Alzheimer’s and the Dreaded Urinary Tract Infection (UTI)

 

cartoon e-Coli bacteria

Urinary tract infection, UTI are often common in older people with Alzheimer’s.

Urinary Tract Infection Results In Trip To The Hospital

June 2, 2013 – My father, Ken, had an emergency visit to the hospital earlier this week so I am filling in for my mom on this week’s blog. A urinary-tract-infection (UTI) resulted in an ambulance ride and a three day hospital stay. He is home and doing better than we expected.

Further investigating the subject lead me to the danger of UTI’s in people with dementia or Alzheimer’s. They can be life threatening when not taken care of quickly. They can also aggravate the dementia itself. UTIs can cause their own dementia-like symptoms, sometimes leading to a false diagnosis of the condition.

When my mother and his caregiver tried to get my dad up for the morning, they found he was weaker than normal and feared he just might fall or pass out if they went about their usual morning procedure.  He was babbling, had a warm forehead, while his body was cold, shivering and shaking. She called their HMO who advised a non-emergency ambulance.  A thorough examination and lab tests determined he had a bladder infection that had progressed to the point where a hospital stay was necessary.

Urinary Tract Infections Are Common Among People with Alzheimer’s

Whether a person has dementia or not, UTIs are common in older people who wear adult protective underwear. But there are steps to take while striving to guard against these infections and their resulting discomfort. Completely cleaning the genital area each time after changing is obviously a given, but infections still happen. Women should always wipe from front to back. Men should be carefully cleaned so that bacteria don’t get into the urine discharge in the penis. I know that my dad’s caregivers are very careful each time he is changed. But given the warm, moist condition of a wet diaper and its nearness to the e-coli bacteria in the colon, it can’t always be helped. That’s what causes these infections.

But Sometimes Hard To Diagnose

Elderly patients who have Alzheimer’s don’t often communicate when they are wet. Frequent trips to use the bathroom, whether the person with dementia wants to or not, can help this situation. His caregivers are always very conscientious about this and they have a set routine for using the toilet. There are certain products that work better than others for keeping the area next to the skin dry. Tranquility ATN, Reassure Fitted Briefs, and Secure X+ all work moisture away from the skin, decreasing bacteria growth and the chances for a UTI. Despite these precautions, a UTI can still occur.

Another good preventative method is frequent bathing or showering. Often times people with dementia put up a fight and/or are fearful of bathing. But persistence in frequent bathing can help with the problem. Though my father only has full showers twice a week, (unless he has a bowel accident), each morning and evening his caregivers give him a complete standing bath in the bathroom, with warm running water and soap. Because I’ve helped with these clean-up procedures I know this is almost as good a cleaning as he gets from a shower, minus the spray.

The typical limited verbal communication of people with Alzheimer’s is another part of the problem. Seldom are they able tell their caregivers they are wet, or need a change. Nor do they share many of the classic UTI symptoms of the general adult population. Because of their diaper, it’s hard to tell if there is frequent urination. They may act different, grouchy, surly, or out of sorts, but they can act that way for many reasons. Negative behavioral changes like agitation or delirium may be a sign of UTIs in the elderly. Added to the problem is that UTIs can cause serious complications in this age group if not treated promptly. Any sign of abnormal behaviors like these should never be ignored.

Standing as a tribute to his excellent caregivers, Ben and Crizaldo and my mother, my father has only had two known UTIs since he developed Alzheimer’s. Despite all of their care and vigilance, he did develop this one. His only other UTI experience occurred when he was in the hospital after my parent’s auto accident more than three years ago. The catheter inserted in him for the convenience of the hospital caused that episode.

During this hospital stay Crizaldo took his regular shift in my father’s room acting as an advocate when my mother couldn’t be there, making sure he was receiving the attention and care he needed. Their presence prevented possible surgical intervention, but that is the subject of next week’s blog.

Helpful Information

For further information, I found these articles helpful.
http://voices.yahoo.com/tips-decreasing-instances-developing-urinary
Hecht, Frederick. “Urinary Tract Infections.” eMedicineHealth . N.p., 2010. Web. 21 June 2010.
http://www.emedicinehealth.com/urinary_tract_infections/article_em.html

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