From Angel to Demon: Urinary Tract Infections will do it!

You go to visit your aunt and her behaviour is quite out of character. She is aggressive towards you, she is not making sense and she is convinced there is a burglar in the garden.  You are right to be concerned and to assume there is a serious issue here. What you may not realise is the root cause could be a urinary tract infection (UTI).  For younger people a urinary tract infection is usually a highly uncomfortable experience; for the elderly it can be a serious illness that causes both physical and mental problems.

What is a urinary tract infection?

This is an infection in the bladder and urethra. It is caused by bacteria that come from your own bowel.  After you pass a stool, some bacteria remain around the back passage and these can travel to the urethra  (the tube from the bladder to the outside).  The bacteria go up the urethra and multiply quickly in the urine to cause a UTI.

Why are the elderly more susceptible to urinary tract infections?

There are three reasons

  1. Elderly people have less resistance to infections due to their immune system being less effective. Hence they are offered flu vaccines each year and younger people are not!
  2. They may have conditions such as diabetes, lowered mobility, bladder or bowel problems. All these make their systems vulnerable to UTI’s
  3. Elderly people have weaker muscles in their bladder and may not empty their bladder properly upon urination. This leaves urine in the bladder in which bacteria multiplies

Signs and Symptoms of a UTI

  • Urine should be pale to medium yellow colour. With a UTI the urine becomes cloudy
  • Blood in the urine
  • The urine has a much stronger odour than usual and may smell fishy
  • You feel pain or a burning sensation when you pass urine
  • You have a low-grade fever
  • Night sweats, shaking or chills

All the above signs are actually as a result of the body trying to fight off the infection.  An elderly person’s immune system may not be able to respond to the infection in this way.

Signs and Symptoms of a UTI in an elderly person

Instead of the signs and symptoms listed above, you may see:-

  • Confusion
  • Agitation
  • Hallucinations
  • Other behavioural changes such as aggression or unreasonableness
  • Poor motor skills or dizziness
  • Falling

How to treat a UTI

The key to treatment is to recognise you may be dealing with a UTI. UTI’s in the elderly are often mistaken in the early stages for dementia because of the confusion and behavioural changes. Next is to take a sample of urine to the GP to be tested for infection. GP’s have two levels of tests available. The first is a test done at the surgery; the second is to send the sample to the laboratory for more detailed analysis. The former is quick and will be suitable for most UTI’s and the second is used when a person does not respond to the usual treatment.  Once a UTI has been diagnosed the person will be given a prescription for the appropriate antibiotics and this need to be started as soon as possible.  An elderly person can go from being mildly unwell to extremely ill from a UTI in a matter of hours.  An untreated UTI can lead to kidney infections, kidney failure and infection of the bloodstream (sepsis)

Get the Upper Hand with UTI’s

Now  I have made you realise that UTI’s are more of a serious threat than you thought for the elderly, here are some simple and basic steps to avoid them

  • Drink plenty of fluids
  • Remember that caffeine irritates the bladder so either avoid it or keep it to a minimum
  • Wear cotton underwear as this ‘breathes’ keeping the genital area dry
  • Change your underwear frequently and definitely if it becomes soiled
  • Wash the genital area daily with soap and water and wash your flannel frequently
  • When cleaning the genital area after using the toilet, wipe front to back
  • People who have memory problems and who leave it long periods of time between going to the toilet can set reminders for themselves


Home Instead Carers help their clients maintain and look after their health every day. If this article has raised concerns or questions, please contact Jean Allen on 01255 672 269