Health and Wellbeing

What is a UTI?

A urinary tract infection is usually caused by bacteria entering the urinary tract via the urethra – the tube that allows the passage of urine from the bladder to outside the body.

The bacteria can then move upwards through the urinary tract, infecting the bladder (a condition known as cystitis) and sometimes the kidneys.

If the person has a sudden and unexplained change in their behaviour, such as increased confusion, agitation, or withdrawal, this may be because of a UTI.

Women are 30 times more likely to develop a UTI compared to men.

What symptoms should you look for?

• Needing to pee more frequently, suddenly or more urgent than usual (this maybe at night)
• Pain or a buring sensation when peeing.
• A constant feeling of a full bladder.
• Pressure or pain in the lower tummy or lower back.
• New incontinence or wetting yourself.
• Blood in your urine.
• Dark, cloudy or thick urine.
• General signs of infection like a fever or feeling hot and shivery or a very low temperature.

There maybe other symptoms in frail people with memory issues:

• Changes in behaviour , such as acting agitated or confused (Delirium  – See NHS for more information). This could be a sypmtom of a UTI or maybe due to an other issue.

More severe symptoms of a complicated UTI can include:

• Fever
• Worsening abdominal pain
• Chills
• Fatigue or malaise
• Nausea and/or vomiting

What are the causes of UTI’s in the elderly?

• Older people are more susceptible to UTIs due to a weaker flow of urine, meaning the bladder doesn’t fully empty.
• In men, an enlarged prostate can also make it difficult to empty the bladder completely. This can lead to bacteria building up in the urine and bladder.
• A weakened immune system and kidney problems can also be factors.
• Diabetes can create extra sugar in the urine that breeds bacteria.
• Older women have UTIs more often because of the female anatomy (a shorter uretha).
• After the menopause women produce lower amounts of estrogen. As estrogen levels go down, your bladder and pelvic floor muscles may grow weaker. This can make it easier for bacteria to make their way into your bladder.
• Catheter usage. A urinary catheter comes with a risk of infection. It is imperative to have very good daily hygiene regime. See NHS advice. 
• Older people are often more dehydrated as they lose their sense of thirst. Liquids help flush bacteria from the urinary tract.

Why are Dementia patients more at risk?

• Typical UTI symptoms like burning and frequent urination often do not appear in the elderly.
• In older age, symptoms of UTIs may not be so evident, especially for those who have Alzheimer’s disease or dementia. Rather than showing pain symptoms, they may start to act more erratically.
• Confusion
• Dizziness
• Agitation or aggression
• Fatigue and lethargy
• Decreased appetite
• Frequent falls

These symptoms may be interpreted as signs of ageing, but if there is a sudden change in ability, behaviour or disposition, it may be an undiagnosed UTI.

How do you prevent UTI’s?

• Make sure you drink enough fluids. The NHS recommends that people should aim to drink 6/8 cups or glasses of fluid a day. Water, lower-fat milk and sugar-free drinks, including tea and coffee, all count.
• Regularly drinking may mean more trips to the toilet. If you are having difficulties getting to the toilet or worried about incontinence discuss this with your doctor or a nurse who will be able to help you. Don’t reduce the amount you drink
• Not holding onto your pee, empty the bladder as soon as possible.
• Keep the genital area clean and dry. Wash or shower daily where possible, especially if you suffer from incontinence.
• Check and change incontinence pads often. If they are soiled, they should be changed right away
• Wipe from front to back when you go to the toilet
• Avoid using irritating products such as scented soaps, gels, and sprays around the genital area
• Wear loose breathable clothing.

How are UTI’s treated?

If you think that you ( or someone you are caring for) has a UTI, ensure you are drinking enough fluids to avoid becoming dehydrated. Take paracetamol up to four times a day to reduce any pain.

Contact your GP if symptoms persist as you may need a course of antibiotics.