How to Identify & Treat Urinary Tract Infections in the Elderly

Though seniors are at an increased risk of developing UTIs, identifying symptoms and treating the infection in a timely fashion can lower the chance of harmful consequences. Learn more here!

Why are the elderly prone to UTIs? How do you tell if an elderly person has a UTI? Urinary tract infection (UTI) symptoms in the elderly can be uncomfortable and inconvenient, not to mention they can cause other health problems.

Luckily, there are simple ways to spot a UTI and several ways to treat them.  Ahead, discover more about urinary tract infections in the elderly, including what foods are good for UTIs and what foods to avoid with a UTI. 

Why Are the Elderly Prone to UTIs?

UTIs occur when bacteria enter the bladder and supporting structures—like the urethra or kidneys. While it may seem like a small problem at first, a UTI can lead to bigger problems. Untreated, a UTI can lead to: 

  • Acute or chronic kidney infections
  • Organ damage
  • Kidney failure
  • Sepsis 

Seniors are particularly vulnerable to UTIs for a couple reasons. One main reason may be that the immune system of an older adult can weaken over time. Additionally, elderly people with the following conditions may have an increased risk for UTIs: 

  • Abnormal urinary tract or urinary function
  • Dementia 
  • Diabetes
  • Drug resistance (antibiotic overuse)
  • Enlarged prostate 
  • Genetic predisposition or family history 
  • History of UTIs
  • Incontinence
  • Kidney stones
  • Multiple sexual partners 
  • Urine retention
  • Weak bladder or pelvic floor muscles 

Surgeries, illnesses, or injuries can also open the door for bacteria to get into the body and, consequently, the bladder. If a urinary catheter is used, it can introduce bacteria into the body as well. Disability or immobility may also increase the risk of bacterial infection for older adults. 

Additionally, older women are more prone to UTIs,  thanks to biological reasons. The urethra in a female body is shorter than in a male body, meaning the trip bacteria take to the bladder is shorter, too. A shift in the balance of good bacteria and bad bacteria that can occur during menopause, along with intense hormone shifts, may also be to blame. 

UTI Symptoms in the Elderly

The more common symptoms of  UTIs in the elderly include: 

  • Blood in the urine (typically red, bright pink, or cola-colored)
  • Burning or stinging sensation while urinating 
  • Constant urge or persistent need to urinate
  • Dark or cloudy urine
  • Fever (usually low-grade)
  • Frequent urination, or passing small amounts of urine frequently
  • Foul-smelling urine 
  • Kidney or bladder stones
  • Night sweats 
  • Pain during intercourse or while urinating
  • Pelvic pain
  • Pressure, pain, or cramping in the lower abdomen 
  • Shaking or chills
  • Urgent need to urinate 

Other symptoms may be harder to spot. Sometimes no symptoms are reported or noticed at all even though bacteria is present in the urine (a condition called asymptomatic bacteriuria). Some symptoms that may not be as obvious include: 

  • Aggravation or agitation 
  • Behavioral changes—confusion, hallucinations, delirium
  • Dizziness, fainting, or falling 
  • Poor motor function—loss of coordination

It’s important to note that UTIs share many symptoms with another bladder condition called interstitial cystitis. While both may cause pelvic pain or discomfort, interstitial cystitis is considered a more chronic condition and is part of a collection of diseases known by the name of painful bladder syndrome. 

In any case, if you are experiencing symptoms, it’s important to connect with your doctor or a urologist before the condition gets worse. The longer you wait while bacteria irritate your bladder, the worse the infection may be. 

How to Treat UTI Symptoms

So, how do you treat a UTI once you know you have one? How do you prevent a UTI if you’ve had recurring ones? Since UTIs have multiple comorbidities and a higher mortality rate in the elderly, this condition needs to be not only addressed but taken seriously. 

When diagnosed with a UTI, doctors generally suggest first receiving the standard of care. This essentially means running a few evidence-based tests on your urine, often before and after specific treatments (i.e. antibiotics) to see how your body responds. Upon re-examination, or in the case of recurring UTIs, your healthcare team may suggest the following approaches. 

Hygiene Tips & Tricks for Listening to Your Body

For women, wiping from front to back helps to prevent bacteria from entering the urethra or bladder. Also, urinating after intercourse can help to wash unfamiliar bacteria away. Showers may also be more effective than baths at rinsing bacteria from the body. 

The bladder also sends signals that indicate fullness, and it is important to listen to the body’s cues. Don’t wait too long to urinate when your bladder feels full. Over time, waiting too long to urinate can stretch the bladder. 

Foods to Eat (and What to Avoid) 

Some foods or drinks can aggravate an infected bladder. It may be wise to avoid the following foods and beverages if your focus is to alleviate symptoms:

  • Acidic fruits such as oranges, lemons
  • Alcohol
  • Caffeinated and citrus-flavored sodas like orange and lemon-lime
  • Coffee
  • Salty foods, as they often cause water retention
  • Spicy foods

Cranberry juice and cranberry juice supplements are often recommended to help heal from a bladder infection. This is because cranberries contain special compounds that might help treat or prevent UTIs, balance gut and urinary tract bacteria, and reduce inflammation. Studies have suggested that older adults in nursing homes may particularly benefit from ingesting cranberry products. 

Drinking plenty of water is also an excellent choice if you are dealing with a UTI. Fluids can help to flush out bad bacteria and support your body’s healing process. Additionally, fruits and vegetables help provide the body with vitamin C, speeding along treatment—just remember to avoid anything too citrusy or acidic. 

Tips for Nursing Homes

For the elderly living in nursing homes, set reminders—like by using a timer or alarm—for emptying the bladder. This practice can help memory-impaired seniors urinate independently and on a schedule instead of having to use incontinence products. 

When possible, encourage wearing cotton underwear, which is more breathable than alternatives.  If incontinence is an issue, be sure to change soiled adult briefs as soon as possible. 

In Summary on UTI Symptoms in Older Adults

While elderly people are more prone to UTIs, there are luckily many options for prevention and treatment. From hygiene practices to diet, the choices you make each day can help prevent a UTI from happening. If you have a UTI, avoiding certain foods and starting antibiotics can also help ease symptoms. 


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