Urinary Tract Infection in the Elderly Geriatric Care What is Urinary Tract Infection (UTI)? You have a urinary tract infection (UTI) if bacteria in your bladder or kidneys multiply and invade the bladder or kidney lining, causing problems in your body. You may feel pain in your lower abdomen or your back, a burning sensation on passing urine or develop fever and tiredness. UTIs must be treated to avoid serious complications such as kidney failure and other health problems. UTIs are common amongst the elderly but they can be avoided. Although some medical conditions, weak immunity, dehydration, using diapers, holding back urination, incomplete urination or constipation can all lead to UTIs, it is important to realise that UTIs can be avoided by good habits and hygiene.
How do I know if I have UTI? • Cloudy or bloody urine •
Strong smelling urine
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Strong need to pass urine all the time
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Pain or burning feeling when passing urine
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Pain over the lower abdomen
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Difficulty in passing urine or unable to pass urine at all
However, an elderly person with UTI may have different symptoms: • Fever, shaking and chills •
Confusion and agitation
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Falling
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Tiredness and drowsiness
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Nausea and vomiting
What causes UTI?
How to prevent UTI?
1. Medical conditions like diabetes can make you more prone to UTI because of poorer immune system.
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Drink 8 to 10 glasses of water in a day unless your doctor has advised you to limit your intake.
2. Constipation creates a full lower gut, which may press on your bladder and stop it from emptying properly. The urine left in the bladder allows bacteria to multiply and cause UTI.
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Reduce alcohol and caffeine intake as these irritate the bladder.
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Keep the genital area clean.
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For women, wipe from front to back after passing motion.
3. For older men with prostate problems, the swelling of the prostate can stop your bladder from emptying properly. This results in urine being left in the bladder which allows bacteria to multiply and cause UTI.
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Do not hold your urine. Empty your bladder when you need to.
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Do not use adult diapers unless necessary. If they need to be worn, check and change them regularly.
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Avoid constipation. Constipation may worsen urine retention and increase risk of UTI.
4. For older women, the tissue lining around your genital area may become more fragile, thin and dry. This change is often associated with UTI. 5. If you have other bladder or kidney problems, such as stones or narrowing of urinary tubes, these may create blockage and cause UTI.
How do I know if I am drinking enough? Look before you flush! The colour of your urine can tell you if you are dehydrated: 1. You are drinking enough 2. You are drinking enough 3. You can drink more 4. You should drink more 5. You need to drink more 6. You must drink more 7. You must drink more Remember if you are feeling thirsty and your urine is in the colour range from 4 to 7, you are dehydrated and should drink more water.
When should I see a doctor? If you have fever, shivering or chills, or have severe back pain, seek medical advice immediately. Please see your GP or call your home care nurse. Also see your GP if you have: •
A nagging pain in your lower abdomen or burning sensation when urinating that persists for 1 to 2 days.
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Blood in the urine without any of the above symptoms.
Yishun Health is a network of medical institutions and health facilities in the north of Singapore, under the National Healthcare Group. Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.
GRM.PE.04.0419