Urinary Tract Infections (UTI) in Seniors – Signs, Symptoms, and Treatment

What is a Urinary Tract Infection (UTI)?

A UTI is an urinary system infection that can affect the urethra, ureters, bladder, and kidneys. Most infections involve the lower urinary tract which includes the bladder and urethra. The classic symptoms of a Urinary Tract Infection (UTI) are burning pain and frequent urination, but UTIs may not cause these same symptoms in older adults.

Instead, older adults may present with behavioural symptoms such as confusion or frustration. Although the reason for this connection is unknown, the connection between UTI and confusion has been well documented.

What are the symptoms of a UTI?

The classic symptoms of a UTI include:

  • Painful urination
  • Cloudy urine
  • Frequent urination
  • Urgent need to urinate

Older adults may also present with different symptoms. Non-classic symptoms to look out for are:

  • Sudden onset of confusion, or increase in confusion
  • Increased irritability
  • Incontinence
  • Lethargy
  • Falls
  • Decreased mobility
  • Pain in pelvic region

It is important to be aware of these alternative symptoms, especially if you are caring for loved ones who have dementia or are unable to easily communicate. If the infection spreads to the kidneys you will see more severe symptoms such as:

  • Fever
  • Flushed skin
  • Back pain
  • Nausea
  • Vomiting

What are the risk factors for UTIs in older adults?

There are several factors which increase the risk of UTIs in older adults. Conditions such as dementia, Alzheimer’s, Parkinson’s, or diabetes are more likely to cause incontinence; if incontinence briefs are not changed regularly, an infection may occur. People with incontinence are more likely to hold in their urine which will increase the risk of infection, creating a difficult cycle to break. Catheter use may also increase risk.

Risks for Men vs Women

In women, the change of hormones that comes with menopause may increase the risk of getting a UTI. In men having a bladder stone, a kidney stone, bacteria prostatitis (chronic infection of the prostate), and an enlarged prostate may increase the risk.

Caring for Seniors with UTI

If you are caring for a person with dementia it is important for you and your loved one’s health team to know the signs that they may have a UTI. Be aware that changing incontinence briefs regularly is a key step in preventing UTIs in those with limited mobility or dementia. If your loved one is in a nursing home, talk to the nursing staff right away if you suspect a UTI.

How is a UTI diagnosed?

Older adults are more likely to have non-classic UTI symptoms, often making it harder to diagnose. Once a UTI is suspected it is easy to test with a urinalysis. Your doctor may perform a urine culture to determine what type of bacteria is causing the infection and what the best antibiotic will be to treat it.

What is the treatment for a UTI?

Antibiotics are a typical treatment for UTIs in both older and younger adults. Antibiotics should be started as soon as possible ensuring the whole course of antibiotics is taken to completion. Failing to take the medication in its entirety can result in an increased risk of recurrence and antibiotic resistance.

Another important practice is drinking plenty of water in order to flush out the bacteria. Healthy older adults may want to take over-the-counter pain medication to ease the sting of the burning during urination. A hot water bottle or heating pad may help relieve pelvic pain. Consult your doctor before using home remedies, especially if you have other medical conditions.

Without treatment the infection can spread to the kidneys and the blood stream which can lead to life-threatening blood infections. Severe infections may require a hospital stay for the use of intravenous antibiotics and it can take weeks to resolve.

How to prevent UTIs?

While it is impossible to completely prevent all UTIs, there are steps you can take to decrease the chance of infection. These measures should include:

  • Changing incontinence briefs frequently
  • Urinating when the urge hits
  • Drinking plenty of fluids
  • Keeping the genital area clean by wiping front to back
  • Avoiding bladder irritants such as caffeine and alcohol

Cranberry juice has shown mixed results in preventing UTIs; if you are diabetic it may be better to stick to water because of the sugar content.

Taking preventative steps and looking out for unexpected UTI symptoms, especially confusion, can help prevent infection. It is critical to act as soon as a UTI is suspected, as the outlook is typically more promising the earlier a diagnosis is made.

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