UTI In Older Adults

October 19, 2021 Jessica Kluetz

How does a UTI affect an elderly person?

My grandma, who we called Ma-maw, was the sweetest lady you could have ever met. She was pretty sharp too. Because we all knew how Ma-maw was at her baseline, it was generally pretty obvious when she had a urinary tract infection (UTI) brewing. It was always such a drastic change, so in general, we knew she had a UTI before the test results came back.

My experience with my Ma-maw has also been similar to my experience in practicing medicine in the inpatient world. If a patient developed a sudden change in her mental status, an infection, especially a UTI, would always be near the top of my list of possible causes. The faster the infection is diagnosed and treatment initiated, the less likely your loved one will need hospitalization for more aggressive antibiotic treatment.

Why is my aging parent prone to UTIs?

Urinary tract infections are not the most exciting post to read about, I know, but I still feel it was an important topic to cover due to how common they are, especially in the elderly. Why is that? Why are they much more common in the elderly population?

The National Institutes of Health (NIH) lists some of these reasons. These include urinary retention (bladder and pelvic floor muscles are weak, so cannot fully empty the bladder, allowing urine to sit in the bladder and grow bacteria), urinary incontinence (soiled undergarments), enlarged prostate, use of a urinary catheter, and diabetes. All of these reasons are more common in the elderly, thus leading to more UTIs in the elderly.

Are there things that can be done to help prevent UTIs?

Absolutely. The biggest thing is to make sure your loved one has processes in place to help keep her undergarments clean. This might be a regular toileting schedule (attempting to urinate every couple of hours while awake in order to avoid incontinent episodes. It might also mean making sure your loved one has his undergarments changed as soon as an incontinent episode occurs. This can be a daunting task, I know.

Unfortunately, no matter what steps you take in prevention, there is still a great likelihood for an occurrence of a UTI.

How do I know if my aging parent has a UTI?

The next step, then, is to be alert for changes in your loved one that might indicate an infection has developed. As I stated earlier, my Ma-maw would usually become quite confused. This seems to be pretty common.

There are other signs, however, and they are not always what you would expect, i.e. not always just burning with urination. Yes, there can be burning with urination, or blood in the urine, or foul smelling urine. Oftentimes, however, if these things occur, there are other symptoms such as confusion or hallucinations, making it difficult for her to tell you there is a problem.

Other signs of a UTI might be worsened generalized weakness, increased drowsiness, agitation, falls or just an overall change in usual behavior.

(Related blog post: Causes Of Delirium)

What do you do if you notice these changes in your loved one?

If it is during the day, and she seems otherwise stable (conversant, no fever, taking in an adequate amount of fluids), make a call to her primary care physician to discuss next steps. If you have any concerns she is not stable or is going downhill quickly, call her primary care doctor first. If you feel like calling her primary care doctor is going to take too long, there is nothing wrong with getting her to the hospital if you feel she is not stable.

If you notice these changes in the night, a call to the primary care doctor’s answering service is the next best step. Again, if you feel your loved one is going downhill quickly, however, it is justifiable to take her to the hospital. In a perfect world, we would be able to keep our loved ones out of the hospital, but oftentimes, the hospital is what they need for the best treatment.

Urinary tract infections seem to come with the territory in the aging population. The hope is to identify the infection early so that treatment can get started right away. Hopefully, knowing what signs to watch for will catch some of these infections early on in order to avoid a prolonged infection or hospitalization.

Feeling overwhelmed with the process?

Afraid you may not make the right decision at the right time? This stage of life for you and your aging parent often brings more questions than answers. Reading information from a trusted source like me can help guide you in the process. However, if you still feel overwhelmed, don’t hesitate to reach out to me. I am happy to help with a personalized plan for your unique situation.