What Causes Utis In The Elderly
Anything that introduces bacteria into the urinary tract or impedes the flow of urine and causes urine to stay in the bladder is very likely to cause a UTI.
Eighty five percent of all UTI infections are caused by Escherichia coli or E. coli bacteria. Several other types of bacteria make up the other fifteen percent, but E.coli is by far the most prominent, and it can make its way into the urinary tract several different ways.
Due to the proximity of the entry and exit of the above two pathways, poor hygiene can cause UTIs. Back-to-front wiping after a bowel movement can transfer bacteria into the urethra. Wearing soiled underwear or disposable undergarments too long can also introduce bacteria into the urinary tract. Bacteria in both cases is an infectious traveler that multiplies.
Urinary Tract Infections In Seniors With Dementia
Suffering from a urinary tract infection at any age is a painful and unpleasant experience. But for seniors and especially those with dementia UTIs can result in additional, serious health concerns.Seniors may be more susceptible to infections in general due to reduced immune function. Certain health conditions including diabetes, enlarged prostate, kidney stones, urinary catheter use, immobility and surgery involving areas near the bladder can increase the likelihood of developing a UTI.
Infections of the urinary tract commonly affect seniors of both genders. Left untreated, a UTI can cause either chronic or acute kidney infections permanent kidney damage and kidney failure can result. In addition, UTIs can cause the dangerous bloodstream infection known as sepsis.
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If you feel burning when you urinate, you may quickly recognize the problem as a urinary tract infection, or UTI. But when youre older, a UTI can be more difficult to diagnose. It may even cause confusion and other symptoms of dementia. At the same time, an older adult with Alzheimers disease or dementia may miss the signs of infection, or be unable to tell you about them.
UTIs are a common bladder condition, usually caused by bacteria. They occur more often in women, and become more frequent as we age. Most infections are not serious and can be cured quickly. But some UTIs can lead to severe, even life-threatening, problems, making it critical to catch them early.
If an older adult is disoriented for no clear reason, ask a health care provider to test for a UTI.
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White House Conference On Hunger Nutrition And Health
The 2022 White House Conference on Hunger, Nutrition and Health was held on September 28 with a livestream for advocates across the country. Several advocates for older adults attended the in-person event. The White House released a national strategy and companies have started releasing their commitments to carrying out the national strategy. The strategy made specific policy recommendations related to the unique nutritional and health needs of older adults including increasing funding for Older Americans Act nutrition programs, making the Supplemental Nutrition Assistance Program online shopping pilot program permanent, developing an older adult nutrition research agenda with external and federal partners, and launching a pilot program to test providing medically tailored meals for traditional Medicare beneficiaries with diet-related health conditions. The work to implement the national strategy has already started and more commitments to action will likely be released in the coming months.
To hear more about the national strategy from the White House Conference on Hunger, Nutrition and Health, join us for a webinar on December 15 from 1 – 2 p.m. Register here.
Preventing Recurrent Urinary Tract Infections In A Woman With Dementia
David Q. Beversdorf, MD Harvey S. Galloway, FSA Raymond T. Foster Sr., MD, MS, MHSc and Paul E. Tatum, MD
Treatment and prevention of urinary tract infections are important aspects of care for patients with dementia, as UTIs frequently result in superimposed delirium that can accelerate cognitive decline in these patients. When UTIs are recurrent, risk of delirium and subsequent cognitive decline is increased, making this scenario particularly problematic. In addition, management of infections is made more difficult in these patients due to altered voiding patterns and complications from efforts to manage their incontinence .1 Numerous studies have examined interventions for preventing recurrent UTIs. Varying results have been reported for cranberry consumption2-4 and for agents such as methenamine5 and antibiotics.6 Probiotics have shown some promise in the treatment of recurrent UTIs.7,8 Among postmenopausal women, intravaginal estrogen cream,9 but not oral estrogen,10 has been shown to reduce the incidence of UTI in those with recurrent infections. We report a case of advanced dementia complicated by recurrent UTIs resulting in delirium that was successfully managed using a systematic hygiene intervention administered by the family caregiver.
Case Presentation
Discussion
References
1. MacMillan RD. Complicated urinary tract infections in patients with voiding dysfunction. Can J Urol. 2001 8:13-17.
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Stroke Or Brain Injury
An injury to the brain, such as from a fall or a stroke, may cause symptoms that seem similar to dementia. Some signs of stroke to watch for
If a person has these symptoms, immediately call 911 or the local emergency number.
People can also develop new or worsened dementia symptoms after a stroke or head injury.
How Does A Uti Affect The Brain
You may be wondering how an infection in the urinary tract affects the brain? Scientists havent found the exact link between UTIs and delirium, but heres what experts believe is happening.
Any time we have an infection, our immune system kicks into gear to fight it off. During this process, our body releases chemicals that cause inflammation. These chemicals can also lead to many of the symptoms we feel, like fatigue or fevers. In older adults, the brain is more affected by the inflammation and the stress hormones that the body produces to fight the infection. The effects of this inflammation and stress on the brain are what show up as delirium.
So, why dont young, healthy adults get delirium with infections like UTIs? This has to do with the blood-brain barrier, a special protection between the brain and the rest of the body. The blood-brain barrier keeps bacteria, viruses, and fungi that threaten the health of the brain from reaching it. This barrier isnt as strong in older adults, so the inflammation from infection has a higher chance of affecting their brains.
However, not all older adults with UTI get delirium, and not all people with delirium have a UTI.
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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.
Can Urinary Tract Infection Cause Incontinence In Dogs
Both urinary tract infections and incontinence can cause leaking of urine. Many times what seems to be incontinence is actually a bladder infection or vaginitis in female dogs, irritating the urinary sphincter and causing leakage of urine when the dog is relaxed.Both urinary tract infections and incontinence can cause leaking of urine. Many times what seems to be incontinence is actually a bladder infection or vaginitis in female dogs, irritating the urinary sphincterurinary sphincterThe urethral sphincters are two muscles used to control the exit of urine in the urinary bladder through the urethra. The two muscles are either the male or female external urethral sphincter and the internal urethral sphincter. When either of these muscles contracts, the urethra is sealed shut. https://en.wikipedia.org wiki Urethral_sphincters
and causing leakage of urine when the dog is relaxed.
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Treatment Of Lower Utis
Lower UTIs are usually treated with a three-day course of antibiotic drugs. Over-the-counter pain relief, such as paracetamol, may also be taken to relieve any associated discomfort.
A urine sample should be taken and sent to a laboratory to identify which bacteria are present. This is called a urine culture. A doctor may request a urine culture for a number of reasons:
- if a person has had two or more UTIs in the past three months
- if there are traces of either blood, white blood cells or nitrites in the urine when the dip test is performed
- if a person has any abnormalities of the urinary tract .
Lower UTIs in men may require further investigation by a urologist. This might include blood tests, an ultrasound scan of the kidneys and bladder, a rectal examination to assess the prostate gland or a cystoscopy to look inside the lower urinary tract with a camera. In some cases the underlying cause may be prostate disease or other urological conditions, such as a bladder stone or tumour, that prevent complete emptying of the bladder.
Does Cranberry Juice Help
Research has come up with different results on this question. Some studies have found a slight benefit of cranberry juice in reducing the risk of UTIs. Others have not found a difference when cranberry juice was ingested. You should check with your healthcare provider first before adding cranberry juice to your diet on a regular basis because it can interact with other medications such as Coumadin .
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The Link Between Uti And Dementia In Older Adults
Your elderly loved one with dementia may suddenly start displaying more severe behavioral symptoms of this disease and you may wonder why. There could be a simple reason behind it all. They could have a urinary tract infection, or UTI. This is a very common phenomenon in elderly dementia patients. Even if your loved one hasnt officially been diagnosed with dementia, you may notice that dementia-like symptoms, such as confusion, come on fairly quickly. Often, this can be traced to the development of a UTI. Whether your loved one is being cared for in a nursing home, in home care, or in hospice, you may wonder why this link exists. Lets explain why.
According to Alzheimers.net, if a senior patient already has dementia, a urinary tract infection may cause behavior changes instead of the physical symptoms that may plague a younger person. Whereas most otherwise healthy people display physical symptoms like burning when urinating, elderly patients may not complain of such pain. However, they may start to behave erratically, which is usually what tips off health care providers. If not detected early, infection can lead to serious health problems.
What To Consider When Helping An Older Loved One Choose A Medicare Plan
With Medicares Annual Open Enrollment ongoing from October 15 to December 7, you may have already begun discussions with your loved one on the basics of Medicare, such as differences from Medicaid and what the different plans and options are. But before such an important decision is made, its important to go more in depth by preparing the right questions with your loved one to guide the conversation and exploring the different points of consideration that will help determine which plan is best for your loved ones individual needs.
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Home Health Caregivers Recognize The Connection Between Dementia And Urinary Tract Infections
The term dementia refers to several medical conditions that reduce an individuals ability to function. Pegasus professionals are trained to meet the special needs of dementia patients. As expert caregivers, they are aware of the connection between dementia and urinary tract infections .
Dementia results from damage to the cells and nerves in the brain. Damaged cells lose the ability to communicate with other cells. The lack of nerve and cellular communication leads to memory loss and a decline in cognitive function.
Dementia patients experience impaired ability to:
- Remember new information
- Speak or interact effectively with others
- Focus or understand activity around them
- Use reason or make good judgments
- Accurately perceive what is seen
Family members will also notice behavioral changes in the dementia patient.
Dementia doesnt occur overnight in most instances. Damage occurs over time. Because its gradual, symptoms often arent noticed until the disease is in advanced stages.
Caring for a dementia patient can be exceptionally difficult for family members. The level of care needed can become exhausting.
Often, a dementia patient does better at home than in a facility. Pegasus home health care makes staying at home possible, as well as relieving the stress family caregivers feel. Home health caregivers provide a much-needed break for families.
When Does A Caregiver Need To Take Action
Any changes in physical or mental status, especially those that come on rapidly, is a warning sign for caregivers to contact a doctor. Quality caregivers can help by keeping clients clean and dry. Noting the symptoms mentioned above and the sudden onset can help minimize the diagnoses time and avoid costly and timely mental health testing. A UTI is quickly identified with a urine test and usually cured with antibiotics. Left untreated, a UTI can spread throughout the body causing serious problems and even death.
While it seems odd that an infection in the bladder can cause a person memory loss and even hallucinations, understanding these symptoms and communicating them to medical professionals can save time and distress in the diagnosis process. Preventive steps and looking out for UTI symptoms should help avoid infection:
- Drink plenty of fluids
- Avoiding bladder irritants such as caffeine and alcohol
- Keeping the genital area clean by wiping front to back after going to the bathroom
- Not using douches
- Urinating as soon as the urge hits
As always, contact your physician with questions or if you suspect your loved one has a UTI.
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When Paired With Dementia Or Alzheimers A Uti Is Often More Than Just An Infection
A urinary tract infection is a type of infection that enters the body through the urethra, and is prevalent among both younger and older individuals. UTIs cause distinct physical symptoms such as painful urination, back pain, and lower abdominal pain. But in older adults, UTIs can often times manifest themselves as behavioral and cognitive ailments.
While a UTI does not necessarily signal dementia or Alzheimers, it can definitely worsen the symptoms of decreased cognitive function. Seniors with a UTI show increased signs of confusion, withdrawal, and agitation, and worse, a person with memory impairment or dementia can experience much more sudden and severe distress, confusion, and behavioral changes known as delirium due to their UTI.
Because a person with dementia may have word-finding difficulty and thus be unable to express their discomfort caused by a UTI, and because UTI-induced behavior changes can be mistaken as a part of dementia and the aging process, the presence of an infection could be hard to identify. This can become very dangerous, as an underlying UTI can eventually spread to the bloodstream and become life-threatening if left untreated. It is important for caregivers to be familiar with the symptoms of a UTI and to seek proper medical help for their loved one. The following are some symptoms of a UTI in dementia to help you identify a potential infection in your loved one:
Urinary Tract Infection In Children
, MD, Golisano Childrens Hospital
Urinary tract infection may involve the kidneys, bladder, or both. Sexually transmitted infections of the urethra , although involving the urinary tract, are not typically termed UTI.
Mechanisms that maintain the normal sterility of the urinary tract include urine acidity and free flow, a normal emptying mechanism, intact ureterovesical and urethral sphincters, and immunologic and mucosal barriers. Abnormality of any of these mechanisms predisposes to UTI.
Urinary tract infections can be divided into upper tract infections, which involve the kidneys , and lower tract infections, which involve the bladder , urethra read more .)
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Four Ways To Prevent Urinary Tract Infections
1. Make sure your loved one drinks plenty fluids six to eight glasses per day. Use cups they can see and hold easily and top them up regularly with drinks you know they enjoy.
2. Give as much assistance as they will allow with personal hygiene. Easy-to-reach wet wipes in the bathroom might help. If they have physical mobility issues which make it harder for them to wipe, there are plenty of products which could make the process easier.
3. Constipation can make it more difficult to empty the bladder, which may, in turn, make a urine infections more likely. Encouraging a healthy, varied diet will lessen the risk of constipation and reduce the chances of another urine infection.
4. Look out for dehydration, as that can increase the risk of urinary tract infections, too. If they struggle to drink fluids , you can still boost their fluid levels through food as well as drink . Thickening agents can also be added to some liquids to make them easier to swallow.
Fungal Urinary Tract Infection
The most common form of fungal infection of urinary tract is that caused by Candida species. Such infections usually occur in patients with indwelling catheters who have been receiving broad-spectrum antibiotics, particularly if diabetes mellitus is also present or corticosteroids are being administered. Although most of these infections remain limited to the bladder and clear with the removal of the catheter, cessation of antibiotics and control of diabetes mellitus, the urinary tract is the source of approximately 10% of episodes of candidemia, usually in association with urinary tract manipulation or obstruction. Spontaneously occurring lower UTI caused by Candida species is far less common, although papillary necrosis, caliceal invasion and fungal ball obstruction have all been described as resulting from ascending candidal UTI that is not related to catheterization.
Hematogenous spread to the kidney and other sites within the genitourinary tract may be seen in any systemic fungal infection, but it occurs particularly in coccidioidomycosis and blastomycosis. In immunosuppressed patients, a common hallmark of disseminated cryptococcal infection is the appearance of this organism in the urine. Cryptococcus neoformans commonly seeds the prostate and far less commonly may cause a syndrome of papillary necrosis, pyelonephritis and pyuria akin to that seen in tuberculosis.
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