Recognizing UTIs in the Elderly and Why it’s Important

A urinary tract infection, or UTI, is the most common type of bacterial infection that affects the elderly. One in ten men over 65 will deal with a UTI, and one in five women over 65 will also. While these infections begin in the bladder, when left untreated they can spread to the kidneys and beyond, leading to serious health complications. In the elderly, these infections may not look like you expect and can be easy to miss. So, how do you recognize a urinary tract infection in a senior, and what should you do about it?

What Causes Urinary Tract Infections?

A urinary tract infection begins when too much bacteria grows inside the urethra (the tube through which urine passes out of the body) or the bladder. Often, this bacteria is introduced from outside the body. Bacteria can come from poor hygiene like infrequent washing, incomplete wiping, or wearing a soiled adult diaper for too long. Sometimes, the bacteria is already inside the body and begins to grow when the bladder is not completely emptied or emptied often enough.

As more bacteria grows, the infection can spread. Sometimes this happens quickly, and an infection that was quite small to begin with can move from the bladder to the kidneys and beyond before you even notice it’s there.

Why are UTIs Different For Seniors?

If you’ve ever had a UTI, you probably recall the symptoms. In younger adults, a UTI often causes pelvic pain, fever, and sense of an urgent need to urinate. Urine may be cloudy or bloody, and often has a strong odor.

In older adults, some of these common symptoms may not be as noticeable. As we age, our immune systems change and often grow weaker. Because of this, many seniors with urinary tract infections do not have a fever.

Another age-related change that can mask a urinary tract infection is bladder weakness. Many seniors already experience some mild incontinence, difficulty, or urgency when their bladder is full. Because this is a normal part of their experience, they may not recognize when there has been a change related to an infection.

All of these difficulties grow if a senior is experiencing any type of age-related cognitive decline, such as dementia. Cognitive decline makes it harder both to notice UTI symptoms and to express that they are happening.

The Biggest Symptom of UTI in a Senior that You Need to Know

For many seniors, the biggest symptom of a urinary tract infection is a behavioral change. This can look like confusion, lethargy, falling or balance problems, agitation, decreased appetite, or even hallucinations. In fact, these changes can be so severe that they can be misdiagnosed as dementia.

If your parent or senior loved one has suddenly developed any of these symptoms, it’s important to get them to the doctor as soon as possible. Urinary tract infections in seniors can lead to life-threatening complications, including permanent kidney damage, or a major infection in the blood known as sepsis.

In seniors who already have a dementia diagnosis, an untreated UTI can speed up cognitive decline. It’s important not to assume that sudden new or worsening confusion is “just” dementia getting worse.

Preventing Urinary Tract Infections in Seniors

There is no way to guarantee that your mom or dad will never contract a UTI. However, these simple measures can help lower the overall risk:

• Emptying the bladder frequently, no “holding it”
• Wiping from back to front
• Staying well-hydrated at all times
• Changing incontinence briefs often throughout the day
• Showering rather than bathing
• For indwelling catheters, clean daily with soap and water as instructed by a doctor

Maintaining urinary tract health is a crucial part of health and well-being for seniors. This is especially important with any kind of condition that raises the risk of UTI, like bladder or bowel incontinence, dementia, catheterization, or immune system compromise.

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