Urinary tract infections in seniors: Watch for warning signs

By March 3, 2011

When you’re caring for a senior, you need to watch for symptoms of a urinary tract infection. Your senior may be too confused at times to report symptoms accurately.

Though there are cases where a urinary tract infection will not present symptoms, and while any one of the following symptoms in and of itself may not be enough to indicate infection, any of these symptoms merits consultation with the urologist: the urine has a strong odor; the urine has blood in it, turning it the color of cola or bright pink; the urine is cloudy; the urine is passed in tiny, frequent amounts; the urine is passed with a burning sensation; the elder feels the constant need to urinate; a female elder feels pelvic pain; or a male elder feels rectal pain.

There are three physical areas where the infection may be localized, listed here in order of seriousness:

* If there is a burning sensation during urination, the infection is probably in the urethra (urethritis).

* If there is blood in the urine, discomfort in the lower abdomen, pelvic pressure and/or frequent, painful urination, the infection is probably in the bladder (cystitis).

* If your elder is experiencing nausea, vomiting, shaking, chills, high fever and/or pain in the back and side, the infection is likely in the kidneys (acute pyelonephritis).

Antibiotics are the usual treatment for urinary tract infections. Because time is often lost attacking infections with the wrong antibiotics, the most efficient way to proceed is for the doctor to identify the specific bacterium through a culture, then prescribe an antibiotic that’s specific to that bug. If the physician isn’t following this strategy, you need to lean on the doctor to get it done properly.

Over time, bacteria will develop resistance to antibiotics. If your elder’s infection isn’t responding to treatment, insist that the doctor employ a different drug from the antibiotic arsenal.

Elders on catheters have special issues. My dad has been on a catheter for more than two years. In the early days, he was often falsely diagnosed with urinary-tract infections. During each office visit, his primary care physician would order that a urine sample be taken directly from the catheter bag. Each time, the result was positive. Each time, the doctor put my dad on ciprofloxacin, which upset his stomach.

Then, one afternoon, when we were having the catheter changed at the urologist, I related all of this to the nurse. She said my father’s doctor didn’t know what he was doing: “You NEVER take a urine sample out of the catheter bag!”

The reason is that catheter bags routinely have bacteria growing in them. Therefore, you’ll get a false positive every time. The only way to take a reliable urine sample is from the urethra itself, usually while the nurse is changing the catheter.

So, if your elder on a catheter is presenting any of the symptoms listed above, make an appointment with the urologist and make sure a urine sample is taken directly from the urethra.

While Citizens Who Care for the Elderly can’t help you with urinary tract infections, be aware that the nonprofit group deploys 100 volunteers in three programs throughout Yolo County: the In-Home Respite and Friendly Visiting Program, Time Off for Caregivers and the Convalescent Hospital Visiting and Pet Visitation Program. You can contact Citizens Who Care at (530) 758-3704 or [email protected]

— Robert Clark Young of San Diego is a caregiver for his parents, both of whom have suffered serious strokes. He is finishing his new book, “The Eldercare Survival Kit,” in which he shares his experience in elder care.  This column appears monthly.

Robert Clark Young

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