What Are the Symptoms of Urinary Tract Infections in Older Adults?
What are the symptoms of urinary tract infections in older adults, and how are they diagnosed?
Urinary tract infections (UTIs) generally cause symptoms related to bladder irritation:
Burning sensation during urination
Blood in the urine
Abdominal pain (sometimes)
New or worsened incontinence (sometimes)
Older 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.
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.
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 :)
Within 2 days of hospitalization and IV antibiotics, her confusion cleared completely. She probably needs to be hospitalized.
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
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.
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......
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.
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!
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!
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.
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.
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?
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
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.
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 :)
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.
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.
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.
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.
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.
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).
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.
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?
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.....
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.
I am a 65 year old woman who last spring ended up on a psychiatric ward of the hospital after suffering from a UTI that did not present with the expected symptoms. I had had a kidney stone attack a few months earlier but no other risk factors. The only thing I had noticed prior to hospitalization was a strong smell to the urine and unexplained weakness and loss of balance. It wasn't until I suffered a grand mal seizure, falling and breaking a rib, that I knew something was wrong. I was then totally psychotic although with some very specific, fixed delusions. Never in my life had I experienced a break from reality and in fact, am myself a mental health therapist. Even with that, I did not know that undiagnosed and untreated UTI's in those over a certain age could lead to sepsis and possible hallucinations. Recovering from that nearly month long hospitalization was brutal! (Of course I thought I was there on an undercover mission: worked in criminal justice too long). I would certainly encourage anybody with an aging loved one to become suspicious if they notice a change in behavior.
My 86 year old father suffered a fall on 27th december. He has neuropathy and can sway and fall without reason. He takes warfarin as so many do. There are two issues with this story I would like people to be aware of. He grazed his head when he fell. An ambulance was called but my dad was his normal self and we all debated and decided he had no damage and should not need to go to hospital. Some 4 hours later my mother rung me to say he had slept, was sleepy and had been sick. I rushed around and my daughter who is a volunteer co-responder attended. He was way too sleepy. We called an ambulance who admitted him and some hours later after a CT scan they declared the bad news that he had a bleed on the brain, the extra bad news was the warfarin. This meant the bleed was huge, extensive and serious. They instantly counteracted the warfarin with a drug and admitted my dad to a ward where, as we left him, he seemed quite alert. The first point, do not risk any elderly fall, with any injury to the head especially when on warfarin. Insist on a check over with a CT scan. I am told that even if we had all agreed he go to hospital the first time it is unlikely it would have been picked up and he may not even have had the bleed at that point. On 31st dec/1st jan we had my old dad back although still in hospital and shakey, not really on his feet. On 1st they also told us he seemed to be sporting an infection but it was not showing itself. He was very prone to water infection as he has to self catherterise twice a day. We then saw from about 2nd Jan onwards what they are telling us to be delirium - either from the injury to the brain - unlikely because he was so well - or the infection that is not showing itself. We told them he is and was on a maintenance dose anti biotic which by now had probably, and was, stopped due to his admission. On Tuesday of this week they finally found the infection and are treating it intravaenously. however, at present, today, he is confused, cannot use his kindle - it may as well be a chocolate tea pot, cannot use the phone and does not recognize that my mother is talking to him from the phone on loudspeaker so does not talk back, is in the deepest sleeps i have ever witnessed and cannot remember things. When he does wake we can get him to respond as best he can which is not brilliant. He is not making any sense with is talking/observations of things around him, starts conversations but forgets to finish them then cannot remember what he was saying. We know he has been confused during a water infection before but not like this. I wonder when it will turn around and he may improve. I will update this post as I feel anyone else in the same position may find it helpful. They cannot see any evidence of a stroke at all. He has now had three more scans which show no deterioration, some improvement on the first scan and they feel it is probably due to the water infections. Lets hope so. I have never been without my mum or my dad and I cannot comprehend losing one of them now. Also of note, obviously this whole thing has been emotional and tiring and at one point I did become upset in front of my father. For me to be in tears and for him to see it would usually leave him mortified and desperate to help. on this occasion he looked at me that his eyes wandered around the ward and back to me then off again. So unlike this extremely caring and amazing father who has always put everyone else first. There was not an ounce of recognition that I was in tears. I know it is not his usual behaviour and want others to know this is what this horrible illness can do. It can completely turn things on their head and one moment is good and the next is bad and the next really bad, then the next not so bad, and so on.
Sorry, I meant to say, On the warfarin issue, he is unlikely to be able to go back on this now. I always knew that warfarin would make a wound bleed but never realized an internal bleed would be bad - how silly am I not to realise that. I assumed the brain would look after itself but this is not the case. I know warfarin is there for a reason but did not know the huge consequences. It is not to be considered a light drug at all.
To the question can it be uti without a test showing. Absolutely. Yes. And it can be bad. Today my father is sitting up and a little lucid. Hooray!!! I can't believe what a uti can do. And, it can cause septic. Dad had to have a double huge strong dose of anti biopics 3 x daily. A nurse I know likened it to caustic soda!!!
Father age 85, debilitating stroke Jan 2011, incontinence - we have experienced the same warning signs of UTI as mentioned above (confusion, hallucinations, etc). Despite dietary changes and cranberrry supplements, continues to have chronic UTI's (one time resulted in ICU stay with sepsis). Antibiotics have helped but I suspect we are dealing with resistance. He is once again showing signs of UTI and Dr says he has maxed out on antibiotic treatment. We are sure this means letting nature take it's course without intervention. I am not sure we are ready to accept that course of treatment or non treatment. I saw the comments on foods to avoid and mention of the supplement D Mannose. Appreciate the information.
I find with my almost 95 year old aunt that lives with me and hubby that if I buy the bathroom wipes and try to get her to bathe at least once a week really helps, she does get them more often than we would like, I give her a glass of cranberry juice and 2 cranberry pills per day, helps alot, I have changed doctors when they tell me that they can't do anything, cause they are just fine and happy until the side effects start, very upsetting for everyone because they are really seeing these things. Hang in there :)
I was a part time caregiver for a cousin in her 90`s who had recurrent urinary tract infections. At my request her doctor put her on a small dose of oral estrogen and she never had another UTI for the remainder of her life.
My 87 yr old mother is prone to UTI's. She gets a couple every year. She NEVER shows any of the usual symptoms - no burning when urinating, no fever, no trouble urinating, etc... the only thing that happens is she gets totally wacked out - delerium - as stated in the article above. So, that is definitely something to look for.
My 83 year old mother has recently had yet another UTI. What I do when I suspect a UTI: I get over-the-counter UTI test strips from the pharmacy and test her urine. I also gather some sample urine and bring to her doctor's office (since she is pretty much house bound - she has pulmonary fibrosis and is on O2 24/7) to test - and they put a script in for Cipro right away if positive. This set up with the doctor's office and method has been extremely helpful. The only sign she has a UTI is the confusion and the Cipro seems to be the medicine that works. I try very hard to get her to drink water but its not something she'll do on her on. The Jello is a good idea to get more liquids in. Any other ideas to for "fooling" our loved ones into drinking more liquids? Thanks!
I also wanted to say that when going to the bathroom, I have to remind my mother not to wipe the front and back with the same toilet paper. If one wipes their behind and then the crotch area, bacteria from fecal matter can cause the UTI. I just watched her again and she was wiping her front area from the back - because she uses a portable potty it is easier for her. But I'm having her adjust herself on the seat so that she can wipe in the front - separate from the back.
Fact UTI can memic stroke like symptoms especially those with dementia. UTI's can cause sever brain damage as week as systemic organ failure if you develop sepsis/delirium. Any s/s of confusion check the urine and check electrolytes. Low sodium also causes severe confusion and halluncinations.
I have found the best prevention, for my 87-yr-old mom who is susceptible to UTIs, is probiotics: Kefir water, fermented pickles (not vinegared), sauerkraut (brined, not vinegared), and daily doses of homemade yogurt. These probiotic foods feed on sugars and help keep her system clear since I cannot seem to "police" her food enough to find the occasional ice cream that the board-n-care home still gives her. They are also excellent at increasing the good bacteria in her system when she has to take antibiotics for a particularly nasty case. Reading labels and sticking to fresh foods with no added sugars. I was surprised where sugars can hide! If you cannot find a local source for kefir water (not sour like dairy kefir), it is easy to make at home with a starter you can purchase online. I make a quart every 2 days & can make it in smaller batches if I need it sooner. Probiotics will keep you and your elderly parents healthier and more resistant to colds, flus, and intestinal upsets.
I have seen this UTI and hallucinations, paranoia, weakness, dehydration... issues in young people also. My daughter who is under 40 has been in the ICU for several weeks at a time for very serious complications of asymptomatic UTIs. She has MS and some mobility limitations, thus after crisis needs rehab. One of the incident got her so bad that she was catatonic for about a week, before she started to slowly come out of this state.
For the past 4-5 months he does not seem to be able to get rid of the UTI for more than a few days, and then they are back again.