UTIs in Elderly Patients with Incontinence
Urinary Tract Infections (UTIs) are extremely common in older adults, especially adults in nursing home or adults experiencing regular urinary or fecal incontinence. In this article, we’ll go over the basics about UTIs in older adults, their connection to incontinence, and how to prevent and treat them.
What are UTIs?
A UTI occurs when bacteria enters through the urethra and spreads to the ureters, bladder and kidneys, unable to be fought off by your immune system.
Who do UTIs affect?
UTIs affect women more than men due to the fact that women have shorter urethras than men do. What’s more, people become more at risk for developing UTIs as they age. More than 10 percent of woman older than 65 and 30 percent of women over 85 have had UTIs in the last year, one study claims.
For patients in nursing homes, more than one-third of all infections experienced are UTIs.
What are the symptoms of UTIs in the elderly?
The most common sign of a UTI is a painful, burning sensation while urinating. Other classic signs include frequent urination, pelvic pain, fever, chills, or blood or abnormal color in urine.
But for older adults and the elderly, symptoms can be much more convoluted.
Some older adults have slower or suppressed immune responses, secondary conditions that mask symptoms, or conditions like Alzheimer's or dementia that make it difficult to recognize or communicate symptoms. Any of these factors can make recognizing a UTI in an older adult significantly more difficult.
Keep an eye out for the following symptoms if you’re unsure an elderly patient has a UTI:
- Urinary retention
- Decreased appetite
- Decreased mobility
What causes a urinary tract infection?
Bacteria entering through the urethra is the primary cause of UTIs at any age. Escherichia coli, also known as E. coli bacteria, causes 85% of all UTIs. A range of other bacterias make up the additional 15%. E. coli appears naturally in the gastrointestinal tract, so poor hygiene surrounding bowel movements is a major cause of UTIs.
UTIs in adults with incontinence
Older adults who wear incontinence products are at an increased risk for exposing the urethra to E. coli, particularly if they are wearing the wrong products or if the products are not changed frequently enough. Soiled incontinence products, when left on too long, can introduce harmful bacteria into the urinary tract.
Are you at risk for a UTI?
UTIs are more frequent in older adults. If the following applies to you, you are at a higher risk of having UTIS:
- Urinary retention or neurogenic bladder
- Disposable incontinence products that aren’t changed regularly
- Alzheimer’s disease
- Parkinson’s disease
- A history of UTI’s
- Use of a catheter
- Regular incontinence
- Bladder prolapse
Older females who are postmenopausal are at a higher risk of UTIs, because they experience an estrogen deficiency after menopause (estrogen may help protect against E. coli overgrowth).
In older males, bladder stones, kidney stones, prostate issues, and a history of prostate infections increase the risk of UTIs.
Treating UTIs in the elderly
Most commonly, a prescription of antibiotics is required to treat a UTI. Amoxicillin and nitrofurantoin are often prescribed to treat UTIs, but there are some more severe cases that will call for stronger antibiotics like ciprofloxacin or levofloxacin.
You should go to the doctor to receive an antibiotics prescription as soon as you suspect a potential UTI. Starting as soon as possible can help to minimize discomfort and other related issues. Because some bacteria will still exist in your urinary tract even as symptoms fade, it’s crucial you take antibiotics for the duration of of your prescription, rather than stopping when you feel better. If you stop treatment early, bacteria can regrow, and you’ll build up a resistance to antibiotics if you are prescribed them again too soon.
If an older person is at a high risk for UTIs or experiences them multiple times a year, it is possible to disguss taking daily antibiotics (called prophylactic antibiotics) to fend off UTIs.
If it doesn’t conflict with other medications or conditions, patients may also take over-the-counter pain relievers like ibuprofen or acetaminophen to ease the immediate pains associated with UTIs.
The importance of water consumption
Drinking plenty of fluids is crucial both for treating UTIs as well as preventing them. Staying hydrated will flush out the remaining bacteria in your urinary track, or help prevent it from forming in the first place.
How to prevent UTIs in the elderly
Sometimes urinary tract infections are impossible to prevent, but many steps can be taken to greatly reduce your chance of infection.
Make sure you drink plenty of fluids daily and, if you’re at a higher risk of UTIs, avoid diuretics like caffeine or alcohol. Make sure you upgrade to a more absorbent incontinence product and that it is changed frequently. Every time you use the bathroom, make sure you wipe from front to back and keep the area clean.
UTIs are often a regular part of life for older adults with incontinence, but with some baseline knowledge and the right preventative measures, can be easily avoided and managed.