UTIs in older adults — Don’t be confused

You were visiting your mom and she seemed very confused and disoriented. She claimed the retirement home had moved her to a different apartment and she didn’t know why.

Fortunately, you knew the reason for her confusion was not to be ignored because you had seen this out-of-sorts behavior before.  Your mom hadn’t been moved to a new apartment, but she probably had another urinary tract infection.

According to Washington University primary care specialist Chelsea Pearson, MD, “Family and caregivers are key in helping us identify infection in older adults. When you notice a sudden change in behavior- even a subtle one- you want to take it seriously.

Falls, agitation, confusion, changes in appetite, and incontinence in someone who was previously able to get to the bathroom can all be signs of a urinary tract infection or UTI.”                                                                                                                                                 

When an older woman has a UTI, the symptoms are different from a younger woman. There might not be any painful burning during urination – always a typical sign. This is because as you get older, your immune response changes – it’s part of normal aging.

A UTI places stress on the body,” says Dr. Pearson, “and any type of stress, physical or emotional, can cause an older adult to become confused. For those suffering from Alzheimer’s disease or dementia, a UTI can make dementia temporarily worse.”

In most cases, diagnosing and treating a urinary tract infection in an older adult is relatively straightforward.  A simple urinalysis can confirm the infection’s presence and, for someone in good health, antibiotics are the first choice of treatment. UTIs often clear up in only a few days.

Dr. Pearson says, “People suffering from UTIs must drink plenty of fluids to flush the bacteria from their systems. Proper fluid intake makes it harder for bacteria to live and multiply in the urinary tract.

UTIs are also more likely to affect people who attempt to manage stress incontinence by limiting their water intake – so they don’t have to go to the bathroom as much.  But this practice puts them at higher risk of infection because the bacteria has an opportunity to build up.

You want to keep your urine clear by drinking four to six 8-ounce glasses of water a day.”

Older adults who are at greater risk for getting a UTI include:

  • Those who require a catheter in the urethra and bladder
  • Those who are diabetics
  • Anyone with kidney stones

It is important to remember that older adults living in a group setting such as senior communities or nursing homes are more likely to be resistant to the antibiotics most often prescribed for UTIs. They might require something stronger, as well as a longer course of antibiotics to combat the urinary tract infection.

If you suspect you or someone you know has a urinary tract infection, and would like to make an appointment to see Dr. Pearson, please call 314-996-8103.