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Urinary Tract Infections

Friday March 26, 2021

Urinary tract infections - a hand and toilet paper

Why is my loved one behaving so differently all of the sudden?

It could be a Urinary Tract Infection.

“UTI” stands for Urinary Tract Infection and is a broad term used to describe any infection within the urinary tract: kidneys, ureters, bladder, and urethra. Most frequently, UTIs involve the bladder and can be called a “bladder infection” or “kidney infection.”  Women are at greater risk due to their anatomy.

A UTI is not a minor inconvenience, like a common cold. It should be taken seriously. 

Classic symptoms of a UTI are burning with urination, foul-smelling urine, feeling the urge to urinate frequently while only producing small amounts of urine, and pain in the lower pelvis. Discolored urine that is pink, red, or tea-colored should prompt you to seek out your physician for an immediate evaluation. As an infection moves upward in the urinary tract toward the kidneys, you may also present with nausea and vomiting, fever (often >101 F), flushed skin, and back pain.

It is important to treat a UTI before it progresses to the kidneys, as it can require hospitalization and IV antibiotics. If left untreated, what started as a simple UTI can turn into a life-threatening infection (sepsis) or permanent kidney damage.

You don’t have to have classic symptoms to have a UTI. Those with dementia may not be able to communicate their symptoms or may show different signs. Symptoms such as increased confusion, lethargy, incontinence, falls, agitation, and hallucinations can indicate a UTI.

Symptoms can be individualized, so it may be difficult to spot. However, a sudden change in behavior can indicate what medical professionals call “delirium.” One person’s hallmark symptom might be sleeping all day, while another’s might be seeing snakes on the floor. Sometimes, the only way we can know whether delirium is caused by an infection is to see if antibiotics improve mental state. As the caregiver, you are the best advocate for your loved one and make a big difference in identifying these symptoms early.

Prevention is the best medicine. So what can you do?

  • Offer toileting frequently. Holding urine for too long in your bladder can increase the risk for developing a UTI.
  • Increase intake of fluids. Water is especially beneficial. Avoid caffeine and alcohol.
  • Change incontinence pads and briefs as soon as possible.
  • Avoid use of feminine products such as deodorizing sprays, douches, or talcum powder.
  • Maintain bowel regularity. Constipation can cause the bladder not to empty fully.
  • Wipe from front to back. Women should wipe from front to back to avoid introducing fecal bacteria to the vagina or urethra.

Communicating regularly with your physician is vital to maintaining good health for your loved one. If you suspect a UTI, call your physician or visit a walk-in clinic.

Some offices may allow you to bring a urine sample to them without having a full appointment. Pick up the sterile cup from the doctor’s office and then bring back the urine sample for analysis. Be sure to ask for a urine collection hat that sits in the toilet to catch the urine for females. If they give you wipes to use before collection, ask for instructions of how to use. Collection of a male’s urinary specimen is simpler and ideally would be a mid-stream collection.

You are your loved one’s best advocate. If they could fully communicate all their symptoms, they would.  It’s up to you to stay vigilant and observe for these acute changes.

Written by Rebecca Surbrook, RN