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What You Must Know About UTIs Among the Elderly

If your parent or elderly loved one shows signs of being confused, it is troubling. Disorientation and delirium can be signs of dementia, Alzheimer's or other age-related mental declines, but it could actually be a sign of a urinary tract infection (UTI). And while this may seem preferable, UTIs can be severe and they are common in the elderly, so it's worth knowing what to expect.

UTI Risk in Seniors

A UTI occurs when bacteria gets into the urethra and moves to the bladder and kidneys. Urinary tract infections are more common in women, although men are more likely to be hospitalized by a UTI. As with many illnesses, seniors are more at risk than the general population, and if they are already showing signs of diminished health, the consequences of a UTI can be far more severe. Other factors that increase the risk of UTIs are more common in the elderly too, such as diabetes, a weakened immune system, an enlarged prostate or kidney problems. Postmenopausal women are particularly at risk.

Symptoms of UTIs

A UTI doesn’t always have obvious symptoms, but they can include:

  • A burning sensation when urinating
  • Frequently needing to urinate, although often passing little
  • Pain in the abdomen
  • Dark or cloudy, strong-smelling urine
  • Blood in the urine
  • Feeling tired or shaky
  • Fever or chills

And in seniors, the above symptoms may be accompanied by an unusual side effect: delirium. According to the Alzheimer’s Society, often when seniors contract a UTI, they may experience “a sudden and unexplained change in their behavior, such as increased confusion, agitation, or withdrawal.” The society warns that the delirium may speed up the progression of dementia and should be identified and treated quickly.

Doctors don’t know why urinary tract infections can cause confusion in the elderly, and with 25 percent of all infections in the elderly being UTIs, it is possible that it’s merely coincidence that seniors have both a UTI and delirium.

Diagnosis and Treatment of UTIs

Most often, your loved one’s doctor will start with a urine sample. The Mayo Clinic says that it’s possible the doctor will attempt to grow a culture to see which bacteria are causing the infection and which medications, if any, will be needed. An ultrasound may be ordered to ensure there are no blockages or irregularity in your loved one’s urinary tract. For recurring UTIs, doctors may have to pass a camera up the urethra to the bladder.

According to the Cleveland Clinic, bacteria in the urine is not necessarily a problem and can often be treated by drinking more fluids, but it’s always safest to check with your loved one’s physician. Gentle heat may help. Antibiotics are commonly prescribed, although the Cleveland Clinic advises that this can encourage antibiotic resistance and that narrow-spectrum antibiotics are preferable for this reason. Severe infections may require hospitalization for IV antibiotics to be administered.

Prevention of UTIs

As with most diseases, prevention is always better than cure, and there are simple steps which can be taken to prevent them:

But if your loved one is infirm, or is suffering from mental decline, these good practices may be hard to enforce.

Professional Caregivers and UTIs

That’s why hiring a professional caregiver to help with your loved one's care could be an excellent way to help avoid UTIs. A caregiver can visit as often or as little as your parent needs and can make sure that your loved one is drinking plenty of the right things. If your loved one needs help with personal care, a caregiver could ensure that she is showering daily and help her should she have that need. A professional caregiver can ensure your loved one is wearing clean underwear daily, which can also help. The caregiver might also gently encourage or remind her to use the toilet, ensuring that she is going as quickly as she feels she needs.

Aside from the physical help they can often give a senior, because of their rich and relevant experience, professional caregivers can help identify the symptoms of UTIs when they occur. A change in the behavior of a senior can signal a UTI. A caregiver, who visits your loved one regularly and knows what her normal behavior is, should be quick to notice the subtle changes like confusion, restlessness, distraction or withdrawal, which could all indicate a UTI.

With senior dementia patients being more at-risk of UTIs, and UTIs being something that could speed mental decline, ensuring your loved one doesn’t contract a UTI can be critical. If your dad isn’t capable of looking after himself like he used to be, then making sure he has someone looking out for him is paramount to protection from a UTI.

If your loved one is showing signs of confusion and disorientation, it's still worth a full medical evaluation. Click here to read more about that critical process. 

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