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Urinary Tract Infections in the Elderly: Causes, Symptoms, Prevention and Treatment

Urinary Tract Infections

Discover how urinary tract infections can display differently in older adults.

Chances are, your elderly parent or grandparent has experienced a urinary tract infection, or “UTI,” at some point during his or her life. In a healthy adult, a UTI can be an annoyance, but is generally pretty straightforward in symptoms and in treatment. The hallmark signs of a UTI are burning pain with urination, frequency of urination, back pain, fever, and cloudy, foul-smelling urine. When UTIs are diagnosed early, antibiotics and fluids are prescribed and recovery lasts just a few days. Yet, the presence of a UTI in an elderly, frail person can be deceptive, and left undetected, can potentially lead to hospitalization and even death.

A UTI generally refers to a bacterial infection in any of the four parts of the urinary tract system: urethra, bladder, ureters or kidneys. An un-checked UTI can eventually migrate into the circulatory system, resulting in sepsis. This is why early detection is so critical.

In the elderly population, UTI’s are the most common, yet often most hidden infection they can suffer from.  Because elders often lack the normal symptoms of a UTI, the infection may become septic before an infection is even suspected or diagnosed.  This is why a UTI in an elder requires immediate attention and treatment.  So, if you are caring for an elder loved one, it will be important to differentiate a UTI from other illness and get your loved one immediate medical attention in order to eliminate the infection.

Causes and Risk Factors

Most often, about 85% of the time, a UTI is caused by Escherichia coli, or E. coli bacteria. This bacteria is naturally found in the GI tract, but especially for women, E. coli can easily sneak into the urinary tract. Although women have a higher risk for developing UTIs and generally acquire them much more frequently, men are much more likely to develop severe UTIs, requiring hospitalization. It is important to note the common causes and risks associated for developing a UTI:

  • Poor hygiene habits
    • Wiping back-to-front after a bowel movement
    • Wearing soiled underwear
    • Wearing incontinent briefs
  • Incontinence
  • Not urinating frequently enough
  • Not relaxing and emptying the bladder with urination
  • Post-menopausal thinning and weakening of the urinary tract (in women)
  • Enlarged prostate, leading to retention of urine in the bladder (in men)
  • Catheterization
  • Immobility
  • Dehydration
  • Diabetes
  • Kidney stones
  • Bladder prolapse
  • Diabetes
  • Certain medications

Seniors in general are more susceptible to UTIs due to the above mentioned factors; however, the biggest culprit to developing UTIs is a weakened immune system. Your loved one may also have a diminished ability to take care of herself/himself for physical and cognitive reasons. These factors lead to decreased attention to hygiene overall. Seniors also tend to limit their fluid intake in an effort to avoid the embarrassment and inconvenience caused by bladder control issues. As urine pools in the bladder longer, it leads to urinary retention and a greater incidence of infection.

If your loved one wears incontinent briefs, there’s a very high probability of developing a UTI. No matter how often briefs are changed, fecal matter can enter the urinary tract very easily, even with minimal contact.

Signs and Symptoms

Detecting the symptoms of a UTI in an elder can be tricky. Your loved one may show all of the classic signs, yet often, because the immune system is not functioning optimally, the normal symptoms we have all come to know are not exhibited. Along with the more typical signs, be alert for these signs and symptoms:

  • Confusion
  • Dizziness
  • Disorientation
  • Agitation
  • Poor motor skills
  • Falling
  • Shortness of breath
  • Cough
  • Blood in urine
  • Malaise
  • Fever and chills
  • Nausea and vomiting

Confusion and UTIs

The symptom of confusion deserves special mention, as this is a frequent sign in an elder suffering from a UTI. Confusion will usually come on abruptly with a UTI, or for those already experiencing memory challenges, will increase dramatically. An infection will weigh down the immune system and lead to an increase in temperature and brain inflammation, which then leads to dehydration. The combination of these factors leads to mental changes in an elder with a UTI. The most important take-away from this: if your elder loved one show signs of a sudden increase in confusion, seek urgent medical attention to rule out a possible UTI or another cause.

UTIs and Dementia

As noted, with the onset of a UTI, confusion can increase rapidly in your loved one living with dementia. It can also worsen other behaviors such as agitation, hallucinations, insomnia and aggression. You may also notice sundowning symptoms becoming worse. It may be even more difficult to narrow down the cause when your loved one has difficulty communicating other symptoms. If you notice your loved one’s symptoms suddenly accelerating, it is better to be safe than sorry, and seek immediate medical attention.

Treatment and Prevention 

The good news is, once diagnosed by a simple urine test, treatment of a UTI in an elder is relatively straightforward. The majority of UTIs are treated with fluids and antibiotics. Once the infection is cured, prevention should be the primary focus. Here are some simple tips to encourage urinary tract health:

  • Stay hydrated: water is best, but any fluids your loved one enjoys should be offered
  • Bladder training: encourage toileting to empty the bladder every two hours
  • Offer a bedside commode or bedpan, if the person is worried about incontinence
  • Practice good perineal hygiene: wipe from front to back, clean the perineal area with soap and water and pat dry
  • If incontinence briefs are used, change frequently and clean the perineum between each change
  • If a catheter is necessary, clean around the insertion site twice daily, and after each bowel movement, with soap and water and pat dry
  • Wear and change loose, breathable cotton underwear daily and when soiled
  • Provide clean linens and towels; even a drop of urine or stool on linens should be changed
  • Avoid perfumed soaps, deodorants, toilet papers and douches
  • Provide wet wipes to make clean-up easier after toileting

The Scottsdale senior home care professionals at Nightingale Homecare are always on hand to provide education, helpful resources, and hands-on assistance in the comfort of home to help older adults remain healthy, comfortable, safe, and thriving. Call us any time at (602) 504-1555 to learn more!

Avoid the Opioids? How to Protect Seniors from Opioid Addiction.

Sun City home health care

Learn how to protect seniors from the hazards of opioid use.

Opioid addiction is a significant problem in America today, and it affects some of the country’s most vulnerable population – seniors. Opioids, while powerful pain relivers, pose some unique risks to older adults. The Sun City home health care team at Nightingale Homecare shares the information you need to know to protect seniors from the dangerous complications of opioid addiction.

With the majority of older adults taking not just one, but multiple prescriptions, and with many seniors struggling with chronic pain from a variety of issues of aging, prescription of opioids is common. Unfortunately, with those prescriptions come some serious complications. In fact, opioid issues in seniors accounted for 17% of Arizona’s hospital admissions in 2015, according to the Arizona Department of Vital Statistics.

While use of opioids is dangerous for people of any age, there are particular risks associated with opioid use in older adults. As reported by the Wall Street Journal, older adults are “especially vulnerable to falls, fractures, and respiratory arrest when using prescription narcotics – and often they are taking other medications that magnify the risks.”

To help protect seniors from opioid complications, there are a number of initiatives underway in Arizona through the Area Agency on Aging:

  • RxMatters: Created with the Arizona Criminal Justice Commission and Prevention Works AZ, this educational presentation helps seniors and their caregivers understand important facts related to opioid use, storage, and disposal.
  • Awareness Campaign: The Area Agency on Aging put together a campaign to address the issue of proper medication use, targeted to thousands of residences state-wide.
  • Substance Abuse Efforts: A collaborate effort between several Area Agencies on Aging and Region One, thanks to a grant from the Substance Abuse and Mental Health Services Administration, AHCCCS, and the Governor’s Office of Youth, Faith and Family, is addressing opioid addiction issues in a variety of counties throughout Arizona.

While these efforts are helpful on a broad scale, what can each of us do individually to help the seniors in our lives reduce the risk for opioid addiction? The top tactic our Sun City home health care team recommends is being an active participant in your senior loved one’s health care:

  • Keep a list of all medications being taken, both prescription and over-the-counter.
  • Ensure that medications are taken exactly as prescribed.
  • Go with the senior to doctor appointments. Talk with the doctor about any potential side effects from medications being prescribed, and if opioids are being considered, ask for the lowest possible dose for the shortest possible duration. Also inquire about any non-opioid options that may be considered as an alternative.
  • Make sure the senior doesn’t drink any alcohol while taking opioids.

It can be challenging for family members to manage all of a senior loved one’s health care needs, particularly when it comes to medication management. The Sun City home health care professionals at Nightingale Homecare are always on hand to partner with families to ensure that all care needs are fully met at all times. With a full range of in-home care services varying from companionship and medication reminders to highly skilled nursing care, we’re able to protect seniors from medication mishaps and ensure they remain safe, comfortable and thriving. Contact us to learn more about how we can improve quality of life for your senior loved one by calling (602) 504-1555.

The Dangers of Ageism and What We Can All Do to Stop It

sun city home careAt Nightingale Homecare, a premier Sun City home care agency, we truly value and respect older adults. The wisdom they’ve gained throughout their lives is priceless, and we have so much to learn by making time to listen to the stories and lessons they have to share.

Unfortunately, this isn’t the case for our country as a whole. While many societies across the world celebrate and embrace their elderly population, sadly, America discriminates. “Ageism” exists throughout our society, including in our health care system; it works to deny our elderly population proper medical care and preventative treatment, ultimately affecting not just the elderly, but those who love and care for them.

Dr. Robert Butler, who coined the term “ageism” and later became the founding director of the National Institute on Aging, wrote a Pulitzer-prize winning book in 1976 on being old in America: Why Survive? Being Old in America. Dr. Butler defined ageism as “a deep and profound prejudice against the elderly which is found to some degree in all of us…ageism allows the younger generations to see older people as different from themselves; thus they subtly cease to identify with their elders as human beings.”

Adults 65 and older made up just over 14 percent of the U.S. population in 2013, and are expected to grow to nearly 22 percent by 2040. The number of people aged 85 and older is forecast to triple from 6 million in 2013 to over 14 million in 2040. Even with our population aging rapidly, only about 10% of U.S. medical schools require work in geriatric medicine. The American Geriatrics Society reports there are only about 7,600 physicians nationwide certified as geriatric specialists, not nearly enough to meet the current demand of our aging population, let alone the future demand.

Although every American over age 65 has the benefit of a federally funded health care system (Medicare), it doesn’t always ensure quality, timely health care. Ageism in America seems to play a role in the elderly being denied high quality care and preventative care. This needs to be recognized and opposed for the benefit of not just the elderly, but for those who care for them and the entire health care system.

Ageism also appears to play a role in the psychology of elder adults themselves; often contributing to individuals underestimating their own physical and mental capacity. This can lead to premature loss of independence, early disability, depression and even death. A recent study published by the American Psychological Association found that elders with positive perceptions of aging lived an average of 7.5 years longer than those with negative images of growing older.

Within the health care system, it is common for practitioners to view many serious and treatable conditions as “just a part of aging.” With this, opportunity is lost to treat, prevent and improve the lives of millions of elderly people. Not only are the elderly under-treated or not treated at all, they are also over-treated for conditions when practitioners do not take into account other chronic diseases the elder may have, and metabolic changes with aging. One of the reasons for over- and under-treatment is lack of communication between the physician and the older patient. Many older patients complain that their physicians do not talk directly with them, they are often talked down to, or communication is between the elder’s caregiver and physician and the patient is often left out of the conversation entirely.

Unless the attitudes that prevail on how we view our elderly change, we will all likely discover that the quality of our health care decreases as we age. We need to all start changing any unpleasant perceptions of what it means to grow old and embrace what it really is: a normal process of living that doesn’t always mean dependence, decline and disability. Changing our thinking towards the elderly ensures that our elders are not isolated from society and viewed as contributors to it.

To learn more about a partnership with senior care professionals who provide the utmost respect for our community’s elderly residents, contact the top Sun City home care agency, Nightingale Homecare. We’re committed to enhancing independence and self-worth in each senior we care for, improving overall quality of life, in addition to safety and security. Contact us at (602) 504-1555 to learn more.

The Top Benefits of Skilled Nursing Care at Home

skilled nursing care at home

With the vast majority of older adults preferring to remain at home throughout aging, in-home senior care, such as companion care, help with personal care needs, meal preparation, transportation, and other non-medical services are invaluable. But what happens when a senior has medical needs that require skilled nursing care, such as a chronic condition like COPD, CHF, or diabetes? Or what about those who are recovering from a fall or surgical procedure? Is a nursing home or transitional care facility a necessity in those cases, or is it possible to receive skilled nursing care at home?

The Sun City home health care team at Nightingale Homecare is pleased to share that not only is this a possibility, but it’s been shown to reduce the risk of rehospitalizations and enhance healing and overall health and wellbeing. Here are just a few of the additional benefits seniors can receive through the services of skilled nursing care at home:

  • One-on-One Care: Quality of care is greatly enhanced when a senior is cared for by his or her own personal nurse and/or home health aide, as opposed to the average ratio of 10 seniors per one caregiver in a nursing home. Changes in condition or any other concerns can be picked up on and addressed immediately without the need to wait until care staff are available.
  • Comfort: There’s no place like home, as the saying goes, and that’s especially true when recovering from an illness, injury or surgical procedure. Seniors can sleep better, eat healthier, and experience reduced stress and anxiety when in their own familiar surroundings and the assistance of skilled nursing care at home.
  • Independence and Freedom: The intangible benefits of being able to choose what and when to eat, where to sleep or relax, when to invite family and friends to visit, and even something as simple as whether to allow the family cat to curl up beside you are priceless in boosting a senior’s feelings of remaining in control of his or her life choices.

If you’d like to explore skilled nursing care at home for your senior loved one, Nightingale Homecare is on hand to help, with a full range of both skilled and non-medical in-home care services for seniors. Just a few of the many ways we can help, right in the comfort of home, include:

  • Medication management
  • Infusion services
  • Ventilator/respiratory services
  • Wound care
  • Blood draws
  • Chronic care management education
  • Tube feedings
  • Stoma care
  • Nursing evaluations
  • Specialized care for Alzheimer’s disease and dementia
  • And much more

Contact us any time to learn more about our Sun City home health care solutions at (602) 504-1555.