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Urinary Tract Infections: Minor Irritation For You, Potential Killer For Elderly People

by — 2015-09-23 in Urinary Tract Issues
When my mom suddenly became confused, we suspected Alzheimer's. The truth, it turned out, was different: she had a UTI, and it nearly killed her.

My mother, about 77 at the time, someties got a little bit confused. She'd get dates wrong, for instance, or the names of nurses she didn't know well. She definitely didn't have dementia though. Then, one day, she asked why my dad's car wasn't in the driveway and whether he'd gone on a trip. My dad, her husband, had passed away about six years earlier. Was this the earliest sign of Alzheimer's? My sisters and I certainly thought so.

As it turns out, though, something completely different was the matter with my mother.

We called the family doctor — despite my mother's avid protests — and by the time he made a house call, my mother was also in bed with a fever. After tests, it became clear that she suffered from something that we have probably all encountered during our lifetimes: a urinary tract infection. As she had been incontinent for a while and used incontinence pads, she did not spot the "tell-tale" symptoms of frequent urination and a burning sensation in the urethra. My mother was promptly transported to hospital. Had I called the doctor a few days later, he said, she would have died.  

Why Older People Get More Urinary Tract Infections

Older people's immune systems are no longer as strong as those of their younger counterparts, making them more vulnerable to the bacteria that enter their urinary tract through the urethra, a process they are more vulnerable to because they often suffer from urinary and fecal incontinence or require urinary catheters for surgical interventions. Bladder prolapse, a condition in which the bladder can't empty as fully as before, also makes them more susceptible to UTIs.

A general lowered standard of hygiene, mobility problems, an increased risk of kidney stones, an increased likelihood of having a history of abdominal surgery, and diabetes all contribute to the risk of UTIs as well. Then, there are some sex-specific risk factors. Men who are senior citizens are more likely to have an enlarged prostate, while postmenopausal women no longer enjoy the protective benefits of estrogen. 

Symptoms Of Urinary Tract Infections In Older People

While younger people can often tell they have a UTI right away, because they will experience burning sensations in their urethra and feel the urge to urinate without being able to pass much urine, those symptoms can be completely absent in older people — especially those who are already in the beginning stages of dementia. 

I was, honestly, uttterly surprised when the doctor told me my mother had a UTI. Yet, the symptoms she displayed aren't unusual at all. 

UTI symptoms in senior citizens can include the symptoms you'd expect, but they can also involve:

  • Confusion, or a delirium-like state.
  • Hallucinations.
  • Becoming aggressive or agitated. Other behavioral changes may also take place.
  • Dizziness.
  • Falling.
  • A sudden deterioration in motor control skills.
Because these symptoms are all alarming, caregivers may not initially notice pink urine (containing blood), a low grade fever, and nightly sweats and chills. The person themselves may not be able to identify urinary urgency and burning sensations.

What You Need To Do If You Suspect An Elderly Loved One Has A UTI

Urinary tract infections in elderly people are serious business. Utreated lower urinary tract infections (cystitis) can quickly develop into kidney infections, and sepsis — a blood stream infection that can quickly become life-threatening if no action is undertaken — can set in. Younger people, especially women, tend to think of UTIs as irritating but pretty much inevitable from time to time. The fact that they are much more serious in older people can't be stressed enough.
 
If you suspect one of your parents or another elderly loved one has a urinary tract infection, you need to take action — now. The behavioral symptoms mentioned on the first page can indeed be signs of cognitive issues as well, but if they occur suddenly, they may very well be caused by a UTI. Older people who mention feeling burning pains in their lower abdomen or needing to urinate more frequently definitely need to be seen by a doctor, but if those symptoms are absent, you should still make an urgent appointment. 
 
My mother was taken to hospital as soon as her UTI was diagnosed. While there, the symptoms continued to worsen: she had developed dehydration, stopped urinating altogether, and had a fever and pains in her body. When I went to visit her the first time, she told me how rude I was: I had forgotten to say hello to my uncle Koos, who was in the bed directly opposite hers. My uncle Koos lived in the United States at the time (I'm from Europe), and he definitely wasn't the man she pointed to.
 
After IV antibiotics and rehydration, however, all was well again soon enough. My mother was discharged about five days after she first got to hospital.

Preventing UTIs In Older People

Because UTIs can be fatal in elderly people, it is crucial to keep your eyes out for symptoms. 
 
Prevention is still better than the cure, of course, and you'll be pleased to know that there are things that can be done to minimize the risk of urinary tract infections in elderly people. 
Whether your elderly loved one lived independently or in a nursing home, a plan needs to be put in place for them to shower regularly and change their underwear every day. Wiping still needs to happen from front to back, and plentiful water consumption is absolutely essential. If your loved one doesn't have a history of kidney stones, drinking cranberry juice every day can help prevent UTIs. Besides that, your loved one will benefit from a caring relative who will be vigilant about their health. That's you. 

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