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Alzheimer's Caregiving Avoiding the Urinary Tract Infection (Part Four)

Posted Aug 30 2010 11:14am
Here are a few tips/tricks that may help you avoid the dreaded UTI -- Urinary Tract Infection.....
By Carole B. Larkin
Alzheimer's Reading Room

First, I am not a doctor, nor am I a nurse. I am an experienced Geriatric Care Manager and a woman. Over the years, I had more conversations with urologists and their nurses about urinary tract infections (UTIs) than I care to remember.


Right out of the starting block I want to say that Bob is spot on (oops, there I go again- sorry!) about E. Coli and cranberry juice.

E. Coli is one of the bacteria and/or viruses that cause UTI’s. There are others. Lucky us! Cranberry juice is the elixir of the gods when it comes to helping prevent or minimize the effects of a UTI.

For those like Dottie who find it poison, cranberry extract comes in pills; you’ll find them near the vitamins at your local pharmacy.

I was told that one reason cranberry works well is that it changes the PH in the urinary tract. (Those of you with swimming pools know what I mean by that!) Nurses out there, correct me if I misheard or misinterpreted that statement.

What if there were ways to stop a UTI before it happens, or at least cut down on the occurrence of UTIs? Wouldn't that be (as I like to say) "more better"?

E. Coli and other nastiness usually enter from outside the body. Women are particularly prone to infection because of the way that we are built. We have a couple of warm, moist environments (vaginal, rectal) located nearby which are lovely breeding grounds for nastiness. If we wipe ourselves the wrong way (meaning from back to front) we can stand a good chance of transferring nastiness from either area left over from not cleaning that area very thoroughly after an event (for example a bowel movement).

So for those of experiencing frequent UTIs, consider watching the way mom wipes herself after urinating or after a bowel movement. If you observe an obvious problem, try to train her to wipe the other way or right way.

Using adult incontinence wear or certain fabrics in underpants on mom may inadvertently be enabling conditions to incubate nastiness leading to UTI’s.

Plastic adult incontinence wear or polyester underwear holds body heat and moisture in, close to the body, thus creating great conditions to “culture” the bacteria needed for creation of infections. The answer? Use cotton or one of the new synthetic fabrics that “wick” moisture away from the body. Also, hold off on using adult incontinence wear as long as you possibly can. (More on that later!)

Another way UTI’s can start or restart is if your mom is not completely emptying her bladder when she urinates. This can easily happen if she is “rushed”.

Old urine, which may be infected, remains in the bladder to reinfect the new urine coming in. It can even travel up to the kidneys, where urine is made! So if mom has a series of UTI’s very close together, it could actually be reinfection from the original UTI over and over again.

Urologists and certain home health companies can actually train mom how to completely empty her bladder using “Kegel” exercises and biofeedback. Learn the procedure and reinforce the training given to mom after the therapy ends.

Remember, with enough repetition (practice) things can be learned and retained later in the disease than you think. But, it takes real effort on your part to keep at it.

Bob says, “Let me say this as clearly as I can -- you get to decide. Choose.”(To make the effort) Bob also says,” I am a turtle. I plod along at my own pace. When I am at my best I have my eye on the finish line. One step by one step, I plod right past all the rabbits I see on the road. I am a turtle.” I think the story was the hare and the tortoise; but what the heck- turtle, tortoise- close enough. So choose to be a tortoise. Persistence pays off!

The biggest cause of UTI’s is dehydration! It’s ironic, because the thought process of many older adults is,
“if I don’t drink much, then I won’t have to go to the bathroom very often, which is better because it’s a pain in the butt (sorry again!) to get up, get over to the bathroom, partially disrobe, and then go to the bathroom and then do it all in reverse, before I get to relax in my chair or bed again.”
So they don’t drink fluids, which of course leads to dehydration, the leading cause of UTI’s and incontinence (at least in early and midstage Alzheimer’s.) So to prevent UTI’s you must be persistent in having mom drink fluids. Water is best, but among one of the hardest things to get some people to drink, so flavor it with Kool-Aid or something similar. I can’t tell you how many times my clients have ended up with UTI’s just because no one insisted that they drink!

Next time: The role of incontinence in the equation.

Carole Larkin MAG, CMC, DCP, EICS is a geriatric care manager who specializes in helping families with Alzheimer’s and related dementias issues. She also trains caregivers in home care companies, assisted livings, memory care communities, and nursing homes in dementia specific techniques for best care of dementia sufferers. ThirdAge Services LLC , is located in Dallas, TX.



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Original content Carole Larkin, the Alzheimer's Reading Room


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