UTI in the elderly

UTIs in the elderly: symptoms, treatment, and prevention Why do elderly people often suffer from UTIs? How can you spot the early signs and symptoms of a UTI? And what can be done to treat and prevent UTIs?

In this article, we look at UTIs in the elderly and discuss signs and symptoms, treatment, and prevention.

What is a UTI? A UTI, or Urinary Tract Infection, is a bacterial infection that impacts the urinary tract. It often starts from the urethra and can move up the ureters, into the bladder (lower UTI). If untreated, a UTI can eventually reach the kidneys (upper UTI).

If not diagnosed and treated in time, a UTI (especially an upper urinary tract infection) can affect the blood system. And in extreme cases, this can lead to sepsis, a life-threatening condition that requires immediate medical attention.

The vast majority of UTIs are caused by a 'common' bacteria called E. coli. This type of bacteria is found in the gastrointestinal tract. And it can easily make its way into the urinary tract via the urethra as a result of poor hygiene or incorrect or insufficient cleaning. UTIs in women are more frequent than in men.

Why do UTIs affect the elderly? Various factors can make elderly adults more susceptible to UTIs. Some of these include: • Poor hygiene. As energy levels and the ability to carry out daily tasks decrease during the ageing process, older adults might struggle to wash or bathe as often as they should. This can increase the risk of infection. • Weakened immune system. With old age, the immune system also weakens. As a result, the body becomes more exposed to and less able to fight external bacteria. • Not drinking enough water. Bladder control issues and weakening of the muscles (mainly bladder and pelvic floor) might be responsible for incontinence and bladder control issues. Because of this, elderly adults sometimes avoid drinking for fear of urinating more often or having accidents when out of the house. This obviously has a detrimental impact on someone's hydration, energy, and concentration levels. But it can also increase the risk of UTIs. • Urinary retention. Again, due to reduced energy levels and poor mobility, senior citizens might struggle to use the toilet as often as they should. When urine stagnates in the bladder, it's more likely to get infected. How can you spot the signs and symptoms of a UTI? Spotting the signs and symptoms of a UTI can sometimes be difficult in elderly relatives or loved one. Physical symptoms can vary between lower urinary tract infections (affecting the urethra and bladder) and upper urinary tract infections. Some of the symptoms include: • Frequent urination. • A burning sensation when going to the toilet. • Cloudy urine. • Mild fever. • Lower abdominal pain. And if the infection has reached the kidneys, you can also expect:

• High fever. • Nausea or vomiting. • Loin or lower-back pain.

Depending on the person's general state of health, these symptoms can easily be confused with other illnesses or ailments. And that's especially true if the person fails to communicate that they're experiencing a burning sensation when using the toilet, for example. In other words, these signs and symptoms can be easily missed or misinterpreted.

But more often than not, UTIs in the elderly can cause changes in behaviour. Why do UTIs cause changes in behaviour in the elderly?

Some of the most striking (and yet still easy-to-miss or misinterpret) signs that an older adult is suffering from a UTI are sudden changes in behaviour. Often referred to as delirium, these can include: • Mental confusion. • Agitation. • Disorientation. • Dizziness. • And even falling and impaired movements.

These symptoms can create a great deal of concern in family members and loved ones, as they can often be associated with other conditions, including dementia. And, if the patient already suffers from dementia, they might be even harder to spot.

The reason why it's believed that UTIs create changes in behaviours in the elderly is that the immune system is already weakened, and fighting infection can be extremely taxing. Generally speaking, UTIs (and other infections) can cause dehydration, an increase in temperature, brain inflammation, and therefore mental and physical changes.

If you want to find out more about UTIs and dementia, this 11-page publication from The Alzheimer's Society contains useful information.

How to treat UTIs in the elderly If you notice any sudden changes in behaviour in an elderly relative or loved one or if you suspect they might have a UTI, contact your GP promptly or call 111 out of hours. A simple urine culture test performed on a urine sample can help diagnose a bladder infection or other UTI and determine the type of bacteria that caused it.

Once a urinary tract infection has been diagnosed, a doctor will be able to prescribe the right course of antibiotics to treat it. To relieve pain and discomfort, over-the-counter painkillers might also be recommended. And finally, older people recovering from UTIs should drink plenty of water (as well as cranberry juice) and rest.

Preventing UTIs in the elderly Here are some simple tips you can follow to prevent the occurrence of UTIs in an elderly relative or loved one. • Monitor fluid intake. This is the most important step to prevent dehydration, so encourage the person to drink between 6-8 glasses of water or other fluids. Alcohol should be consumed in moderation. • Prompt them to use the toilet frequently and not hold urine in the bladder for too long. Becoming constipated also increases the risk of developing UTIs. • Maintain good hygiene.

Does your elderly relative or partner suffer from frequent UTIs?

Detecting the signs and symptoms of a UTI can be difficult, especially if a loved one has dementia or lives on their own. This can make it harder for you to seek medical help at the right time.

If you or your family feel you need some additional care or support, our CAREGivers are professionally trained to spot any changes in mental state or behaviour. Having a carer for a few hours a day could make all the difference in obtaining an early diagnosis and starting treatment sooner rather than later. If you'd like to talk about how we can help, feel free to contact us on 02087 461213 or fill in this form, and we'll be in touch.

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