Preventing urinary tract infections (UTIs) in the elderly involves a combination of education, lifestyle adjustments, ongoing monitoring and preventative measures.

UTI Infections In Elderly: Education and Awareness

• Inform Caregivers: Educate caregivers and family members about the importance of preventing UTIs and recognizing early symptoms.
• Patient Education: Teach elderly women and men about the importance of hydration, proper hygiene, and regular urination.

Hydration

• Encourage Fluid Intake: Ensure that elderly individuals drink plenty of water throughout the day to flush out bacteria from the urinary tract.
• Monitor Fluid Intake: Keep track of the amount of fluids consumed to ensure adequate hydration.

Bladder Health

• Regular Urination: Encourage regular trips to the bathroom to avoid holding urine for extended periods, which can allow bacteria to grow.
• Complete Bladder Emptying: Ensure that the bladder is fully emptied during urination to prevent urine stagnation.

Proper Hygiene

• Regular Cleaning: Maintain good personal hygiene with regular bathing and proper cleaning of the genital area.
• Frequent Changes: Change underwear daily and more frequently if incontinence is an issue.
• Manage catheters: Ensure that catheters are inserted using aseptic techniques and are properly maintained.  Follow guidelines for regular changing and proper care of indwelling catheters.

Dietary Considerations

• Avoid Irritants: Reduce consumption of bladder irritants like caffeine, alcohol, and spicy foods.

• Adopt An “Aromatic” Diet: Researchers at Washington University School of Medicine found that managing the pH level of urine may limit bacterial growth in the urinary tract.  Read more about the "aromatics" which keep the pH level balanced at Understanding UTIs.  

Frequent Monitoring

• Routine At-Home Urine Tests with Test Strips: The elderly often do not even know that they have a UTI.  Due to their aging systems, they do not always exhibit the typical symptoms such as burning upon urination or frequent pressure to urinate.  So it is very important to frequently monitor their urine for “early warning” signs of a UTI.   At-home testing is now available by purchasing test strips which include easy-to-understand instructions on how to read the results.  Read more here.

• Monitor Cognitive Changes: The most common first sign of a urinary tract infection in the elderly is UTI delirium.  Look for sudden, atypical behaviors like confusion, difficulty communicating  or hallucinations.

UTI Infections in Elderly - Prevention Measures

There are three specific prevention measures which will protect against UTIs in the elderly. This is known as “The Triple Play” which includes:

• Estrogen Therapy: Postmenopausal women can benefit from topical estrogen therapy to maintain the health of the vaginal flora which reduces UTI risk.
• Probiotics: Keeping the good bacteria flourishing in both the bladder and the digestive tract helps fight off the bad bacteria which cause UTIs.
• Natural Supplements For the Bladder: Flushing the bladder with D-Mannose and protecting the bladder lining from new infections with cranberry extract.

Read the full Triple Play article at Understanding UTIs.

Treating and Preventing UTI Infections In The Elderly

Antibiotics Resistance Limits Treatment

Recurrent UTIs are common among elderly female and male patients.  The first line of UTI treatment for the elderly is a course of oral antibiotics.  

Because antibiotics have been so over-prescribed, most older patients have become “antibiotic resistant”.  There are only two oral antibiotics which remain effective against UTIs.  Read more about antibiotics resistance at Understanding UTIs.

Doctors Can No Longer Prescribe Antibiotics for Prevention

The American Medical Association has recently issued guidance on UTI prevention for the elderly: doctors are no longer permitted to prescribe long-term antibiotics as a preventative against recurring UTIs due to the serious side effects they caused in older women and men. 

Two Natural Supplements Are Now Being Recommended

The good news is that there are two all-natural alternatives which have been proven effective in both treating and preventing UTIs in the elderly females and males.  The medical community has begun to recommend both.

1.      D-Mannose powder which binds to the UTI bacteria and flushes them out of the bladder.  This supplement can be used to treat an active UTI and provide relief from symptoms; it can also be used as a daily UTI preventative.  A March 2022 article in Antibiotics Magazine confirmed that D-Mannose is as effective as antibiotics in the treatment of ­­­­­­­­­­­­­­­­­­­­­­­­uncomplicated urinary tract infections.

2.      Cranberry Extract capsules which deliver a daily dose pf 36 mg. of proanthocyandins (PACs) prevents bacteria from sticking to the bladder lining and starting an infection.  A November 2019 article in Today’s Geriatric Magazine confirmed that 36 mg of PAC was as effective as the antibiotic trimethoprim in preventing recurring UTIs in the elderly.

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