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Prevention & Treatment of UTIs in Elderly
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UTI Prevention & Treatment in the Elderly

February 12, 2019

Urinary tract infections (UTIs) are common in all people and account for more than 8 million doctor visits annually, according to National Institutes of Health data. But UTI risk increases with age, and older people are more vulnerable to contracting UTIs for several reasons, including their susceptibility to infections due to a weakened immune system. 

UTIs in the elderly are especially dangerous. If left untreated, a UTI can lead to acute or chronic kidney infections and sepsis, a potentially life-threatening infection of the bloodstream. Read on for more insight and best practices for preventing UTI in the elderly.

Group of senior women sitting on a bench

How Do UTIs Happen?

A UTI happens when bacteria enter the urinary tract and multiply in the bladder. UTI infections in the elderly are more common because of underlying problems like a weakened immune system that can’t fight the bacteria, less-efficient bladder emptying, incontinence or bladder obstructions. Other conditions that make elderly people more susceptible to UTIs include:

  • Diabetes
  • Use of a urinary catheter
  • Enlarged prostate
  • Immobility
  • Surgery of any area around the bladder
  • Kidney stones

Why Symptoms of UTIs in the Elderly Aren’t Easy to Spot

It can be difficult to know if an elderly person has a UTI. Some elders who are frail or who have dementia or aphasia can’t communicate their discomfort to caregivers. In addition, the typical symptoms of a UTI (like frequent and painful urination) often don’t show up for elders. Because their bodies respond differently to infection, it is important to look for other signs and symptoms of a UTI in the elderly, particularly sudden changes in behavior like these:
  • Confusion or delirium
  • Agitation
  • Hallucinations
  • Poor motor skills or loss of coordination
  • Dizziness
  • Falling
  • Lethargy
  • Decreased appetite
  • Back pain
  • Nausea or vomiting

Diagnosing UTI in the Elderly

Luckily, once a UTI is suspected, it is easy to confirm by urinalysis. While there are over-the-counter tests you can use at home, these check for bacteria that are often in the urine of older adults to some degree. A positive at-home test may not necessarily mean there is a UTI. If an at-home urine test shows a positive result, call your doctor immediately.

Treating UTI in the Elderly

If a UTI is diagnosed, the likely treatment will be antibiotics. The infection should clear in a few days, but it is important to take the full course of the antibiotics prescribed. It is also important to drink plenty of water while taking the antibiotics to flush out the bacteria. To ease discomfort, over-the-counter pain relievers and a heating pad can be used.

Preventing UTI in the Elderly

There are easy ways to prevent UTI in the elderly:
  • Drink the right beverages: Drinking plenty of water throughout the day will help prevent the buildup of bacteria that cause UTIs. Cranberry juice or cranberry juice blends or cocktail can help fight that bacteria. On the other hand, caffeine and alcohol should be limited as these beverages can irritate the bladder
  • Urinate frequently. By drinking more water, the urge to urinate will become more frequent. Urinating more often prevents infecting bacteria that cause UTIs from building up.
  • Get moving: Elderly people who are sedentary have a higher risk for UTIs. Walking more frequently, even in small increments, helps in preventing UTIs in the elderly.
  • Especially for women: Women should always wipe their perineal area from front to back to prevent bacteria from entering the urethra. In addition, feminine hygiene products like douches, sprays or scented powders should be avoided for the same reason.
  • For brief wearers: People who wear incontinence briefs are at higher risk for UTIs because of the close contact of those products – and the urine and fecal matter they are designed to contain – with the urethra. Incontinence briefs should be checked every two hours and soiled briefs immediately changed. The wearer should be wiped and cleaned before a change of briefs. For seniors who wear briefs and who are memory impaired, set timers to remind them to use the bathroom rather than the brief.
  • For catheterized patients: Catheters can increase the risk of developing a UTI by irritating the urethra and bladder and promoting the growth of bacteria. Gloves should be used during catheter insertion and perineal cleaning, which should happen at least twice daily.

As people age, the risk for UTIs increases, and UTIs in the elderly become more challenging to diagnose. Taking preventive action can reduce the risk of a UTI and the dangerous kidney and bladder issues that can occur. 

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