Pain due to infection in the urinary tract can be from the passage of urine and/or felt over the bladder or flank area (upper abdomen or back and sides) when bacteria enter the urine via the urethra, the bladder or the kidneys. A urinary tract infection (UTI) can vary from a simple infection to a potentially life-threating one. UTI is the second most frequent infection in long-term care settings, and can be challenging to identify and treat because some UTI’s show no symptoms (limited bacteria in urine). Medical treatment of a UTI with limited bacteria in the urine is not recommended because it increases the rate of adverse drug effects from antibiotics and increases the rate of recurrent infections due to multiple drug resistant bacteria.

  • Normal Changes of Aging/Risks of UTI
    • General immunity is lower or worse with co-existing conditions, such as diabetes, cancer or autoimmune disorders.
    • Estrogen deficiency thins vaginal tissue causing more vulnerability to bacteria.
    • An enlarged Prostate in older males can cause urinary retention which predisposes men to chronic infection due to entrapped bacteria.
    • Incontinence and functional decline further weakens ability to fight infection
    • The use of indwelling urinary catheters which may increase with age increase the risk of UTIs, hospitalizations, and antibiotic resistance.
  • Assessment
    • Assessment should include vital signs, review of mental status and level of pain.
    • Presence of back pain with tenderness (one side) could indicate kidney infection.
    • Review history: UTIs or catheterizations, kidney stones, or recent dehydration?
    • Mental status change is a MAJOR and common symptom of infection.
    • Obtain urine sample
  • Possible Intervention
    • Prescription or OTC Medications - depends on diagnosis
    • Non-Drug Treatments include: maintaining a calm environment (i.e. calming music, etc.), adequate hydration, and providing support as needed to maintain safety. 
  • What Caregivers can do to help their loved one with UTI
    • Contact health care provider for assessment of condition
    • Write down adn share information about your loved ones pain with their provider.
    • Consider using a Pain Diary to note important information useful to the provider.
    • Encourage your loved one to try a non-drug treatment to decrease minor pain. 

PDF iconFAST FACTS - Caregivers: Urinary Tract Infection - PDF Version