What About Urinary Tract Infections?

What About Urinary Tract Infections?
Urinary tract infections, better known as UTI’s, are among the most common infections in older adults, especially in women. A urinary tract infection happens when urine pools in the bladder which can cause bacteria in the bladder or kidney to multiply. Younger people tend to empty their bladders completely upon urination, which helps to keep bacteria from accumulating within. But elderly men and women experience a weakening of the muscles of the bladder, which leads to more urine being retained there. In addition, poor bladder emptying and incontinence can cause UTIs as well.

UTI’s aren't just a nuisance – they can result in serious health problems. Left untreated, a urinary tract infection can become something more serious than merely a set of uncomfortable symptoms. UTIs can lead to acute or chronic kidney infections, which could permanently damage the kidneys and even lead to kidney failure. UTIs are also a leading cause of sepsis, a potentially life-threatening infection of the bloodstream.

Older adults are more vulnerable to UTIs for many reasons, not the least of which is our overall susceptibility to all infections due to the suppressed immune system -- this concern comes with age and with certain age-related conditions. Unfortunately, these infections are also commonly over-diagnosed and over-treated. Many doctors note that there is an overuse of antibiotics to treat these infections.

The typical signs and symptoms of a UTI include:
Urine that appears cloudy; Bloody urine; Strong or foul-smelling urine odor; Frequent or urgent need to urinate; Pain or burning with urination; Pressure in the lower pelvis; Low-grade fever; Night sweats, shaking, or chills.

Older adults with serious urinary tract infections don't often get fevers along with a UTI because their immune system is unable to mount a response to infection due to the effects of aging. In fact, older persons often don't exhibit any of the common symptoms – or don't express them to their caregivers.

UTIs in older persons are often mistaken as the early stages of dementia or Alzheimer's, according to NIH, because symptoms can include: Confusion, or delirium-like state; Agitation; Hallucinations; Other behavioral changes; Poor motor skills or dizziness; Falling. Sometimes, these are the only symptoms of a UTI that show up in the elderly—no pain, no fever, no other typical symptoms of a UTI.

Some recommendations to help reduce the risk of UTI’s include the following:
If a person is incontinent, the briefs worn need to be changed frequently; Front-to-back cleansing needs to be encouraged; The genital area needs to be kept clean; Reminders/timers need to be set for those who are memory-impaired to try to use the bathroom instead of the adult brief.

For those of us who are not incontinent but do have recurring UTI’s, there are several recommendations that work to help us reduce our chances of getting a UTI. We need to:

*Drink plenty of fluids (2 to 4 quarts each day).
*Drink cranberry juice or use cranberry tablets, but NOT if we have a personal or family history of kidney stones.
*Avoid caffeine and alcohol, because these irritate the bladder.
*Do not douche or use other feminine hygiene products.
*Always wipe from front to back (for women).
*Wear cotton-cloth underwear, and change them least once a day.

We need to see our doctor right away if we think we have a UTI. It’s an easy urine test and we shouldn’t hesitate as the infection may only get worse and harder to fight. Often antibiotics are prescribed to eliminate the infection.

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Content copyright © 2023 by Patricia Villani, MPA, PhD. All rights reserved.
This content was written by Patricia Villani, MPA, PhD. If you wish to use this content in any manner, you need written permission. Contact Patricia Villani, MPA, PhD for details.