Urinary Tract Infections Hit Home… Nursing Homes

Urinary tract infections can be serious in older adults. If you have a loved one in a nursing home or long-term care facility, you can help by being aware of the seriousness of urinary tract infections and learning how to recognize them.

Remember the last time you had a urinary tract infection (UTI)? All those trips to the bathroom and that burning sensation?

Now, imagine your mother, grandmother, elderly aunt or even your grandfather having to go through that. No. Fun.

Unfortunately, urinary tract infections are quite common among the elderly and chronically ill, especially those who live in nursing homes or other long-term care facilities. According to researchers from New York City’s Columbia University School of Nursing, more than 5% of nursing home residents experience a UTI each month.¹

Why? Because of:

• Age-related changes to the urinary system
• Age-related changes to the immune system
• Chronic medical conditions (such as diabetes and heart disease) that affect the immune system
• Medical issues that impact the bladder and/or the brain’s bladder control (examples include Alzheimer’s, multiple sclerosis, Parkinson’s disease, and past pelvic surgeries)
• Needing a catheter to drain urine (a catheter is a small, flexible tube inserted through the urethra and into the bladder)
• Dehydration, which can be common in those needing long-term care, especially if they require assistance or encouragement to drink fluids
• Lack of mobility leading to incomplete bladder emptying^2,3,4

In a younger, generally healthy person, a urinary tract infection is usually uncomplicated and straightforward to treat with doctor-prescribed antibiotics. But in an older person or anyone with chronic medical problems, a urinary tract infection can lead to a more serious infection, can increase the risk of falling, and may require hospitalization to manage.¹

So, while it’s always important to quickly recognized UTI symptoms and seek medical help, it’s even more important to do so if the person involved is older or has a long-standing medical issue.

If you have a loved one in a nursing home or long-term care facility, you can help by being aware of the seriousness of urinary tract infections and learning how to recognize them.

Many of the symptoms of a UTI are similar no matter your age, but there are some differences to be aware of that make it harder to recognize a UTI in an older or medically frail person – especially if that person has difficulty communicating or suffers from dementia.

If you think your loved one is exhibiting signs of a UTI, speak up. Talk to his or her nurse or physician, ask questions, and discuss your concerns.

Here are potential UTI symptoms in an older person or other long-term care facility resident:

• Pain, especially during urination: This may be manifested by vocalizations (moans, groans, cries, sighs, or gasps), facial grimaces (winces, a furrowed brow, or clenched teeth), bracing (holding onto furniture or abdomen/flank during movement), restlessness (rocking or difficulty keeping still), and/or rubbing of the painful area.
• New or marked increase in frequency of urination or incontinence (bed- or clothing-wetting)
• Delirium: New or increased confusion, disoriented thinking, or reduced awareness.
• Change in appetite
• Agitation^3,4

Thankfully, while urinary tract infections can be common and more serious in the nursing home population, there are many ways to help prevent them.

The list below includes steps that healthcare providers and facility administrators can take to reduce UTI risks among their patients, but as a loved one or friend, you have a role, too:

• Advocate for practices that help prevent UTIs
• Ask Questions
• Discuss your concerns with care providers
• Give kudos when you see that things are being done to maintain urinary health

Tips for healthcare providers as well as other nursing home and long-term care facility workers to help prevent UTIs:

• Wash hands frequently and adhere to standard infection control practices.
• Support patients in being as mobile as possible.
• Maintain patient hydration. Provide access to fluids and assistance with drinking as appropriate (unless the patient is on a fluid restriction for a medical reason.)
• Provide regular trips to/access to the toilet, commode, or bedpan.
• Keep patients clean and dry. Wash patients frequently with soap and water.
• Use catheters only when “clinically needed,” assess them daily, and discontinue their use when no longer needed.
• Use portable bladder ultrasound scanners to confirm that certain patients have emptied their bladders.
• If a catheter is necessary, attach urine collection bags to the patient’s leg to limit bag movement and tugging.
• Keep urine collection bags below the bladder to facilitate drainage.
• Avoid any kinking or twisting of tubes.
• Clean urine collection bags regularly.
• Employ and utilize trained “infection control specialists.”^1,4

Thank you for looking out for the urinary health of those in your family and extended network of loved ones! It’s takes a village to provide compassionate, comprehensive care and we hope that after reading this blog you feel more empowered to be a part of that.

Wondering how else you can assist a loved one who’s at risk of a UTI? Talk to his or her healthcare provider about whether Cystex is right for them.

We have two over-the-counter urinary health products available:

Cystex^® Urinary Pain Relief Tablets: To ease UTI symptoms and to help keep infections from getting worse while waiting for a doctor’s prescription antibiotic.

Cystex® Urinary Health Maintenance: For urinary wellness. Just one tablespoon per day provides:

• Antioxidants – to help protect the body
• Antalkalines – to help maintain healthy urine
• Anti-adherents – to help keep bad bacteria from hanging around
• Prebiotics – to help promote healthy bacteria

Let’s all continue to raise awareness of UTI symptoms, treatment, and prevention for better health throughout the ages.

References

1. Study finds little consistency for UTI prevention in nursing homes. Association for Professionals in Infection Control and Epidemiology website https://www.apic.org/Resource_/TinyMceFileManager/Practice_Guidance/Surveillance-In-Long-Term-Care.pdf. Accessed March 16, 2017.
2. Dangerous Urinary Tract Infections Common in Nursing Homes. HealthDay website https://consumer.healthday.com/caregiving-information-6/nursing-homes-and-elder-care-health-news-501/dangerous-urinary-tract-infections-common-in-nursing-homes-711612.html. Accessed March 16, 2017
3. Urinary Tract Infection (UTI) Event for Long-term Care Facilities. Centers for Disease Control and Prevention website https://www.cdc.gov/nhsn/PDFs/LTC/LTCF-UTI-protocol_FINAL_8-24-2012.pdf. Accessed March 16, 2017.
4. H Kamel. Managing Urinary Tract Infections in the Nursing Home: Myths, Mysteries and Realities. The Internet Journal of Geriatrics and Gerontology. 2003 Volume 1 Number 2
5. Educational Module for Nursing Assistants in Long-Term Care Facilities: Urinary Tract Infections and Asymptomatic Bacteriuria. Minnesotar Department of Health website https://www.health.state.mn.us/diseases/antibioticresistance/basics/faq.html. Accessed March 16, 2017.