Urinary Tract Infections are one of the most common afflictions in women aged 65 and older. Studies show that women 65+ get UTI’s one or more times annually and they usually become a recurring issue. Unlike UTI’s that occur when women are younger and are approached by drinking cranberry juice and 8 glasses of water a day, UTI’s in the elderly are very different.

A UTI is when a bacteria or fungal infection enters the upper or lower area of the urinary tract. Bacteria can grow and spread into other parts of the urinary tract. Worse still, the bacteria can enter the bloodstream and travel to other organs, including the brain. Without treatment, a UTI can lead to urosepsis.

What’s different about getting it when older? 

  • Symptoms
    1. UTIs in the elderly can cause more intense and long-lasting symptoms beyond the difficulty passing urine, back or abdominal pain, and frequent painful or burning urine
    2. UTIs in the elderly cause nausea, fatigue, confusion, or dizziness. In extreme cases, agitation at being frequently unwell can cause long term effects like weakness or depressive episodes or significant mood swings or memory issues that are similar to dementia like symptoms
  • Signs
    1. Spotting a UTI can be complicated. Usually, most people (both patients and caregivers) are not aware until the symptoms peak and there is significant discomfort or the obvious inability to pass urine and signs of an infection
    2. In the elderly population, this can be harder to diagnose because the signs and symptoms of a UTI may be masked by pre-existing conditions that cause incontinence or medication that triggers frequent urination
  • Risks
    1. Getting a UTI after the age of 60 is vastly different than occasionally when younger. Studies and statistics show that it is both prevalent and recurring. As the human body ages, our immune function naturally begins to decrease. Combine this change with a common pre-existing condition or comorbidity like Diabetes (affects 1 in 4 Americans), Kidney stones (affects 1 in 11 Americans) or Bladder related issue (affects 1 in 13 Americans), the prevalence of UTIs becomes clear
    2. UTIs are prevalent in Assisted Living Facilities or elderly community living populations. This is due to reduced prevention strategies and 1:1 care in a communal setting
    3. Short term effects of a UTI are symptom related. The discomfort of constantly feeling the urge along with the inability to pass urine, abdominal pain, or a burning sensation in the ureter are daily challenges that either you or an elderly caregiver must navigate
    4. Long term effects of UTIs are mental health impacts (constantly navigating or monitoring for signs and symptoms), severe symptoms that require hospitalization or antibiotics, and a careful but frequent toileting routine to reduce the risk of a recurring UTI. This adds a layer of complexity in the elderly population – reduced mobility might prevent this from happening and the need for intervention like a caregiver becomes apparent. If a caregiver is already present, then the need for an established toilet routine becomes necessary

Prevention

  1. Preventing a UTI is both simple and challenging at once. Simple because paying attention to a few daily things like:
    1.  correct wiping technique
    2. maintaining water/ fluid intake to reduce dehydration
    3. vigilant monitoring for any changes to indicate the onset of a UTI 

can help reduce the recurrence and severity of a UTI

  1. These factors become challenging in the elderly because pre-existing conditions, changes in physical health or declining mobility can impact the effectiveness and consistency of simple preventive measures

UTI and Alzheimer’s, Dementia, Parkinsons 

Along with the usual health conditions that are common with aging and can cause UTIs, Alzheimer’s and Dementia diagnosis add a level of complexity and need for constant monitoring to help reduce the recurrence of UTIs. 

  1. UTIs in a person with a memory impairment or dementia can cause sudden and severe confusion known as ‘delirium’. The Alzheimer’s society has a useful checklist of things for caregivers working with patients with dementia and UTIs here
  2. UTIs is a common precursor to acute neurological deterioration in patients with Parkinson’s and a leading cause of delirium, functional decline, falls, and hospitalization

Next Steps

The signs, symptoms, risks, and preventive strategies point to a need for constant monitoring or vigilance in the elderly. This means education, awareness and a plan for next steps once you see the signs or symptoms. Sharing this or similar articles with parents or loved ones can help. External interventions such as engaging the services of a full-time or part-time caregiver can help because there is both assistance with toileting and daily preventative strategies, as well as constant monitoring for signs and symptoms

Care Mountain

Aging is a challenging process and with a growing population of seniors in the US, more and more families will have to navigate these scenarios with their loved ones. With over 17 years of experience providing live-in and hourly in-home care to families across Dallas and Ft. Worth in areas ranging from Arlington, South Lake, Preston Hollow, Highland Park, Plano, McKinney, and Friso – Care Mountain is well-versed in understanding the nuances and specifics of every family needing caregivers and can help you

 Contact us today to help with your caregiving needs

2 Comments

  1. Taz says:

    UTI symptoms in elderly can be different. My mother who is close to 88 years old, recently suffered severe case of UTI. Her symptoms were uncontrollable shaking from head to toe, chills and confusion. We had to immediately hospitalize her, oral antibiotics were ineffective, her condition stabilized after two days in the hospital with strong antibiotics delivered via IV. She was in the hospital for almost two weeks. She is home now, but very weak and her mobility is severely limited. Doctors told us it will take months of physical and occupational therapy to get her mobility back to semi normal. I am also observing signs of delirium which is also a side effect. Our family will follow the advice by Care Mountain to prevent a reoccurrence of UTI.

    • Taz, We fully agree with your observations. UTI or Urinary Tract Infection seems “innocuous” to most of us but in the elderly it can be a very very serious thing. Not only because its symptoms can be confused with dementia like symptoms or delirium, but as your Mom experienced, it can be a extremely serious and debilitating situation with a long tail of recovery, including rehab, PT, OT. Thank you for sharing your observations and we hope it will benefit other families that are dealing with this innocuous but difficult situation for their elderly loved one.

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