UTIs the Enemy of Aging in Place

Wellness is a connection of paths: Knowledge and Action.

– Joshua Holtz

Aging in Place

Urinary tract infections (UTIs) are the nemesis of many older adults and the enemy of aging in place.

For decades I’ve been on the frontlines battling UTIs not just with patients in ICU, but my own aging loved ones at home. I have witnessed medical emergencies caused by UTIs that went untreated, or neglected until it was too late–and in many cases led to premature death (urosepsis).

As an informal caregiver I have had to fight to get treatment of family members who were in the early stages of the infection–only to be put off by a medical system with a different sense of urgency at best–at worst medical ageism.

The symptoms can be deceiving, come on gradually–or rapidly, causing fever, confusion (delirium), foul smelling urine, polyuria (peeing frequently or urgency), generalized weakness, or mistaken for sundowners or dementia.

UTI Defined

A urinary tract infection (UTI) is a bacterial infection that can occur anywhere in the urinary system, which includes the kidneys, bladder, ureters, and urethra. UTIs are more common in women than men and can cause a variety of symptoms, including:

• Frequent and urgent need to urinate.
• Pain or a burning sensation while urinating.
• Cloudy, bloody, or strong-smelling urine.
• Pain or pressure in the lower abdomen or back.
• Feeling tired or shaky.
• Fever or chills (a sign that the infection may have reached the kidneys).

UTIs are usually caused by bacteria, most commonly Escherichia coli (E. coli), which normally inhabit the gastrointestinal tract. Elderly people are highly prone to UTIs due to poor hygiene or inadequate care in nursing homes or care centers.

The treatment is antibiotics prescribed by a healthcare provider. It’s essential to seek medical attention if you suspect a UTI–and you MUST be a strong advocate because even I had challenges getting help for infected family members!

Testing

• Hospital or Healthcare Facility Testing:

1. Urinalysis: The most common initial test for UTIs is a urinalysis. This involves collecting a urine sample and analyzing it for the presence of white blood cells, red blood cells, bacteria, and other substances. Abnormal levels of these components can indicate an infection.
2. Urine Culture: If the urinalysis suggests an infection, a urine culture may be performed. A sample of urine is cultured in a laboratory to identify the specific bacteria causing the infection and determine its susceptibility to antibiotics. This helps in choosing the most effective treatment.
3. Blood Tests: In more severe cases or when there is a risk of the infection spreading to the bloodstream (sepsis), blood tests may be conducted to assess kidney function and check for signs of systemic infection.
4. Imaging Studies: If there are recurrent or complicated UTIs, healthcare providers may use imaging studies like ultrasound or CT scans to assess the urinary tract’s structure and identify any underlying issues.
5. Cystoscopy: In some cases, a cystoscopy may be performed to visually examine the bladder and urethra for abnormalities or signs of infection.

• Home Testing:

1. Urinary Test Strips: Over-the-counter urinary test strips are available for home use. These strips can detect nitrites or leukocyte esterase in the urine, which are indicators of infection. However, they may not provide a definitive diagnosis and should be followed up with a healthcare provider’s evaluation.
2. Home UTI Test Kits: Some companies offer home UTI test kits that include urine collection cups and test strips. These kits may provide more detailed information than basic test strips.
3. Telemedicine Consultation: Some telemedicine services offer UTI testing at home. They provide test kits, and after you collect a urine sample, a healthcare professional reviews the results and prescribes antibiotics if necessary.
4. Symptom Assessment: Monitoring your symptoms is also an important aspect of home testing. If you experience common UTI symptoms like frequent urination, burning during urination, and lower abdominal pain, it’s essential to consult a healthcare provider for further evaluation and treatment.

It’s crucial to note that while home tests and kits can be convenient, a confirmed diagnosis and appropriate treatment should be provided by a healthcare professional. UTIs can lead to more severe complications if left untreated, so seeking medical advice is essential if you suspect you have a UTI.

Prevention

To prevent UTIs, it’s recommended to stay hydrated, urinate regularly, practice good hygiene, and wipe from front to back after using the toilet. In some cases, doctors may recommend prophylactic antibiotics for individuals who experience recurrent UTIs.

Summary

UTIs are all too common in older adults (especially women), they need to be prevented optimally, when possible early diagnosis, treated quickly, and teaching done frequently.

This aliment is a very real threat to remaining home “independently” and aging in place. Prevention and prompt treatment are a systems approach to remaining home by choice.

________________________________________________________________________________________

UTIs / CDC Guidelines

Aging in place is done “Inter-dependently”