You have probably experienced the unpleasant symptoms of a urinary tract infection (UTI) at one time or another. What you may not be aware of is that the symptoms that alerted you to the presence of the infection may not be present in elderly people who develop UTIs. Instead of the classic itching, burning and urinary frequency, older people are more likely to exhibit cognitive symptoms such as confusion, unsteadiness and dizziness.
A UTI is an infection of any part of the urinary system. This includes the urethra, or the tube that allows us to expel urine from the bladder; the ureters, or the tubes that carry urine from the kidneys to the bladder; the bladder; and the kidneys.
Most people with UTIs have symptoms that centre around the pelvic area. These can include urinary urgency, urinating frequently, burning pain while urinating, urine that is cloudy, dark or pink in colour, foul-smelling urine and pelvic pain. Some people also experience fever and chills.
Symptoms in the Elderly
Very often, older people do not experience the pelvic-centred symptoms that younger people do. Instead, the first sign of a UTI in an older person is likely to be a change in cognitive status. Someone who is usually oriented may become confused. Other symptoms include dizziness, poor motor coordination and an increased risk of falls. If your elderly loved one has a sudden onset of any of these symptoms, have him or her evaluated for a UTI.
The presence of a UTI is easily identified through a urinalysis (UA). All that is needed for a UA is a small sample of urine. Some doctors also will run a culture and sensitivity (C&S) test to identify the bacteria causing the infection. This tells the doctor which antibiotics will most effectively treat the infection. A UA takes only a few minutes to perform. A C&S can take two to three days.
The treatment for a UTI is a course of antibiotics. If the doctor performed a C&S, he or she will know exactly which antibiotic to prescribe. However, some doctors would rather not wait for the results of a C&S before beginning treatment. In this case, the doctor selects a broad-spectrum antibiotic, or an antibiotic that treats the most common types of UTIs. Both physical and cognitive symptoms usually start to clear within a day or two of initiating the antibiotics, though it is important to continue taking the antibiotics even after you start feeling better.
Elderly patients are especially vulnerable to UTIs due to declines in the immune system and a weakening of the muscles in the bladder. If you are helping to care for an elderly loved one, make sure to keep his or her genital area as clean as possible and encourage him or her to drink lots of fluids. Finally, try to avoid having your loved one catheterised. If he or she has an indwelling catheter, be sure it is changed on schedule to avoid bacterial build up.
Because a UTI in an elderly person often causes confusion and dizziness, an elderly man or woman with a UTI is often especially vulnerable to falls. If you know or suspect that your loved one has a UTI, take extra precautions to prevent falling, such as walking with your loved one or having him or her use a cane or a walker.