Strategies to Reduce UTIs in Senior Care Residents

Urinary tract infections (UTIs) are one of the most commonly diagnosed infections in older adults. They are the most frequently diagnosed infection in long-term care residents, according to a study published in Aging Health. The study reveals that UTIs are second only to respiratory infections in hospitalized patients and patients over age 65 who live in community settings.

In fact, over 10% of women over age 65 and nearly 30% of women over age 85 had reported having a UTI within the past 12 months. The risk of UTIs substantially increases in men and woman over age 85, making UTI prevention and identification key concerns for senior living communities.

Here, we discuss why UTIs are so common in senior care settings and offer suggestions on how to recognize and prevent UTIs in residents.

Why UTIs are Prevalent in Senior Care Settings

Shelly Pashley, RN, clinical educator at Eddy SeniorCare PACE

UTIs are prevalent in seniors due to age-related factors, including urinary retention, incontinence, vaginal and prostrate changes, decreased thirst and oral fluid intake, uncontrolled diabetes, constipation, and the inability to perform self-hygiene. “In long-term care facilities, you have a lot of people with different comorbidities that might be contributing,” says Shelly Pashley, RN, clinical educator at Eddy SeniorCare PACE.

Other factors can increase the risk of UTIs, too, such as situations where residents who need to go to the bathroom face communication barriers. Residents may have difficulty expressing the signs and symptoms of a UTI, too.

How Senior Care Communities Can Help Prevent UTIs

Eddy SeniorCare PACE focuses heavily on education to help prevent UTIs. “We strive to educate our patients, families, caregivers, and staff to make sure that patients are drinking a good amount of fluid each day,” Pashley explains. “We push for 50 ounces of water per day, but we get creative – we count coffee and tea, juice, and popsicles.”

Other educational components include teaching good hygiene, such as encouraging female patients to wipe from front to back. Proper hygiene practices such as regular toileting and thorough cleaning can minimize the risk of infection in residents. “We encourage toileting schedules for every two to three hours for some people,” says Pashley. She notes that patients are also taught relaxation techniques to help them fully empty their bladders.

“We encourage the use of cranberry supplements,” she explains. “A lot of people swear by cranberry to help reduce bacteria growth.” Pashley notes that good diabetic control is also important, because uncontrolled diabetes could contribute to increased UTI frequency.

How to Recognize UTIs

It’s also important to educate both staff and residents on UTI symptoms so they can quickly recognize if something is wrong. Common UTI symptoms include pain or burning with urination, increased urination frequency, the inability to fully empty the bladder, cloudy or bloody urine, and fever. Those with UTIs often don’t feel well and confusion is also very common.

Any of these symptoms are cause for concern and necessitate prompt diagnosis and treatment. “Prompt treatment is really critical to help prevent the spread of infection into the kidneys and bloodstream,” says Pashley. “UTIs can cause sepsis quickly, and that can be life-threatening.”

“If we receive a report of those signs and symptoms, we send a nurse out the same day to assess further and get a collection of urine based on findings,” Pashley notes. She explains that they run a urinalysis, and sometimes if patients are very symptomatic, they will start treating them with a broad-spectrum antibiotic, then potentially change the antibiotic depending on the results of the culture.

“We also have standing orders for nurses here, which gives them the ability that if they feel there may be the sign of a UTI, they can just collect and run the urinalysis and see if there’s concern to send it off for a culture,” explains Pashley. “Nurses will get an order from a provider if a culture is needed. It’s nice to have those protocols so nurses can act on things they might see on their assessment without having to find a provider. It lets them get to it quickly.”

UTIs are an ongoing concern for senior care facilities and residents alike. By actively addressing UTIs through prevention and early detection, senior care communities can enhance the overall well-being of residents, improve their quality of life, and potentially reduce healthcare costs associated with more serious complications.

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.