Urinary Tract Infections in Older People: Signs Families Often Miss
What is a UTI?
Urinary tract infections (UTIs) are usually caused by bacteria from the gut entering the urinary tract. The bacteria enters the urinary tract through the urethra and then can travel up into the bladder or kidneys, causing irrigation and inflammation. As the NHS says, “The bacteria enter through the tube that carries pee out of the body (urethra).”
UTIs can affect different parts of the urinary tract, such as bladder infection (cystitis), urethritis, and kidney infection. It’s vital to get UTIs treated, as if not, permanent kidney damage could result. Bacteria could also enter the bloodstream, causing sepsis. This is a medical emergency that would require immediate hospital care.
Why are older people more at risk?
There are several reasons why older people may be more at risk of UTIs. Older people may not drink adequate fluids as they’re worried about continence or mobility difficulties, which can leave them at risk of UTIs. They may also have weakened bladder emptying, bladder muscles lose strength with age, leaving urine behind where bacteria can multiple. They may also be taking various medications, some of which may have side-effects that inhibit the bladder emptying completely, including certain antihistamines, antidepressants, and opioid pain relievers.
Common symptoms of a UTI
Needing to urinate more often than usual
Pain or a burning sensation when urinating
Needing to urinate more often than usual during the night
Needing to urinate suddenly or more urgently than usual
Bloody, cloudy or strong-smelling pee
A high temperature, feeling shivery, hot or cold
A very low temperature (below 36C)
Feeling tired or weak
Pain low in the tummy, or pain in your back, just under the ribs
Signs families often miss
Because it can sometimes be difficult to recognise whether an older person’s symptoms are down to a condition they already live with, or because of a UTI, loved ones may not act as quickly as they could. However, it’s important to seek medical advice if they are displaying symptoms and you have concerns, says the NHS, especially if they have the following:
Sudden changes/confusion
If the person’s behaviour changes, such as agitation or confusion (delirium), medical advice should be sought.
Falls or new unsteadiness
Excessive falls or lack of balance could be due to dehydration, immune response, delirium, or lack of sleep.
Loss of appetite/tiredness
A compromised immune system will expel more energy, while lack of appetite can suggest kidney infection.
New or worse incontinence
If the person is leaking urine, or struggling with their incontinence more than usual, it should be investigated.
UTIs and dementia
UTIs “can cause sudden confusion (also known as delirium) in older people and people with dementia” says The Alzheimer’s Society. “If the person has a sudden and unexplained change in their behaviour, such as increased confusion, agitation, or withdrawal, this may be because of a UTI.”
A person living with dementia may not be able to communicate in a traditional way, which is why it’s essential for loved ones and caregivers to be aware of UTI symptoms. They shouldn’t just be dismissed as part of their dementia and medical advice should be sought in a timely manner if symptoms present.
When to contact a GP or get urgent help
According to the NHS, “Sepsis is a serious reaction to an infection that can be life-threatening. It develops very quickly and needs urgent treatment in hospital.” If a UTI isn’t treated as a priority it can develop into sepsis and lead to the risk of organ failure. It can be harder to recognise the symptoms of UTI or sepsis in people living with dementia, people who have a learning disability, or people who have difficulty communicating. Symptoms such as very fast breathing, confusion or slurred speech, pale, blotchy or blue skin, a very high or very low temperature or shivers, or any other symptoms you feel may be sepsis, should be treated as a medical emergency.
How to help prevent UTIs
Helping to prevent UTIs can be done at home through various lifestyle choices. These include improving toilet hygiene and drinking more fluids.
Staying hydrated
“Adults should drink between six and eight glasses of fluid a day and drink alcohol only in moderation” according to the Alzheimer’s Society. Some older people won’t drink enough, due to continence concerns or because of confusion or memory loss. Encourage them by drinking fluids with them and always having fluids available.
Good hygiene and continence care
If a person is struggling to conduct their own personal care effectively it can leave them at risk of UTIs. This is because if bacteria from the back passage get into the urethra it can cause UTIs. Making sure the person wipes front to back after going to the toilet and changes incontinence pads as soon they are soiled, or the carer does so for them, will help.
Not putting off going to the toilet
If a person’s mobility isn’t strong then they can put off going to the toilet as they don’t want to have to get out of a chair, or because of pain when walking, for instance. They may also worry that they can’t clean themselves effectively after going. Caregivers should encourage the person to go regularly, supporting them to get to the toilet and back.
Why a regular Helping Hands carer can spot the signs sooner
Having a Helping Hands carer coming to your home regularly will mean you get essential support to help prevent UTIs, while giving you a friendly face you’ll look forward to seeing every day. Because our carers are dedicated to getting to know their customers and making sure they have a personalised plan of care, they become as welcome as friends and as familiar as family. Your visiting or live-in carer will carry out practical care tasks for you such as personal care and mobility support, plus essential emotional support when you feel like a chat and a cuppa. However, they’ll also make your loved ones feel better, knowing there’s someone who will spot changes quickly and act on them without delay.
Frequently Asked Questions
Yes, men can get UTIs, although due to women having a shorter urethra, they may be more common in women. Men often get UTIs due to prostate problems, which should always be investigated without delay.
There is evidence that cranberry products – such as juice, tablets or capsules – can be beneficial when someone has recurring UTIs, however you should always seek medical advice before taking. This is because cranberry products can contain a lot of sugar and are not suitable for people taking certain medications, such as warfarin.
While it’s not impossible, it’s unlikely that a UTI will clear up on its own. Factors for this include the severity of the infection, underlying health conditions, and the individual’s immune system. Waiting to see if the UTI clears up is risky because it may spread in that time, making symptoms worse and leading to more severe health complications.
No, UTIs are not contagious and cannot be passed from one person to another, such as through sex, casual contact, or shared bathrooms. UTIs develop from bacteria already present on or in the person’s own body, especially those present in the gut such as E.coli. Sexual intercourse can lead to existing bacteria being pushed further toward the person’s urethra, leading to confusion around whether they are sexually transmitted.
Some people keep getting UTIs due to existing health conditions, a compromised immune system, or bacteria that are resistant to antibiotics. Hormonal changes can also cause recurring infections, such as declining oestrogen after menopause altering the vaginal microbiome. Women are at greater risk of UTI due to a shorter urethra too.
Page reviewed by Honor Elliott, Clinical Manager, on October 21st 2026.
How we wrote this page
This page has been produced referencing key insights and data from external experts, trusted medical sources and our team of in-house specialists. We have worked hard to ensure that all information is as accurate as possible and reflects current consensus at the time of writing and reviewing.