What you need to know about urinary tract infections in older adults

Urinary tract infections often go undiagnosed in the elderly. This can lead to more serious infections and extreme changes in behavior if left unchecked.

Published: by Interim HealthCare in Alzheimer’s, Senior Care

Urinary tract infections are fairly straightforward in younger adults. When bacteria enters the urethra, it can multiply until it reaches dangerous levels, causing an infection. The bacteria can remain in the lower urinary tract or travel upwards, causing a bladder or kidney infection. Common symptoms are tingling or burning during urination, blood in the urine and localized pain, which are easily treated with antibiotics. Elderly patients are unique in both their lack of awareness of an infection and their unique symptoms related to UTIs.

More likely to get an infection

An easy way to prevent infection is to practice proper hygiene after using the restroom. For elderly people who suffer fecal incontinence, mobility issues, or other problems that negatively impact toileting, infection is much more likely. The inability to make it to the bathroom in time can allow bacteria to migrate to the urethra. Mobility issues can prevent adequate access to clean oneself after toileting, and memory issues can result in a person forgetting proper wiping procedures, effectively spreading bacteria.

Waiting a long time between bathroom breaks and dehydration can also increase the likelihood of a UTI. Every time a person urinates, it flushes out the urinary tract and helps remove naturally occurring bacteria. By holding urine, or not creating enough due to dehydration, a person fails to flush their system and bacteria can flourish.

Failure to diagnose

Unlike younger patients, elderly people may not report symptoms of a UTI in a timely fashion. People with memory problems might forget to mention symptoms or forget about them shortly after using the restroom. There’s also a huge uptick in asymptomatic cases in older adults, according to the report Urinary Tract Infection in Older Adults. Whereas a young woman might have an asymptomatic UTI 1 percent – 5 percent of the time, cases can be asymptomatic 25 percent – 50 percent of the time for an older woman in long-term care. In an asymptomatic case, the infection may not be discovered until a caregiver notices signs of more serious problems including blood in the urine, fevers, or signs of sepsis.

Symptoms

In elderly patients the immune system works differently, meaning that typical localized genitourinary symptoms might not present themselves. Instead, behavioral changes and agitation are common especially in patients with dementia, according to Alzheimers.net. This makes diagnosis even more difficult as Alzheimer’s patients might not notice any physical discomfort and agitation or withdrawal is common with memory disorders.

When assessing the health and well-being of an older person, always keep an eye open for signs of a UTI including emotional distress or increasingly anti-social behavior. To help prevent infection, make sure to encourage proper toileting habits and frequency, and provide adequate fluids for hydration.