Tuesday, March 2, 2010

Urinary tract infections in the elderly, hard to spot but cause big trouble

Urinary tract infections  (UTI) are very common in elderly people and can cause secondary problems. A UTI is a term that covers bacterial infection in the bladder, urethera, kidneys and the tubes that connect these organs.   Generally symptoms are burning and frequent urination; sometimes there's a need to pee with little or no urine discharge.  Your elder might also have low fever and urine with a strong odor and bright color.   Often, there are no symptoms at all.  If the infection spreads to the kidneys there can be back pain below the ribs.   UTIs are treated with a variety of antibiotics and when caught early, are easily treated.  In my Mom's case, the bacteria is drug resistant ecoli and it is slow responding to antibiotics.

When undiagnosed, a UTI will weaken the elder's immune system and can mean that elders are more susceptible to other infections. I've heard several reports of grandma or grandpa's confused or mean, aggittated state going away after treatment for UTI.   I've also heard first hand accounts of elders getting confused or seeming demented when taking strong antibiotics for UTI.  In my own experience, I believe my Mom's UTI weakened her system, which meant her epilepsy meds weren't absorbed normally. This meant she had a lower than optimum levels of the medicine leading to a grand mal seizure.  For this reason it's probably good practice to test for UTI -or other infections - regularily.  I definitely suggest it when you see sudden changes in your Elder's personality.  If they are suddenly confused about current events, people or things around them, or if they become argumentative, hostile or agitated - ask that they be tested.  

It's been my experience with Mom's assisted living facility that I had to push for things like this; they were not proactive unless the resident complained of pain or the family was assertive..  My Mom complained of strong colored and smelling urine for weeks but she was taking multi-vitamins which could also be the cause. She always has pain in her back due to arthritis so a new pain might go unnoticed.  Given this, there was no reason for the assisted living staff or me and family to suspect a UTI.  It was discovered when she was hospitalized for the seizure.  

Because I'm not a physician or nurse, I feel it's important to include information from a trustworthy source, I copied this information below from Web MD.  If you're concerned about yourself or your Elder, please talk with your physician immediately about being tested.  

From Web MD: Urinary tract infections (UTIs) in older adults

Urinary tract infections (UTIs) are common in older women and men. Factors that make older adults more likely to develop UTIs include:
  • A reduced ability to control urination and bowel movements (incontinence), which increases the chance of getting bacteria into the urinary tract.
  • Hospitalization or residence in a long-term care center, where the person may have a urinary catheter inserted, making bladder infections more likely.
  • Problems with the bladder dropping down out of its normal position (bladder prolapse or cystocele). When this happens, the bladder cannot empty completely, making infections more likely.
  • Lack of estrogen in women who have gone through menopause. Lack of estrogen may allow bacteria that can cause UTIs to grow more easily in the vagina or urethra and cause an infection in the bladder.
  • In men, partial blockage of the urinary tract by an enlarged prostate.
  • Other conditions, such as diabetes, lack of activity, poor hygiene, or problems releasing urine.
  • Use of medicines that can cause difficulty urinating or a complete inability to urinate. If you think your medicine may be causing urination problems, talk to your doctor.
Older adults also are more likely to have conditions that complicate UTIs, such as a lower resistance to infection. They may require more thorough evaluation and longer antibiotic treatment than do young adults with uncomplicated infections.
Author Monica Rhodes
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman, MATC
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Avery L. Seifert, MD - Urology
Last Updated June 8, 2009