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What Are the Symptoms of Urinary Tract Infections in Older Adults?

26 answers | Last updated: Oct 16, 2014
Caring.com User - Leslie Kernisan, M.D.
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Dr. Leslie Kernisan is a senior medical editor at Caring.com and a clinical instructor in the University of California, San Francisco, Division of Geriatrics....
100% helpful

Urinary tract infections (UTIs) generally cause symptoms related to bladder irritation:

  • Burning sensation during urination

  • Blood in the urine

  • Fever (sometimes)

  • Abdominal pain (sometimes)

  • New or worsened incontinence (sometimes)

Older See also:
How to Talk to Someone With Dementia: New Insights

See all 157 questions about Incontinence
adults, especially those with dementia, can also develop delirium -- a new worsening of the mental state -- as a result of a urinary tract infection. In fact, sometimes new or worsened confusion can be the only outward sign of a UTI or other infection.

It's a good idea to suspect UTI whenever an older person is having uncomfortable urination or new incontinence. In these cases, make sure the person is seen within 24 hours by his or her doctor or by an urgent care facility.

Consider the case even more urgent if you notice new or worsened confusion or drowsiness and decreased responsiveness. This probably is delirium, a more critical situation: Bring the person in to get urgent medical care without delay.

UTIs are diagnosed by testing urine for blood, white blood cells, and other signs of infection. Doctors also sometimes order a urine culture in order to confirm the presence of bacteria. This allows the lab to test different antibiotics against the bacteria, since some bacteria have become resistant to certain antibiotics.

If a person is delirious or otherwise seems seriously ill, doctors will also check to make sure that there isn't another serious infection or other illness that needs to be addressed.


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36% helpful
sop832 answered...

My mother has had 3 hospitalizations for UTIs. Literally her first symptom was confusion and hallucinations. Each one has resulted in 3-5 day hospitalizations then 4-6 wks of rehab b/c each time she gets so debilitated. She now takes a prophylactic dose of Bactrim every day, plus rigorous hydration and perineal cleaning.


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sboland@allanbrosfru answered...

My 89 yr old Aunt Mary lives with my husband and I, for the past month she has been hallucinating, due to I believe a bad UTI, she has taken 2 different anti-biotics, on her 3rd bottle now, still showing bacteria in her urine culture. I'm at the point where I need to find a geriatric doctor, her reg doctor just gave us Seroquel, which I hate to give her, but I finally gave in and she had taken it the last 2 nights, the visions are overwhelming her and me. She is just not getting anybetter, only worse. Makes me wonder if she should be in the hospital, which she would hate, but if it could help, Sop832 did your mom's hullucinations stop when she got back home from the hospital? Thanks, Steph :)


67% helpful
sop832 answered...

Within 2 days of hospitalization and IV antibiotics, her confusion cleared completely. She probably needs to be hospitalized.


43% helpful
sboland@allanbrosfru answered...

Thanks Sop, She had a really rough night last night, even with the Seraquel, she just fights it, worrying about all the bugs etc falling on her, I am waiting for her doc to call me, I want to take her to the emergency room, but feel like her doc should have some imput, but not getting anywhere again, two days waiting for help, if I don't hear from doc today, I will to take her in after work tonight, thanks for listening, Steph


56% helpful
sop832 answered...

Yes, I would take her to the ER. It sounds to me like she needs to be admitted and IV antibiotics given. Because she has been on antibiotics, they probably knocked out the weaker bacteria, and now what are left are the resistant ones. They will need stronger antibiotics, and her doctor seems to be taking too long to get to the source of the UTI. By all means, call her GP when she's in the hospital, and let him/her know.


57% helpful
eviltwin answered...

my dad had continual UTI's for several years, being hospitalized over and over. Finally they did a scope on his colon and found that he had a fistula (where his bladder was "stuck" to his colon and a hole had formed allowing feces and bacteria to leak into his bladder) and diverticulitis - he ended up having a coloetomy where they removed the diseased part of his colon, it took several months for him to recover, but since then he's not had a single UTI! You might want to consider having them check her for that......


67% helpful
sboland@allanbrosfru answered...

thanks eviltwin :) My aunt is actually doing much better, when she was at her worst it was a big accumulation of things going wrong, the UTI, lack of sleep, her cateract which we are having removed in two weeks, lots of floaters in her eyes. We now have her on Trazadone, which helps her sleep and she doesn't seem worry about the little visions that she does still have ocasiionaly. Also makes sure to give her 8 oz cranberry juice everyday, it coats the bladder so infections can't adhere so easliy. She hasn't had a UTI since, but I still check it sometimes to stay on top of it.


92% helpful
An anonymous caregiver answered...

I've been a caregiver for my Mom who suffered a significant stroke 7 years ago, and has been incontinent of both her bladder and bowels for the last 5 years. She is 87. UTI's have become an all too frequent part of our lives. Yes, changes in mental condition are a BIG warning sign of UTI, as well as (at least with my Mom) 'seeping' bowels. It always seems that these 2 conditions present before any change in color, clarity or odor of the urine. An antibiotic that seems to work very well for her is Cipro. I've asked our Dr. several times about a maintence antibiotic, in hopes of helping to prevent the UTI from occuring so frequently, but he's vetoed the request, as she does not get them often enough, so he says. I beg to differ. Some things I try to do for prevention are give cranberry supplement capsule, taken apart and stirred into applesauce, peppermint tea, as peppermint kills bacteria in the bladder (according to the good Dr. Oz) I make cranberry relish with fresh cranberries and oranges, and, of course, as much liquid as possible. In the morning I mix orange poweraide with water, as it's good for electrolyte balance, and not as much sugar as gatorade. Jello is also good for hydration. There are also several 'rehydration' drinks you can make at home. Anyway, I hope these suggestions can help someone, and if anyone has anything to add into our mix, I'd love to hear! Thanks much!


71% helpful
maryan answered...

my mother is 81 and she gets alot of uti's her first sign is confusion and her eyes get infected and of course urine cloudy, with fever. i think when they have demetia really bad it is hard to keep up with this issue. i know all signs of infection but doctors do not want to give out antibotics. they have to do urine test amd by that time my mother is very ill. i still have not found the best solution yet!


100% helpful
grannylove2 answered...

Something the home Mom is in told me that they look for in their residents - unexplained falls. It seems that Alzheimer's patients are more likely to fall when they have a UTI. My mom has had a lot of UTIs over her lifetime and I have been looking back over the last few years. Seems like they are right - most of my mom's unexplained falls have occurred around the time we discovered another UTI.


75% helpful
Tessa52 answered...

Thank God I found this website. I did not know about UTI and delirium,or dizziness. Thank you for all the info. maryan I would get another doctor or at least a second opinion.


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2many2care4 answered...

One thing that the resistant bacteria made me think of was the time my daughter kept getting ear infections. It seems that they were caused by staph and the only way we finally got rid of it was by treating everyone in the whole family, even our dog got medicine from the vet. Apparently one of us or more were carriers of the bacteria with out showing symptoms. And she had the least resistance so showed the symptoms. Could this be happening to some of the people in our care?


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Emily M. answered...

Hello 2many2care4,

That's a great question! If you'd like, you can ask it by creating a new Ask & Answer page, here.

Take care, Emily | Community Manager Caring.com


88% helpful
WiserNow answered...

Do not wait on the possible effectiveness of oral antibiotics prescribed for an "old-old" loved one's funny talking/fantasies/delirium to go away. Even if the person is attended by a visiting physician to a nursing home or skilled nursing facility. The waits are too long, first for the lab samples to be sent out and results sent to the doctor, then for the prescription to be filled, then for some small effect to give hope. Get the person to an ER for immediate lab tests, even if hospitalization is required for the IV antibiotic to be administered. And even if you have to hop on a plane yourself to get the person to the hospital. And make sure you have an original or notarized original of the health care power of attorney with you at all times. Be nice and smile at everyone, but be persistent.


73% helpful
sboland@allanbrosfru answered...

Today is a good day, this last week not so good, Aunt Mary got another UTI, the worst so far, which led to no sleep, weakness from the hallucinations for about 5 days, which led to falling, of course couldn't keep her in bed because she had to go smack the people in her room stealing her things etc. Took her to the hospital to the ER friday and they gave her antibiotics and IV fluid, by Sunday she was back to normal, whew, we made it through another bout. I read this weekend that if is not taken care of asap, it can cause permenant brain damage. I wonder how many elderly loved ones caretakers just figure it's just old age and don't get it checked. The brain is actually getting poisoned from the infection getting into the bloodsteam. Boy the first sign of delirium and hallucinations they need medical attention, so glad this site is here, so many wonderful people going thru the same ordeals of life. Thanks everyone for your help :)


67% helpful
sad and broken answered...

Foods that tends to irritate the bladder, even though very healthy, oranges, grapefruits, lemons, limes tangerines, pineapple are highly acidic. Better substitute bananas, apples pears, berries. Avoid chocolate, contains caffeine it annoys the bladder, better choice dark chocolate above 70 percent cocoa. avoid tomato and tomato products, sauces, paste, juice, spaghetti sauce, taco sauce, and salsa, substitute mushrooms and other vegetable, beans when ever you would use tomatoes or tomato sauce. (In article from www.caring.com/articles/6-avoid-tomato-products-overactive bladder) on 3/17/2012. (10 Foods to Avoid if You Have an Overactive Bladder) in the overactive bladder articles. Thank you. Hope this will help, since reading this article I have quit serving prune juice, oranges at super, no tomatoes on sandwiches. I think I have seen a small improvement. I was serving the prune juice for my husbands bowel problem.


40% helpful
Megstutu answered...

Please, please read articles about Seroquel being administered to seniors with dementia. Doctors will tell you not to read anything on the internet but when this drug was given to my husband, I saw a rapid decline in his mental faculties. A niece (RN in a New York hospital) told me to investigate the drug. My husband is 77 and has neurological dementia.


86% helpful
drichof7 answered...

my mother was 80, she had recurrent UTI's hallucinations, it shot her blood pressure to the roof. Her doctor did not treat her quick enough, waiting a month in between just giving her more blood pressure meds, not rechecking her for UTI's. In December she went into the hospital 215/115 BP, they couldnt find anything wrong , when she came home she slurred and was never quite the same. She wouldnt change doctors, had this one for 20 years but he was not proactive enough because she was elderly. After months of high blood pressure and infections she had a stroke and was in a coma for 7 weeks she finally passed away almost 2 weeks ago. Now my goal is to reach out to those whose doctors are not treating their patients right and making sure all patients their are knowledgeable about thse things. I am in the process of opening my own patient advocate business to help guide, navigate, make sure elderly receive the best treatment and care. not based on their insurance, private or medicaid, or medicare. So know for all of you prayer and knowledge are your best weapons to help you.


75% helpful
An anonymous caregiver answered...

Yes I believe in having elderly patient advocates. I was thinking of doing that myself. My dad is in the hospital for uti infection that was not treated immediately because of tests they had to run at the skilled nursing facility he was at. I was so upset that I talked to nurses and doctors. They say it's a gray area when it comes to giving antibiotics right away or waitin for a culture. Well the place he was at had to wait for cultures until it was too late. My dad was suffering dementia but thought it was normal since he has it and then got a fever an aspirated. He was finally rushed to the ER where they said it became septic. Now we are in CCU a step down from ICU but a lot of complications now from that uti. We are still waiting if antibiotics through IV will fight all infections now. If I saw this site earlier we would have rushed him to the hospital ourselves. Now it's a waiting period to see if he gets through this. I've learned do not trust doctors or nurses and be proactive with you or your parents.


50% helpful
sandikat answered...

Be sure to insist on checking the urine if you take an older person into ER or Urgent care. My Mom's symptom was stable objects on the wall were "dancing" all over. I sent her to ER 911 and met her there. They spent 6 hours doing xrays, blood tests.. and didn't find anything.
They were going to send her home, and I asked that they help me take her to the bathroom, so they did a urine collection. She had a massive UTI, but they weren't even going to check for that. There are a lot of bizzare symptoms for UTI's that younger folks don't get. Falling a lot is also one. So anytime you are concerned about any symptom or behavior, best to have the urine checked to be safe. Don't assume they have thought of that. There are also some good herbs that make it hard for bacteria to set up shop, so that could be a good preventative so that you are less likely to create the anti-biotic resistant strains.


An anonymous caregiver answered...

My mother has suffered from U.T.I.s and the doctors were of little help. I came across a supplement called D Mannose with which I treated the last U.T.I. (we caught it at a very early stage). From what I've read, it appears to be a natural sugar but doesn't work metabolically. It would seem that it binds to the bacteria rendering them incapable of remaining in the body. I've also read that fenugreek seeds can help as can cinnamon and honey ( I can't comment on these).


50% helpful
Luzbonita answered...

My 89 year old mom had three UTI's within a year, one with hallucinations. We both dislike overusing antibiotics but she needed relief. Now she takes a cranberry extract that you dissolve in water and drink. It's pink and fizzy. She was forgetting to drink it regularly until symptoms of UTI reappeared. Then she got very consistent with it and YAY! Didn't develop a UTI and still doing fine. The liquid form is good because she doesn't like swallowing pills. I read that the VA did a study of cranberry extract and found it very effective for this.


50% helpful
Jigadake answered...

My 89 year old mother is in the hospital now with a UTI and dehydration. It happened so quickly. She also has dementia and we moved her into a skilled nursing facility on Tuesday of this week and on Wednesday she evidently got a stomach bug (the rest of the family has had it this week to as well) . By Thursday she was not speaking, very weak and I told the facility that she was not herself and acting like she was dehydrated. They told me to take her to the ER because it would take them a few days to run the tests and we wanted it sooner. She was put in the hosptial and been there since Friday. She is doing better with the dehydration and UTI that she also had but all of a sudden today she is just staring and not responding to much. What she does respond to takes a bit to come out...like she is having to process something first. Yesterday she wasn't doing this. Has this happened to anyone else?


wrongdiagnosis answered...

My grandmother is 99 years old and about 8 months ago...she was taken to the emergency room for psychiotic episodes that came up out of nowhere. She was seeing thing, could not sleep ( no pain at all anywhere). They did lots of tests and said she had early stages of dementia and was told it would get very bad very quick. She was ordered into a geriatric mental facility and put on a psychiotic drug...7 days later she was home. Night time...very bad visions...hallucinations, etc. Back to the ER...a UTI was discovered. Admission to hospital and 12 days later she was given no more than 6 months to live and moved to a nursing home. The doctors got her straightened out and lots of activity and constant attention...3 months later my mom said bring her home. That day doctor took her off of psychiotic meds....fast forward to 45 days later..my grandmother is doing incredible..no drugs...no hallucinations no nightmares no outburst.... MORAL of the story...when a person reaches 99 with no mental problems...look for a UTI and treat it first before doing anything else. She had bern getting uti's about every 6 weeks and her mental condition would get worse. She does not nor ever had dementia...only a UTI....i mean really 99 and outstanding health to all of a sudden develop dementia....hard to believe horrible mis diagnosis....a simple UTI.....


An anonymous caregiver answered...

My mother is more confused all of a sudden in the last 2 weeks. She does get confused about some things like how to turn off the phone. In the last 2 weeks this has increased. She has had many recurrent bladder or UTI infections. She is 87. The last 3 cultures they have done showed no infection. She still has all the signs that she had previously with all her infections. I want them to try an antibiotic just to see if her confusion and hallucianations improve. I read that they can still have an infection even though the culture does not show one. Has anyone else ran into this? Thanks.


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