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UTI and Seniors

Tuesday, September 01, 2015

UTI and Seniors

For an adult aged twenty to sixty, a UTI (Urinary Tract Infection) can be a painful, uncomfortable experience, but with proper medication and treatment  it will be gone within a few days. For a senior, it is a very different experience; an elderly UTI rarely causes such clear symptoms and might not involve pain or discomfort at all. "As you get older your immune response changes; it's part of normal aging," says Anna Treinkman, a nurse practitioner at the Rush Alzheimer's Disease Center in Chicago and president of the National Conference of Gerontological Nurse Practitioners. 

The population most likely to experience UTIs is the elderly. Elderly people are more vulnerable to UTIs for many reasons, not the least of which is their overall susceptibility to all infections due to the suppressed immune system that comes with age and certain age-related conditions. According to the National Institutes of Health (NIH).

Younger people tend to empty the bladder completely upon urination, which helps to keep bacteria from accumulating within the bladder. But elderly men and women experience a weakening of the muscles of the bladder, which leads to more urine being retained in the bladder, poor bladder emptying and incontinence, which can lead to UTIs.

Symptoms of UTIs

The typical signs and symptoms of a UTI include:

  • Urine that appears cloudy
  • Bloody urine
  • Strong or foul-smelling urine odor
  • Frequent or urgent need to urinate
  • Pain or burning with urination
  • Pressure in the lower pelvis
  • Low-grade fever
  • Night sweats, shaking, or chills

Elderly people with serious urinary tract infection don't exhibit the hallmark sign of fever because their immune system is unable to mount a response to infection due to the effects of aging. In fact, elders often don't exhibit any of the common symptoms – or don't express them to their caregivers.

UTIs in the elderly are often mistaken as the early stages of dementia or Alzheimer's, according to NIH, because symptoms include:

Confusion, or delirium-like state



Other behavioral changes

Poor motor skills or dizziness


Sometimes, these are the only symptoms of a UTI that show up in the elderly—no pain, no fever, no other typical symptoms of a UTI.

According to NIH, the following conditions make the elderly more susceptible to UTIs:


Urinary retention (unable to empty the bladder, even if your loved one has just used the bathroom)

Use of a urinary catheter

Bowel incontinence

Enlarged prostate

Immobility (for example, those who must lie in bed for extended periods of time)

Surgery of any area around the bladder

Kidney stones

How to Reduce Risk of UTIs

People with incontinence are more at risk for UTIs because of the close contact that adult briefs have with their skin, which can reintroduce bacteria into the bladder. Some recommendations to help reduce this risk include the following:

Change the briefs frequently

Encourage front-to-back cleansing

Keep the genital area clean

Set reminders/timers for those who are memory-impaired to try to use the bathroom instead of the adult brief

Other ways to reduce the chance of UTIs:

Drink plenty of fluids (2 to 4 quarts each day).

Drink cranberry juice or use cranberry tablets, but NOT if your elder has personal or family history of kidney stones.

Avoid caffeine and alcohol, because these irritate the bladder

Do not douches or use other feminine hygiene products

Always wipe from front to back (for women)

Wear cotton-cloth underwear, and change them least once a day

There are great kits you can buy at the drug stores, such as, Walgreen’s, CVS, and RiteAid between $10 and $20 that will give you an accurate reading and if it does show positive, see your doctor right away.


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