The Article below was kindly provided by:
Chipema Chitambala RGN, Dip HSM, MSc Public Health, CBF, END 941,298, 998.
Thank you Chip from WhereIsTheCare.

It is important you know the facts.

What is a urinary tract infection?

A urinary tract infection (UTI) (also known as acute cystitis or bladder infection) is an infection that affects part of the urinary tract.

The urinary system consists of the kidneys, ureters, urinary bladder, and urethra. The kidneys filter the blood to remove wastes and produce urine.


What can be the reasons why elderly people get one?
A urinary tract infection happens when bacteria in the bladder or kidney multiplies in the urine. Left untreated, a urinary tract infection can become something more serious than merely a set of uncomfortable symptoms.
The population most likely to experience UTIs is the elderly. Elderly people are more vulnerable to UTIs for many reasons, not the 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, according to the National Institutes of Health (NIH).
Younger people tend to empty the bladder completely upon urination, which helps to keep bacteria from accumulating within the bladder. But elderly men and women experience a weakening of the muscles of the bladder, which leads to more urine being retained in the bladder, poor bladder emptying and incontinence, which can lead to UTIs. Very little water intake in old age has also been documented as a very common cause of UTI.


What are the symptoms? And how can a UTI affect an elderly person?

The typical signs and symptoms of a UTI include:

• Urine that appears cloudy
• Bloody urine
• Strong or foul-smelling urine odour
• Frequent or urgent need to urinate
• Pain or burning with urination
• Pressure in the lower pelvis
• Low-grade fever
• Night sweats, shaking, or chills
Elderly people with serious urinary tract infection don’t exhibit the hallmark sign of fever because their immune system is unable to mount a response to infection due to the effects of aging. In fact, elders often don’t exhibit any of the common symptoms – or don’t express them to their caregivers.
UTIs in the elderly are often mistaken as the early stages of dementia or Alzheimer’s, according to NIH, because symptoms include:
• Confusion, or delirium-like state
• Agitation
• Hallucinations
• Other behavioural changes
• Poor motor skills or dizziness
• Falling
Sometimes, these are the only symptoms of a UTI that show up in the elderly—no pain, no fever, no other typical symptoms of a UTI.

According to NIH, the following conditions make the elderly more susceptible to UTIs:

• Diabetes
• Urinary retention (unable to empty the bladder, even if your loved one has just used the bathroom)
• Use of a urinary catheter
• Bowel incontinence
• Enlarged prostate
• Immobility (for example, those who must lie in bed for extended periods of time)
• Surgery of any area around the bladder
• Kidney stones

What to look out for to recognise the first signs of infection? And what should we then do?
Once you observe the following in the elderly it’s always vital to carry out a urine test or go to your GP to have the urine tested by the practice nurse. Usually a positive test will show, leucocytes or white blood cells, nitrite and protein.
• Confusion, or delirium-like state
• Agitation
• Hallucinations
• Other behavioural changes
• Poor motor skills or dizziness
• A strong, persistent urge to urinate
• A burning sensation when urinating
• Passing frequent, small amounts of urine
• Urine that appears cloudy
• Urine that appears red, bright pink or cola-colored — a sign of blood in the urine
• Strong-smelling urine
• Pelvic pain, in women
• Rectal pain, in men
• Falling

UTIs may be overlooked or mistaken for other conditions in older adults.
People with incontinence are more at risk for UTIs because of the close contact that adult briefs have with their skin, which can reintroduce bacteria into the bladder. Some recommendations to help reduce this risk include the following:

• Change the briefs frequently
• Encourage front-to-back cleansing
• Keep the genital area clean
• Set reminders/timers for those who are memory-impaired to try to use the bathroom instead of the adult brief

Other ways to reduce the chance of UTIs:

• Drink plenty of fluids (2 to 4 quarts each day).
• Drink cranberry juice or use cranberry tablets, but NOT if your elder has personal or family history of kidney stones.
• Avoid caffeine and alcohol, because these irritate the bladder
• Do not douches or use other feminine hygiene products
• Always wipe from front to back (for women)
• Wear cotton-cloth underwear, and change them least once a day
• If you think your elderly parent might have a urinary tract infection, see your doctor right away.

How do we test for a UTI? Is this easy to do?
You can buy dipstick test kits without a doctor’s order (nonprescription) to use at home to check for urinary tract infections (UTIs).
Talk to your doctor about using a test kit. Make sure that your doctor knows about any abnormal test results, so that a urinary problem is not missed.
The urinary tract consists of the kidneys, bladder, ureters, and urethra. Urine in the bladder normally is sterile—it does not contain any bacteria or other organisms (such as fungi). But bacteria can enter the urinary tract through the urethra.
Urinary tract infections are more common in women and girls than in men. This may be partly because the female urethra is shorter and closer to the anus, which allows bacteria from the intestines to come into contact more easily with the urethra. Men also have an antibacterial substance in their prostate gland that reduces their risk.
Can this be done with our own test?
The dipstick test kit contains specially treated plastic strips (dipsticks) that you hold in your urine stream or dip into a sample of your urine. The strips test for a substance (called nitrite) produced by most urinary tract infections. Certain types of strips also test for white blood cells (leukocytes). Some types of dipsticks can test for both nitrite and leukocytes, but most types test for only one or the other. An area on the end of the strip changes colour if you have an infection.
Where can we obtain such a test?
You can buy dipstick test kits without a doctor’s order (nonprescription) to use at home to check for urinary tract infections (UTIs).
You can purchase this over the counter at most chemists.
Are there different levels/strengths of infection? How are these described?
Types of urinary tract infection
Each type of UTI may result in more-specific signs and symptoms, depending on which part of your urinary tract is infected.

Signs and symptoms
Kidneys (acute pyelonephritis)

• Upper back and side (flank) pain
• High fever
• Shaking and chills
• Nausea
• Vomiting

Bladder (cystitis)

• Pelvic pressure
• Lower abdomen discomfort
• Frequent, painful urination
• Blood in urine

Urethra (urethritis)

• Burning with urination

Are there different types and strengths of medication?
Doctors typically use antibiotics to treat urinary tract infections. Which drugs are prescribed and for how long depend on your health condition and the type of bacterium found in your urine.
Simple infection
Drugs commonly recommended for simple UTIs include:
• Sulfamethoxazole-trimethoprim (Bactrim, Septra, others)
• Amoxicillin (Amoxil, Augmentin, others)
• Nitrofurantoin (Furadantin, Macrodantin, others)
• Ampicillin
• Ciprofloxacin (Cipro)
• Levofloxacin (Levaquin)

Usually, symptoms clear up within a few days of treatment. But you may need to continue antibiotics for a week or more. Take the entire course of antibiotics prescribed by your doctor to ensure that the infection is completely gone.
For an uncomplicated UTI that occurs when you’re otherwise healthy, your doctor may recommend a shorter course of treatment, such as taking an antibiotic for one to three days. But whether this short course of treatment is adequate to treat your infection depends on your particular symptoms and medical history.
Your doctor may also prescribe a pain medication (analgesic) that numbs your bladder and urethra to relieve burning while urinating. One common side effect of urinary tract analgesics is discolored urine — orange or red.
For a severe UTI, you may need treatment with intravenous antibiotics in a hospital.


How can a UTI be medically treated?
Most urinary tract infections can be easily cured with antibiotics. But an untreated infection may spread to the kidneys and cause a more serious problem. (If you use a home test kit, make sure that your doctor knows about any abnormal test results, so that a serious problem is not missed).

• Growing urinary tract bacteria in a lab. Lab analysis of the urine is sometimes followed by a urine culture — a test that uses your urine sample to grow bacteria in a lab. This test tells your doctor what bacteria are causing your infection and which medications will be most effective.
• Creating images of your urinary tract. If your doctor suspects that an abnormality in your urinary tract causes frequent infections, you may have an ultrasound or a computerized tomography (CT) scan to create images of your urinary tract. In certain situations, your doctor may also use a contrast dye to highlight structures in your urinary tract. Another test, called an intravenous pyelogram (IVP), uses X-rays with contrast dye to create images. Historically, doctors used this test for urinary tract imaging, but it’s being replaced more often by ultrasound or CT scan.
• Using a scope to see inside your bladder. If you have recurrent UTIs, your doctor may perform a cystoscopy, using a long, thin tube with a lens (cystoscope) to see inside your urethra and bladder. The cystoscope is inserted in your urethra and passed through to your bladder.


Can symptoms be mistaken for dementia or Alzheimers Disease?
Yes symptoms can be mistaken for Alzheimers Disease