If You Suspect A Uti In A Senior
Contact the seniors doctor immediately for a urine test to verify the diagnosis. The type of bacteria present will determine the most effective treatment solution, which may include one of several different antibiotics in addition to antipsychotic drugs to help with delirium and confusion.
But as the saying goes, An ounce of prevention is worth a pound of cure. The following measures can help the older adults you love avoid a UTI:
- Drinking plenty of fluid throughout each day, especially plain water. The recommendation for seniors is a little over 7 cups of water per day.
- Avoiding alcohol and caffeine.
- Making sure underwear and/or incontinence pads are dry, and changing immediately when they become wet.
- Urinating right away when the need arises .
Abby Senior Cares home caregivers in Denver, CO and the surrounding areas can help a senior with a UTI in many ways, through services such as:
- Transportation to medical appointments, tests, and procedures
- Picking up prescriptions and running other errands
- Preparing nutritious meals and ensuring adequate hydration
- Assisting with personal care needs, such as incontinence care and other hygiene needs
- Companionship for enjoyable activities as well as to watch out for and report any alterations in condition
Help a senior you love remain healthy and well with a little help from our care specialists! Give us a call at to request a complimentary in-home consultation to learn more.
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You were visiting your mom and she seemed very confused and disoriented. She claimed the retirement home had moved her to a different apartment and she didnt know why.
Fortunately, you knew the reason for her confusion was not to be ignored because you had seen this out-of-sorts behavior before. Your mom hadnt been moved to a new apartment, but she probably had another urinary tract infection.
According to Washington University Clinical Associates primary care specialist Chelsea Pearson, MD, Family and caregivers are key in helping us identify infection in older adults. When you notice a sudden change in behavior- even a subtle one- you want to take it seriously.
Falls, agitation, confusion, changes in appetite, and incontinence in someone who was previously able to get to the bathroom can all be signs of a urinary tract infection or UTI.
When an older woman has a UTI, the symptoms are different from a younger woman. There might not be any painful burning during urination always a typical sign. This is because as you get older, your immune response changes its part of normal aging.
A UTI places stress on the body, says Dr. Pearson, and any type of stress, physical or emotional, can cause an older adult to become confused. For those suffering from Alzheimers disease or dementia, a UTI can make dementia temporarily worse.
You want to keep your urine clear by drinking four to six 8-ounce glasses of water a day.
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Why Asymptomatic Bacteriuria Usually Doesnt Warrant Antibiotics
Clinical studies overwhelming find that in most people, treating asymptomatic bacteriuria with antibiotics does not improve health outcomes.
A 2015 clinical research study found that treatment of asymptomatic bacteriuria in women was associated with a much higher chance of developing a UTI later on, and that these UTIs were more likely to involve antibiotic-resistant bacteria.
Even for frail nursing home residents, there is no proof that treating asymptomatic bacteriuria improves outcomes, but it does increase the presence of antibiotic-resistant bacteria.
Despite the expert consensus that this condition doesnt warrant antibiotics, inappropriate treatment remains very common. A 2014 review article on this topic notes overtreatment rates of up to 83% in nursing homes.
Is there a role for cranberry to treat or manage urine bacteria?
The use of cranberry juice or extract to prevent UTIs has been promoted by certain advocates over the years, and many patients do prefer a natural approach when one is possible.
However, top quality clinical research has not been able to prove that cranberry is effective for this purpose. In a 2016 study of older women in nursing homes, half were given cranberry capsules daily. But this made no difference in the amount of bacteria or white blood cells in their urine.
A 2012 systematic review of high-quality research studies of cranberry for UTI prevention also concluded that cranberry products did not appear to be effective.
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What Is A Uti
UTIs happen when bacteria enter the body through the urethra, which is the opening that carries urine from the bladder, and the immune system isnt able to fight off the bacteria. As a result, the bacteria multiply and can spread to the bladder and kidneys, causing an infection.
Typically, women are more susceptible to UTIs because the urethra is shorter, meaning bacteria doesnt have to travel as far to reach the kidneys or bladder. However, seniors are also at a higher risk of a UTI because of weaker immune systems, chronic health conditions, urinary incontinence, reliance on catheters, or other factors.
UTIs can be treated with medication to kill off the bacteria. However, if left untreated, a UTI can cause kidney infections, kidney failure, sepsis, and other health problems. In fact, the infection can even spread into the bloodstream, leading to life-threatening infection and a long road to recovery. However, with proper care and attention, many UTIs can be avoided.
Common Bladder Problems And When To Seek Help
Bladder problems can disrupt day-to-day life. When people have bladder problems, they may avoid social settings and have a harder time getting tasks done at home or at work. Common bladder problems include urinary tract infections, urinary incontinence, and urinary retention.
Some signs of a bladder problem may include:
- Inability to hold urine or leaking urine
- Needing to urinate more frequently or urgently
- Pain or burning before, during, or after urinating
- Trouble starting or having a weak stream while urinating
- Trouble emptying the bladder
If you experience any of these symptoms, talk to your health care provider.
Treatment for bladder problems may include behavioral and lifestyle changes, exercises, medications, surgery, or a combination of these treatments and others. For more information on treatment and management of urinary incontinence, visit Urinary Incontinence in Older Adults.
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How Can Utis In The Elderly Be Prevented
Once a UTI infection is gone, prevention should consist of maintaining a more set schedule. Some older people start a urination schedule, setting up alarms to remind themselves to urinate. Implementing better hygiene to keep the midsection area clean and dry is also key. Seniors should regularly wear and change loose, breathable cotton underwear that can be cleaned easily. A ritual of wiping from front to back when using the bathroom is also critical.
Some urologists claim that there is an ingredient in cranberry juice that prevents bacteria, especially E coli, from adhering to the bladder wall. The ingredient is A-type proanthocyanidins or PACs. There is debate in the medical and healthcare communities as to whether there are enough PACs in cranberry juice to actually stop bacteria from grabbing on to the bladder wall. You could say that the theory has caused a healthy, sweet and sour debate! Essentially, all of these preventative measures mentioned boil down to one theme: better care.
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What Causes A Urinary Tract Infection
The main cause of UTIs, at any age, is usually bacteria. Escherichia coli is the primary cause, but other organisms can also cause a UTI.
In older adults who use catheters or live in a nursing home or other full-time care facility, bacteria such as Enterococci and Staphylococci are more common causes.
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How To Prevent Utis In Seniors
Older adults can help prevent UTIs by drinking plenty of fluids to flush the bacteria from their systems, Forciea says. She recommends older adults drink four to six 8-ounce glasses of water a day. Forciea further notes that drinking cranberry juice or taking cranberry tablets also can make urine less inviting for bacteria.
Use these strategies to help prevent UTIs in elderly women:
- Urinating promptly after the urge arises
- Wiping front to back
Seeking Treatment For A Uti
Urinary tract infections sometimes resolve on their own, but they can easily worsen due to a seniors compromised immune function. When left untreated, UTIs can lead to chronic incontinence. The infection can also spread to the upper urinary tract and cause serious kidney damage. When that happens, patients often experience a fever and severe pain. The infection could spread even further to the bloodstream and cause sepsis, which can be fatal. Therefore, timely testing and treatment with antibiotics is crucial.
Once Altman recognized the behavioral symptoms that often accompanied her mothers UTIs, she and her sister were more vigilant about assisting with personal hygiene and pursuing tests and prescriptions to clear up the infection. Most family caregivers are not aware of the unique symptoms of UTIs in seniors, but this information is vital for speedy diagnosis, treatment and recovery.
Its nice to have that early warning, Altman notes. Its well worth sending in a urine sample when the symptoms first become apparent. Early treatment saves our mom days of feeling bad and being more confused than usual.
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Know The Signs And Symptoms Of A Urinary Tract Infection In Aging Adults
Urinary tract infections can present differently and be riskier for older adults.
Itching. Burning. Urgency. If youve ever had the misfortune of suffering from a urinary tract infection , you recognize these symptoms all too well. For younger individuals, a UTI may be simple enough to detect and take care of. But it is usually more challenging for older adults, as symptoms can be less apparent or even significantly different in how they present.
How Forward Helps Older Adults Obtain Uti Treatment
For many older adults, a visit to the doctor isnt all that simple. Mobility issues and a lack of transportation may make it hard to visit the office and pick up prescriptions. Thats why Forward allows you to schedule virtual visits with your primary care provider. Then, the medication your doctor prescribes comes right to your door. We provide one-on-one, personalized care that will include exploring potential causes of UTIs. By identifying your risk factors, we can give you advice on how to modify your lifestyle and your habits to make urinary tract infections less likely to reoccur.
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How Is It Diagnosed
If doctors suspect that a UTI is present, they will test a urine sample in the office or send it to a laboratory for a urinalysis.
A urine culture can confirm which bacteria are causing the infection. Knowing the specific type of bacteria allows the doctor to determine a suitable treatment plan.
A condition called asymptomatic bacteriuria is also common in older adults. ASB occurs when there are bacteria in the urine, but they do not cause any signs or symptoms of infection.
Although ASB is common in older adults, it does not typically require treatment, unless it causes other clinical symptoms.
The standard treatment for a UTI is antibiotics, which kill the bacteria causing the infection. Doctors will prescribe an antifungal medication instead if a fungus is causing the UTI.
It is essential that people take the antibiotic or antifungal medication precisely according to the prescription, even if they begin to feel better. Completing the entire prescription will help to destroy all of the infectious bacteria.
What Is A Urine Infection And What Causes It
Most urine infections are caused by germs that come from your own bowel. They cause no harm in your bowel but can cause infection if they get into other parts of your body. Some bacteria lie around your back passage after you pass a stool. These bacteria sometimes travel up the tube called the urethra and into your bladder. Some bacteria thrive in urine and multiply quickly to cause infection.
A urine infection is often called a urinary tract infection by healthcare professionals. When the infection is just in the bladder and urethra, this is called a lower UTI. If it travels up to affect one or both kidneys as well then it is called an upper UTI. This can be more serious than lower UTIs, as the kidneys can be damaged by the infection.
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Urinary Tract Infections And Dementia Urinary Tract Infections And Dementia
Urinary tract infections are a type of infection common among older people. If a person with a memory impairment or dementia has a UTI, this can cause sudden and severe confusion known as delirium.
Urinary tract infections and dementiaUrinary tract infections and dementia .
Quality Assessment / Risk Of Bias
Two review authors assessed the risk of bias of included studies independently, with any discrepancies being resolved by consensus, or through discussion with a third reviewer , if necessary. The risk of bias was assessed using a modified version of the assessment checklist developed by Downs and Black . Quality items that pertained to interventions and trial studies were removed as they were not deemed to be appropriate for the studies included in this review. An additional five quality items were added to the quality assessment to determine if studies described the criteria used for confusion, UTI and bacteriuria, and if their criteria for UTI and confusion were valid and reliable. Criteria for confusion were deemed valid and reliable if accepted criteria were utilised, including: the Confusion Assessment Method, the Organic Brain Syndrome Scale or the Diagnosis and Statistical Manual criteria . Similarly, criteria for UTI were deemed valid and reliable if established criteria for UTI were utilised, including: the McGeer Criteria, the revised McGeer Criteria, the Loeb Criteria, or the Revised Loeb Criteria . The modified checklist finally consisted of 14 quality items, grouped into: reporting, internal validity, external validity and criteria . The risk of bias for each quality item was reported as low risk of bias, high risk of bias, unclear risk of bias or not applicable.
Table 2 Quality Assessment Criteria
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What Are The Common Symptoms
Common symptoms of a UTI infection include the following:
- Dark or cloudy urine
- Pain or burning sensation during urination
- Pressure or tenderness in the lower abdomen
- Low-grade fever
- Night sweats, shaking, or chills
However, older adults may not experience any of these symptoms when they have a UTI, which can make identifying the infection difficult. This is due to the fact that seniors have weakened immune systems that arent able to respond to bacterial infections as effectively. The symptoms mentioned above are actually signs that the immune system is working to fight the infection off.
Seniors have a unique set of symptoms as a result of a UTI, including the following:
- Poor coordination, which can lead to falling
Usually, these symptoms will appear suddenly if the cause is an infection. But many of these symptoms could be symptoms of other health conditions, like dehydration, dementia, and others. They could also be normal signs of aging, which makes it difficult to identify a UTI in a senior loved one.
Another factor that seniors face with experiencing a UTI is a lack of communication with their loved ones or caregivers. Many seniors may choose not to tell others about their discomfort or simply cannot express it.
The symptoms of a UTI can also change when the infection worsens and spreads to the kidneys. These symptoms include:
- Nausea and vomiting
Summary Of The Evidence
Following this review, it is evident that all of the studies which have explored the association between suspected UTI and confusion are methodologically flawed, due to poor case definition for UTI or confusion, or inadequate control of confounding factors introducing significant bias. Subsequently, no accurate conclusions about the association between UTI and confusion can be drawn. One study of acceptable quality shows an association between confusion and bacteriuria. However, this sample of patients in whom they tested bacteriuria and pyuria were patients already suspected of having a UTI, introducing a bias into their calculation . In summary, none of the 22 publications had sufficient methodological quality to enable valid conclusions.
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Bacteria In The Urine Isnt Necessarily A Problem
Elevated urinary bacteria doesnt cause any symptoms and can often be corrected by increasing fluid intake.
The condition occurs in about 6 to 16 percent of women over age 65, 20 percent of women over age 80, and 25 to 50 percent of women living in nursing facilities.
Doctors should not treat urinary bacteria with antibiotics unless there are multiple other signs or symptoms of a UTI. This can encourage antibiotic resistance and make future UTIs harder to treat, says Dr. Lathia.
The presence of antibiotic-resistant bacteria in the urine also increases the risk of serious complications, including C. difficile infection and death.
How To Prevent Urinary Tract Infections In The Elderly
With a proper understanding of UTI, its potential causes, and risk factors there are some simple things that all of us can do to help prevent infections in our urinary tracts. Some of the most practical preventive behaviors are:
Drink plenty of fluids daily, especially water
Urinate as soon as the urge hits
Urinate immediately after sexual intercourse
Wipe from front to back after a bowel movement
Avoid bladder irritants like caffeine and alcohol
Avoid irritating feminine hygiene products like deodorants, douches, and powders
Drink cranberry juice
In addition to the suggestions listed above, here are some preventive behaviors specifically for avoiding UTI in seniors:
Establish and follow a regular urination schedule, using alarms if necessary
Take enough time to empty the bladder completely when urinating
Wear cotton underwear and loose-fitting pants
Change incontinence pads and underwear immediately after they are soiled
The prevention of UTI in older adults boils down to two words: better care. Remember, as people age, they sometimes lose the ability to care for themselves in ways that we all take for granted when we are younger. This makes it essential for loved ones and professional caregivers to be vigilant, look for unmet care needs, and respectfully provide that care when necessary.
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