Urinary tract infections, also known as UTIs, are not just an annoyance; they have the potential to cause life-threatening complications such as kidney damage and sepsis in elderly patients. Older adults are more susceptible to UTIs than the rest of the population because of the decreased immunity and weakening of the bladder muscles that occurs with age. For this reason, it is very important that you, as the caregiver, keep an eye out for the signs and symptoms of UTIs in your elderly patients and loved ones.
The most common symptoms of a UTI are pain with urination, a foul smell to the urine and the urge to urinate frequently, even though little urine is passed. Some patients also pass a small amount of blood in the urine. This is sometimes quite alarming for the patient, and is often the symptom that causes them to first tell their caregiver that something is wrong. Some, but not all elderly patients experience a low-grade fever when they have a UTI. Those who have weakened immune systems are not able to mount a response to the invading bacteria, and thus they do not develop fevers.
Because many elderly patients do not report their symptoms to caregivers, it is important that you also know the outward signs of UTIs in the elderly. UTIs are frequently mistaken for dementia because of the signs that they cause. Agitation, delirium and confusion are quite common in patients whose immune systems are not able to fight off the infection.
Some elderly UTI patients also experience loss of motor skills, dizziness, hallucinations and falling. It is not unusual for these to be the only signs of a UTI that show up in an older patient; fever, pelvic pain and bloody urine are sometimes absent.
If you think that one of your patients may have a urinary tract infection, be sure to report it to his or her physician, who can take a swab to test for the offending bacteria. Once the condition is diagnosed, it is important that treatment is begun immediately. Left untreated, the infection can spread to the kidneys and lead to kidney failure. It can also spread to the blood, leading to sepsis, which is often deadly.
The typical treatment for a UTI is a one to two week course of an antibiotic such as trimethoprim-sulfamethoxazole, amoxicillin, augmentin or doxycycline. It is important that the patient also drink plenty of fluids. If necessary, the patient can be given IV fluids to restore hydration while the infection is being treated. The undergarments must be changed regularly to prevent the buildup of bacteria, and you must make sure that the patient thoroughly cleans the genital area after passing urine.
Urinary tract infections become a recurrent problem in some patients. If the infection returns following a course of antibiotics, a longer course of stronger antibiotics is generally prescribed. It is important to catch the infection early, since recurrent UTIs that are left untreated often call for hospitalization.