Last week, I talked a little bit about delirium in the elderly, and how it can come about suddenly from infections or other acute causes. One of the causes of delirium in older people can be a urinary tract infection
Last week, I talked a little bit about delirium in the elderly, and how it can come about suddenly from infections or other acute causes.
One of the causes of delirium in older people can be a urinary tract infection that goes unnoticed. Medical experts at Harvard University state that it is not all that unusual to see an older patient who gets infections without symptoms. It may be a result of a prior stroke, Parkinson’s disease, diabetes or simply because older people many times do not develop a fever or a higher white blood cell count when they have an infection.
Urinary tract infections can come about in women because bacteria from the rectum can infect the opening of the urethra, which connects the bladder to the outside. In a women’s anatomy, the urethra is much shorter than a man’s, so women experience this situation more often than men do.
In older people, because they may be less mobile or less able to get the bathroom, they may wet or soil themselves, setting up a place for bacteria to thrive and invade. Urinary tract infections may also happen when the urine pools in the bladder create an ideal environment for the proliferation of bacteria.
In older men, this may happen as a result of an enlarged prostate that doesn’t allow complete emptying of the bladder, and in older women, pooling of urine in the bladder may occur due to a prolapsed bladder or because lower estrogen levels facilitate bacterial growth.
Having a catheter inserted is also a common cause of urinary tract infections. In both sexes, kidney stones can lead to reduced urinary output and thus lead to urinary tract infections.
The most common symptoms of a urinary tract infection is a burning feeling when urinating, frequent urges to go and pain in the bladder area. In older people, because they may be asymptomatic and not experience these indicators, the urinary tract infection may go unnoticed and untreated. The infection can spread to the kidneys causing kidney damage, and on to the blood stream (sepsis) leading to death.
Although sudden onset of delirium can be noted through symptoms of confusion, hallucinations, hostility, apathy, loss of appetite or fatigue, in order to pinpoint a urinary tract infection as the cause, additional symptoms such as noticing foul smelling urine, abnormal color of urine, blood in the urine or lower back pain (from kidney involvement) are more definitive.
As long as an urinary tract infection is caught quickly, it can be turned around promptly with appropriate antibiotics. If the condition becomes more encompassing, it may require a hospital stay with strong antibiotics given intravenously.
Older people have a tendency to limit the amount of water and fluids that they take in because they are afraid of not making it to the bathroom in time. Because of urinary incontinence and the inability to control urine flow, their urine stagnates, becomes more concentrated and becomes a perfect environment for bacterial growth.
Drinking lots of water helps flush out bacteria and keeps the urine from pooling. If older women are experiencing frequent urinary tract infections, they may be advised to use a vaginal, estrogen-based cream as a preventive measure.
Changing the undergarments daily and keeping the entire area clean is important. For those women who are sexually active, experts recommend that they urinate after having intercourse to flush out any bacteria from their urethra. Bottom line (sorry, couldn’t resist that ), drink water and keep clean.
• Jane Riley, M.S., B.A., C.P.T., Certified Nutritional Adviser, can be reached at janerileyfitness@gmail.com, 212-1451 or www.janerileyfitness.com.
