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A pee in the night – a guide to avoiding Urinary Tract Infections

A pee in the night – a guide to avoiding Urinary Tract Infections

The other day I read an article about an old lady and her swift decline into becoming another statistic – bedblocking in her local hospital.   It was a sorry, sorry tale about a lonely, frightened old woman and it was completely unnecessary.

As she became increasingly frail so she became more frightened of falling over alone in her home. To avoid falling particularly in the night, she drank less and less during the day so she was less likely to need to go to the loo once she’d gone to bed.   She also stopped going out as much to limit falling over, so she wasn’t shopping for fresh – or indeed much – food on a regular basis.

The net result of this was that whilst she didn’t fall over so much, she became severely dehydrated, and her immune system started to pack up with her absence of a proper diet.   Ironically of course, a neighbour finally found her completely delirious on the floor in her home having fallen over.  She was taken to hospital where her diagnosis was a severe urinary tract infection (UTI), brought on directly by the dehydration and a low immune system.

She spent a week or two in bed in hospital, which rendered her even more physically unfit than before she arrived, and with no-one to help her at home, had to wait until a suitable care solution was found before she could be discharged from hospital.

This made me so sad to read.   It also made me wonder about  UTIs in the elderly.   I thought a brief guide might be useful to try and stop other people going through the same thing.

What is a Urinary Tract Infections (UTI)?

UTIs can cause serious health problems.   A urinary tract infection happens when bacteria in the bladder or kidney multiplies in the urine.  Left untreated it can become something more serious than merely a set of uncomfortable symptoms.  They can lead to acute or chronic kidney infections, which could permanently damage the kidneys and even lead to kidney failure.  They are also a leading cause of sepsis or infection of the blood.

UTIs in the elderly

The elderly are most likely to experience UTIs for many reasons, not least of which is their overall susceptibility to all infections due to the suppressed immune system that comes with age and certain age-related conditions. These include diabetes, bowel incontinence and/or use of a catheter;  enlarged prostate.  In addition, kidney stones and general lack of mobility are contributory factors.  Further, the elderly experience a weakening of the muscles in the bladder which leads to more urine being retained in the bladder, poor bladder emptying and incontinence, all of which can lead to UTIs.

Signs of a UTI

Alarmingly, elderly people do NOT exhibit any of the common symptoms experienced by younger people; cloudy and/or bloody urine with a strong smell;  frequent need to go to the loo and pain or burning with urination; pressure in the lower pelvis;  night sweats or shaking, chills;   or a low-grade fever.

UTIs in the elderly are often mistaken as the early stages of dementia or Alzheimer’s, as the symptoms include:

  • Confusion or delirium-like state
  • Agitation
  • Other behavioural changes
  • Poor motor skills or dizziness
  • Falling

How to Reduce the chances of a UTI

People with incontinence are more at risk of UTIs because of the greater chance of bacteria being reintroduced into the bladder.   Recommendations include frequent changing of COTTON underwear and general cleanliness; other ways to reduce the chances of UTIs are to drink plenty of fluids – including cranberry juice; avoid caffeine and alcohol.

The lovely lady in the article might have avoided so much of her resulting ill health if she had felt able to drink more during the day, and eat more healthily.   It seems so sad that the price of being alone is a feeling you can’t go for a pee in the night in your own home for fear of falling over.

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