How to Prevent UTIs in the Elderly

Last Updated: July 31, 2022 References

Urinary tract infections, or UTIs, are common in older adults, especially in elderly women. Fortunately, there are ways to reduce the risk of developing one. Good hydration and personal hygiene are vital to UTI prevention. Additionally, remedies and medications, such as cranberry juice, probiotics, and estrogen therapy, might discourage harmful bacterial growth. Catheters increase the risk of infection, so proper management is essential for older adults who use them.^{[1]
X
Trustworthy Source
PubMed Central
Journal archive from the U.S. National Institutes of Health
Go to source} If you are a caretaker for an elderly person, make sure their health and hygiene needs are being met to minimize the risk of UTIs.

Method 1

Method 1 of 6:

Staying Hydrated

1
Drink about 64 fluid ounces (1.9 L) of water per day. Staying hydrated promotes regular urination, which flushes bacteria from the urinary tract. Drinking plenty of fluids also improves kidney function and reduces the risk of kidney stones.^{[2]
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Research source}
- In addition to being painful, kidney stones can block or irritate the urinary tract and cause UTIs.^{[3]
  X
  Trustworthy Source
  National Health Service (UK)
  Public healthcare system of the UK
  Go to source}
- A glass of water is 8 fluid ounces (240 mL); try to drink around 8 glasses per day.
2
Drink at least 1 glass of cranberry juice daily. Cranberry juice contains a substance that might prevent bacteria from building up in the urinary tract. While there’s limited scientific evidence that cranberry juice actually prevents UTIs, you can still try drinking 1 to 3 glasses per day.^{[4]
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PubMed Central
Journal archive from the U.S. National Institutes of Health
Go to source}
- A glass is 8 fluid ounces (240 mL).
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3
Avoid drinking caffeine and alcohol. Caffeine and alcohol irritate the bladder and urinary tract. They also have dehydrating effects, so cut down your consumption if necessary.^{[5]
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Research source}
- Food and beverages that contain caffeine include coffee, non-herbal teas, soft drinks, energy drinks, and chocolate.

Method 2

Method 2 of 6:

Preventing UTIs in Elderly Women

1
Wipe from front to back after using the toilet. If you’re a woman, keeping residue from the anus away from the urethra is vital to UTI prevention. When cleaning yourself, wipe away from the urethra, or where urine comes out. Fold the paper or cloth to a clean section before wiping again.^{[6]
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Trustworthy Source
National Health Service (UK)
Public healthcare system of the UK
Go to source}
2
Take showers instead of baths, if possible. Baths can allow water to enter the vagina and urethra, which encourages germs to spread. If you’re physically able, take showers instead of baths.^{[7]
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National Health Service (UK)
Public healthcare system of the UK
Go to source}
- A shower seat and handheld shower head can make it easier to shower if you have mobility issues.
3
Change your undergarments and incontinence pads or briefs often. Wear loose, breathable undergarments, and change them at least once daily or whenever they’re soiled. If you wear adult diapers or incontinence pads, change them whenever they’re soiled.^{[8]
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Research source}
4
Ask your doctor about estrogen replacement therapy. Estrogen levels decrease after menopause, which leads to changes that make the vagina more hospitable for harmful bacteria. An estrogen cream might help, but you should ask your doctor if it’s the right solution for you.^{[9]
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PubMed Central
Journal archive from the U.S. National Institutes of Health
Go to source}
- A typical regimen involves applying a topical cream nightly for 2 weeks, then twice weekly for 8 months.^{[10]
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  Trustworthy Source
  American Academy of Family Physicians
  Organization devoted to improving the health of patients, families, and communities
  Go to source}
- These creams can help minimize UTIs by changing the vaginal flora and helping rebuild weakened vaginal tissue.^{[11]
  X
  Expert Source
  
  Robert Dhir, MD
  Board Certified Urologist & Urological Surgeon
  Expert Interview. 12 October 2020.}
5
Try probiotic vaginal suppositories. Vaginal suppositories of Lactobacillus crispatus can help repopulate the vagina with "good" bacteria that don't cause UTIs. This can discourage the growth of harmful germs. Probiotic supplements are available at pharmacies and online, but you should consult your doctor before trying one.^{[12]
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Research source}
- A typical regimen involves taking a suppository once weekly.
6
Be sure to completely empty your bladder. Try to urinate about every 2 hours if you're prone to urinary tract infections. If you're not sure you're emptying your bladder completely, try double-voiding. To do this, urinate as you normally would, stand up like you're finished, then sit down and try to urinate again.^{[13]
X
Expert Source

Robert Dhir, MD
Board Certified Urologist & Urological Surgeon
Expert Interview. 12 October 2020.}
7
Urinate after sex if you’re sexually active. Young and elderly women alike should urinate after sexual contact. This helps flush bacteria from the urethra and reduces the risk of infection.^{[14]
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PubMed Central
Journal archive from the U.S. National Institutes of Health
Go to source}
- You should also drink more fluids before having sex. Drink 1 to 2 more glasses of water on days you plan on having sex to promote urination and flush your urinary tract.
- If you can, take a shower immediately after sex, as well.

Method 3

Method 3 of 6:

Preventing UTIs in Elderly Men

1
Urinate regularly and avoid holding it when you have to go. If you don't wear adult diapers or use a catheter, focus on urinating regularly to flush your urinary tract. Additionally, do your best to use the toilet whenever you feel the urge instead of holding it.^{[15]
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Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source}
- The main causes of UTIs in older men are blockages (such as kidney stones), prostate issues, and catheter use. Staying hydrated and urinating regularly can help flush the urinary tract and prevent blockages.
2
Discuss your prostate and kidney health with your doctor. In older men, UTIs are usually associated with kidney or prostate issues. If you develop an infection, your doctor should test your kidney function, check for prostate enlargement or infection, and look for other underlying conditions.^{[16]
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Trustworthy Source
National Institute of Diabetes and Digestive and Kidney Diseases
Health information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of Health
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- Your doctor might recommend medication to manage any underlying issues.
- To diagnose the problem, your doctor may recommend a cytoscopy, where they insert a scope into your bladder.^{[17]
  X
  Expert Source
  
  Robert Dhir, MD
  Board Certified Urologist & Urological Surgeon
  Expert Interview. 12 October 2020.}
3
Change your incontinence garments often, if you wear them. Soiled undergarments can lead to UTIs, so change adult diapers or briefs whenever they're dirty. While the risk of infection due to incontinence garments is higher in women, soiled diapers or briefs can still cause infections, sores, and other problems in elderly men.^{[18]
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Research source}

Method 4

Method 4 of 6:

Managing a Catheter

1
Talk to your doctor about minimizing catheter use. Catheters are used for a variety of conditions, so ask your doctor if there are any alternatives available for your specific medical issue. Sometimes, long-term catheter use is necessary and there are no alternatives. If this is the case, proper care and cleaning of your catheter can help prevent UTIs.^{[19]
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Trustworthy Source
PubMed Central
Journal archive from the U.S. National Institutes of Health
Go to source}
- Long-term catheter use greatly increases the risk of recurrent UTIs.
2
Clean your catheter twice daily if you have one. Wash your hands and wet a clean washcloth with soap and warm water. Hold the catheter tube and carefully wash the end near your vagina or penis. Take care not to tug it as you slowly clean down the tube away from your body, then dry it with a clean cloth.^{[20]
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MedlinePlus
Collection of medical information sourced from the US National Library of Medicine
Go to source}
- Always wash the catheter away from your body. Cleaning it from the bottom toward your body increases the risk of infection.
- Wash your hands again when you’re finished.
3
Clean the skin around your catheter at least once a day. Wash your hands, wet a clean washcloth with soap and warm water, then gently wipe the area where the catheter enters your urethra. If you’re a woman, wipe away from the urethra from front to back. If you’re a man, wipe from the tip of the penis down the shaft.^{[21]
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MedlinePlus
Collection of medical information sourced from the US National Library of Medicine
Go to source}
- Continue to wipe your groin area with the soapy cloth. Rinse the soap away with a stream of water or wet washcloth, then dry yourself thoroughly with a clean cloth.
- Wash your hands again when you’re finished.
4
Empty the bag every 8 hours or whenever it’s half-full. Open the bag’s spout or clamp and pour the contents into a toilet or the receptacle your doctor or nurse provided. Clean the spout with a cotton ball or swab soaked in rubbing alcohol, close the spout, then attach the bag to your leg fastener.^{[22]
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Trustworthy Source
MedlinePlus
Collection of medical information sourced from the US National Library of Medicine
Go to source}
- Keep the bag below your waist at all times.
- Be aware of the tube’s position as you pour, and make sure it doesn’t twist or tug.
- Take care not to get urine on your hands as you pour.
- Wash your hands after draining the bag.
5
Keep the catheter bag lower than your waist at all times. Attach the drainage bag to a leg fastener, and never hold it above your waist when you’re emptying or cleaning it. Holding it above your bladder level can cause urine to re-enter your urinary tract.^{[23]
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Trustworthy Source
MedlinePlus
Collection of medical information sourced from the US National Library of Medicine
Go to source}

Method 5

Method 5 of 6:

Caring for Elderly Patients

1
Ensure your patient or loved one stays hydrated. If your patient or loved one has a memory or cognitive impairment, you’ll need to closely monitor their fluid intake. Make sure they drink 6 to 8 glasses of water or juice per day.
- Try to be patient if they don’t want to drink water when you offer it. If they refuse, try again in 15 or 20 minutes. Offer different kinds of juice and other hydrating beverages, and try to find which options they enjoy most.
- Offer a daily 8 fluid ounces (240 mL) glass of cranberry juice, which may also help prevent UTIs. If your patient or loved one doesn’t like cranberry juice, try variations, such as cranberry apple.
2
Offer prompt assistance if they have to use the toilet. If your patient or loved one says that they need to go to the bathroom, help them go immediately. Holding a full bladder can cause a UTI.^{[24]
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Research source}
3
Check adult diapers or briefs at least every 2 hours. Check every 2 hours at a minimum or more frequently if you consistently find that undergarments need to be changed. Change them promptly if they’re soiled. Never let your patient or loved one sit in a soiled diaper or briefs for an extended period of time.^{[25]
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Research source}
4
Clean your patient or loved one after they use the bathroom. After helping them use the toilet or when you change their incontinence garment, wipe their private area with a clean washcloth soaked with soap and warm water. Wipe from front to back if they’re a woman, and from the tip of the penis down if they’re a man. Rinse or wipe away soap residue, then dry the area thoroughly when you’re finished.^{[26]
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Research source}
- Wash your hands before and after cleaning your patient or loved one.

Method 6

Method 6 of 6:

Recognizing the Signs and Symptoms of a UTI

1
Watch for pain and urgency during urination. Pain during urination and a need to go frequently and urgently are the main early signs of a UTI. If you notice these symptoms in yourself or someone in your care, schedule an appointment with a health care provider right away.^{[27]
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Trustworthy Source
Cleveland Clinic
Educational website from one of the world's leading hospitals
Go to source}
- You may feel the urgent need to urinate, but only pass a very small amount.
2
Look for cloudy or discolored urine. Urine may appear cloudy, pink, red, or dark brown with a UTI. If you notice that your urine, or the urine of someone in your care, has an unusual appearance, schedule a visit with a healthcare provider.^{[28]
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Trustworthy Source
Cleveland Clinic
Educational website from one of the world's leading hospitals
Go to source}
- If you are using a catheter, hold the bag up to the light to check if it is clear. If you see cloudy residue, this may be a sign of a urinary tract infection in its early stages.
3
Note any unusual urinary odors. If you have a UTI, your urine may smell strong or unpleasant. See a doctor if you notice that your urine smells bad, particularly if the smell is accompanied by other symptoms of infection (such as pain during urination or discolored urine).^{[29]
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Trustworthy Source
Cleveland Clinic
Educational website from one of the world's leading hospitals
Go to source}
- Some foods, like asparagus, can also affect the odor of your urine.
4
Pay attention to pelvic pain in women. For women, a UTI may cause pain in the center of the pelvis, in the area of the pubic bone. Pelvic pain can also be a sign of some other serious condition. Schedule an appointment with your doctor if you or someone in your care experiences pelvic pain.^{[30]
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Trustworthy Source
Cleveland Clinic
Educational website from one of the world's leading hospitals
Go to source}
5
Check for other early signs of a UTI. UTIs in their early stages may cause a variety of other symptoms in the elderly, some of which may mimic other conditions.^{[31]
X
Trustworthy Source
Cleveland Clinic
Educational website from one of the world's leading hospitals
Go to source} Schedule an appointment with a health care provider if you notice:
- Confusion.
- Light-headedness.
- Pale skin.
- A low-grade fever. For someone using a catheter, do a daily temperature check to catch any signs of infection early.