A UTI in elderly folks is quite common and can affect anyone at any time. In this article, we want to dissect what UTI’s are, show what types of symptoms accompany them, break down different kinds and provide educational information on how to diagnose and treat them. Although commonly managed and alleviated in a short period, some cases are more severe and require additional treatment.
WHAT IS A UTI?
Firstly, let’s discuss what a UTI is. A UTI is a Urinary Tract Infection. Generally speaking, infections are caused by microbes. Sometimes referred to as “microscopic organisms,” microbes are living things that are so small they cannot be seen with the naked eye. The term references different life forms, all who have unique sizes and characteristics. Some examples of these include bacteria, fungi, and viruses.
The most common cause of a UTI in elderly person(s) stem from bacteria. Bacteria in the urinary tract usually exits rapidly before causing any symptoms. However, in some cases, our bodies’ natural defenses aren’t enough to eliminate all bacteria, and these bacteria wind up causing infection.
When bacteria get into the urine and travel up into the bladder, UTI’s occur. Cystitis refers to an infection in the bladder while infections in the urethra are called urethritis. Health care providers receive more than 8.1 million visits for UTI’s each year.
WHO DO UTI’S AFFECT?
No one is immune to getting a UTI, but some are more likely to get one than others. Some examples of those at higher risk include:
- People who have suffered injuries to their spinal cord or have nerve damage in the vicinity of the bladder
- Individuals who have a blockage in their urinary tract. Kidney stones, birth defects, or an enlarged prostate can create an obstruction and trap urine in the bladder
- Those who have diabetes
- People who have weakened or problematic immune/natural defense systems
Those who have pelvic organ prolapse, caused by pelvic organs such as the bladder, uterus, or rectum shifting out of place and into the vagina are also more likely to get a UTI. Pelvic organs that are displaced can put pressure on the bladder which makes it difficult to empty completely. Urine that remains in the bladder for too long makes infections more likely to occur.
Certain activities can increase the risk of a UTI in the elderly, such as:
- Sexual activity which can transfer bacteria from the vaginal cavity or bowel to the urethral opening. Urinating after sexual activity can lower the risk of a UTI
- Needing a catheter to urinate which can create a direct path allowing bacteria to reach the bladder
SYMPTOMS OF UTI’S IN THE ELDERLY
In most cases, UTI’s include symptoms such as frequency, urgency, pain, chills, and tenderness. However, in seniors, these symptoms may be different or may not be present at all.
Symptoms that may occur in the elderly but typically do not occur in younger adults include confusion or mental changes, vomiting or nausea, shortness of breath, coughing, or abdominal pain.
Other symptoms that may indicate a UTI in the elderly include urine that is cloudy, has traces of blood, or is foul-smelling, a painful burning sensation during urination, a constant and strong urge to urinate even after voiding, and a mild fever.
If a UTI spreads to the kidneys, symptoms typically include:
- Night sweats
- Shaking and chills
- A feeling of not being well or constant tiredness
- A fever exceeding 101 degrees Fahrenheit
- Flushed, warm, or reddened skin
- Nausea and vomiting
- Very noticeable pain in the abdominal area as well as the side, back, or groin
In some instances, a urine test reveals the presence of germs in the urine despite the absence of any UTI-related symptoms. It is possible in this scenario that no treatment will be necessary, but it is important to discuss with your health care provider anyway.
Diagnosing UTI’s in the elderly often requires testing a urine sample. Testing will determine where the infection is and what is causing it.
The use of a plastic or paper dipstick is the most cost-effective method for urinalysis. The dipstick contains chemicals that cause a color change. A color coded chart reveals the result of the test.
A urine culture diagnoses UTI’s by identifying infection causing bacteria or yeast. Performing a urine culture can aid your physician in determining which drug(s) are likely to be most successful in treating it. Doctors may order urine cultures in conjunction with urinalysis’ or as follow-ups to urinalysis’ containing abnormal results.
Sometimes a physician will opt for a clean catch sample. A clean catch sample is a slightly different method of collecting urine. The purpose to prevent germs from getting into the stream. These samples involve a process that includes washing the hands thoroughly, using a sterile wipe to clean the outside of the genital area and urinating a small amount before collecting the sample.
In some cases, an ultrasound may be necessary. An ultrasound can give a doctor a better idea of what types of bladder or kidney problems may be occurring and how these issues may be contributing to the infection.
CAT Scans and X-Rays are less common diagnosis methods, but in some cases, these can also be helpful in locating abnormalities or getting a clearer picture.
HOW TO TREAT UTI’S ONCE DIAGNOSED
Because bacteria cause most UTI’s in seniors, the standard treatment practice is to prescribe antibiotics. The antibiotic prescribed and the length of the treatment will depend on the history of the patient. Treatment will vary from a patient with recurring UTI’s and another with a standalone infection.
Commonly used antibiotics for uncomplicated UTI’s include:
- A 3-day course of trimethoprim-sulfamethoxazole which is a combination of an antibiotic and a sulfa drug
- A common antibiotic called Nitrofurantoin, which usually involves a five day administration period
- Fluoroquinolone antibiotics, which are also sometimes referred to as quinolones, are only used when other antibiotics cannot be prescribed and are usually taken over a 3-day period
- Amoxicillin, cefaclor, and cefpodoxime-proxetil are other considerations when other antibiotics are not appropriate
In these cases, antibiotics will usually clear the infection up within a week. If a relapse occurs, physicians will treat the infection in a similar fashion but will extend the duration of the time the patient takes the antibiotics.
Some urinary tract infections in the elderly are classified as “complicated.” Complicated UTI’s refer to infections that occur in those who are also weakened by other conditions or when there is an existing abnormality (structural or functional) of the urinary tract. Examples of this include kidney stones or prostate enlargement affecting the urethra.
Treatment for complicated UTI’s vary from standard, uncomplicated infections. Complicated infections must target and address the underlying problem which may include surgery. Kidney damage can result without proper treatment of the root cause.
Overuse of antibiotics is prevalent and preventing UTI’s in the elderly is an important issue. Cranberry formulations are an effective non-antimicrobial therapy because of their ability to reduce bacteria.
Simple diet and nutrition habits also may prevent recurrent UTI’s. Regular exercise and a healthy diet can benefit the body in multiple ways including strengthening the ability to fight off infections. Consuming plenty of water on a daily basis is important. The standard water consumption recommendation lies between six and eight 8-oz glasses per day.
Frequent urination is also a good preventative measure for UTI’s. A person should use the bathroom any time the urge to urinate arises. When urine remains in the bladder for extended periods of time, bacteria can grow and cause issues.
Sometimes clothing may also have an effect on susceptibility to UTI’s. Tight fitting undergarments or jeans can trap moisture and aid the growth of bacteria which can lead to infections. Wearing looser fitting clothing around the urethra can keep the area dry and less inviting for bacteria.
THE FINAL SAY
If you’re getting older and are experiencing a UTI, chances are it’s not the first time. However, if it is, it’s important to understand what is causing it in order to receive proper treatment. Dangerous kidney or bladder issues may occur if UTI’s are left untreated or are not correctly addressed. Following preventative care methods will help lower your chances of recurrence.
Do you have personal experience with UTI’s or have you cared for someone who has had them? We encourage you to share all of your tips and tricks for treatment below in our comments section!