Wyss Institute and is now CEO and co-founder of vaccine maker Attivare Therapeutics.

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    Addressing Urinary Retention Or Urinary Obstruction

    Urinary Tract Infections in the Elderly: Signs, Symptoms, and ...

    Conditions such as prostate enlargement in older men and neurological damage due to diabetes, stroke or multiple sclerosis may lead to urinary retention. When this happens, a senior is unable to completely empty their bladder. Urine will accumulate and stagnate within the organ, eventually resulting in bacterial colonization and possibly UTI.

    Urinary retention is diagnosed by measuring a seniors post-void residual, which is the amount of urine that remains in the bladder after urination. To obtain a post-void residual measurement, a catheter is inserted through the urethra and into the bladder after urinating to drain any leftover urine. Sometimes an ultrasound machine can be used to take this measurement. A residual of 100 mL or more indicates that the bladder is not emptying properly.

    Another cause of incomplete voiding is urinary obstruction caused by a kidney stone stuck in a ureter . This blockage can contribute to recurrent UTIs and even kidney infections. Diagnostic imaging, such as an ultrasound or CT scan, can be used to diagnose a ureteral stone and treatment must usually be provided by a urologist.

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    Drink Plenty Of Water

    Other fluids like cranberry juice, orange juice, hibiscus tea, white/black tea are helpful as well.

    Drinking water and increasing your fluid intake in general, allows your body to make more urine.

    The urine your body produces will wash out the bacteria that would otherwise hang around and cause an infection.

    Data Extraction And Quality Assessment

    One reviewer extracted study characteristics and outcome data from included trials. We contacted two authors for subgroup data on postmenopausal women. One author replied and provided relevant outcome data. Two reviewers independently assessed the risk of bias of the included studies using the Cochrane Collaborations risk of bias tool. Disagreements were resolved through discussion. We used RevMan V.5.3 to meta-analyse the data and generate forest plots.

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