Urinary tract infections (UTIs) are common in the elderly and can lead to serious complications.
A UTI is an infection of the urinary tract, which consists of the kidneys, ureters, bladder and urethra. UTIs are most commonly caused by bacteria entering through the urethral opening and travelling up to the bladder, and can continue to the kidneys.
UTIs are more common in women due to their anatomy as they have a shorter urethra than men, so less distance for bacteria to travel to get to the bladder. UTIs are prevalent in the elderly due to improper emptying of the bladder as we get older, along with diabetes, incontinence, use of a catheter, immobility and easily becoming dehydrated.
How can a UTI affect you?
Common symptoms of UTIs include burning and/or lower abdominal pain when urinating, urgency, frequent need to urinate, darker/cloudy/bloody/smelly urine, constant feeling of a full bladder, only passing a few drops of urine, leaking or incontinence before being able to get to the toilet, and fever.
If left untreated, the infection can worsen, causing nausea, vomiting, fatigue and damage to the kidneys, requiring urgent medical treatment.
In older adults and those living with dementia, UTIs can cause confusion and functional decline, which can compromise safety and increase the risk of falls and injury. Someone living with dementia may not be able to effectively communicate what they are feeling and simply appear to be more confused, agitated, fatigued, dizzy or have a reduced appetite.
It is important for family and caregivers to be aware of and identify these symptoms, or notice a sudden and unexplained change in usual behaviour, so the infection can be treated in a timely manner.
When someone experiences two UTIs in a three-month period, or more than three infections in a year, they have a recurrent UTI (RUTI).
Not only can RUTIs affect health, they can also have social implications as the anxiety of getting to the bathroom may stop people from enjoying outings, or being able to comfortably complete simple but necessary outings such as going grocery shopping.
Medical treatment for UTIs is typically antibiotics prescribed by a doctor, but we all know prevention is better than cure. It is far preferable to reduce the risk and frequency of infection in the first place than frequently needing to take antibiotics. This is where physiotherapy can help.
How can physiotherapy help?
In combination with medical management, physiotherapists can help with the following to encourage proper/full emptying of the bladder and reduce the risk of contracting a UTI:
- Provide education around posture while using the toilet to promote proper emptying of the bladder.
- Provide education regarding muscle coordination between pelvic floor (relax) and abdominal muscles (isometric contraction) to improve emptying of the bladder.
- Provide education regarding fluid intake – ensuring staying well hydrated – and frequency of urination, along with improving bowel habits.
- Provide education regarding hygiene habits – wiping front to back for women (caregivers to follow this protocol if assisting in toileting process), regular showers, ensuring a clean environment if using a catheter or continence aids.
- Providing education on the function and purpose of the pelvic floor.
- Treatment of potential pelvic floor dysfunction, such as incontinence.
If you or a loved one is experiencing the effects of a UTI or RUTI, The Physio Co is here to help. Please call our friendly support office to discover more.
Article written by Brooke Cherubin, The Physio Co.