UTI in older adults
Informed by recognized medical guidance
Overview
A urinary tract infection (UTI) is an infection in any part of the urinary system, such as the bladder or kidneys. It happens when bacteria get into the urine and multiply. In older adults, UTIs can sometimes cause confusion or a sudden change in behaviour.
Key facts
- Most UTIs are caused by bacteria from the bowel, such as E. coli.
- Older adults may have symptoms like confusion or falls instead of typical pain.
- UTIs are usually treatable, but can become serious if the infection reaches the kidneys or blood.
Yes. UTIs are one of the most common infections in older people, especially in those who are in hospital, live in care homes, or have a urinary catheter.
UTIs can affect anyone, but they are more common in older adults, particularly women. Men can also develop UTIs, especially if they have an enlarged prostate or use a catheter.
Symptoms
- High fever with shaking chills
- Confusion or drowsiness that is not normal
- Inability to urinate or pass any urine
- Severe pain in the back or side
- Fast heartbeat, fast breathing, or feeling extremely unwell
- ⚠Blood in the urine
- ⚠Fever with a UTI symptom
- ⚠Burning or pain on urination
- ⚠Need to see a doctor today rather than waiting
Common symptoms
- A burning feeling when urinating
- A strong, frequent urge to urinate
- Passing small amounts of urine
- Cloudy, bloody, or strong-smelling urine
- Pain or pressure in the lower belly
Symptoms in children
- High temperature
- Irritability or fussiness
- Poor feeding
- Vomiting
- Unusual-smelling urine
Symptoms in older adults
- Suddenly feeling confused or more confused than usual
- Falls or dizziness
- Change in behaviour, such as being withdrawn or agitated
- Lower abdominal discomfort
- Fever or low body temperature
- Loss of appetite
- Wetting themselves (loss of bladder control)
Causes
Main causes
- Bacteria entering the urinary tract through the opening of the urethra
- The most common cause is E. coli bacteria from the bowel
- Rarely, bacteria can reach the kidneys through the bloodstream
Risk factors
- Being female, especially after menopause
- Urinary catheter use
- Difficulty emptying the bladder fully
- Enlarged prostate in men
- Dehydration or poor fluid intake
- Weak immune system due to illness or medication
- Recent urinary tract surgery or procedure
When to see a doctor
See a doctor urgently if:
- If you or the person you care for has a high fever, confusion, or is unable to pass urine, get care right away.
- If there is blood in the urine, see a doctor or nurse that same day.
Book a routine appointment if:
- If you have burning or pain when urinating, or a frequent need to urinate, book an appointment with a healthcare provider.
- If an older person suddenly becomes confused or falls, a doctor should assess them.
Diagnosis
A healthcare provider will ask about symptoms and may press on your lower belly to check for tenderness. They will usually ask for a urine sample to test for infection.
Tests that may be done
- Urine dipstick test
- Urine culture (sending the sample to a lab to find the exact bacteria)
- Sometimes a blood test if the infection may have spread
What to expect at your appointment
The doctor or nurse will explain the results and let you know if treatment is needed. It may take a day or two to get the culture results.
Treatment
Most UTIs are treated with a course of antibiotics. The specific antibiotic and how long you take it will depend on your health, the type of bacteria, and any allergies you have. Always follow the prescriber's advice.
Self-care at home
- Drink more fluids, especially water, unless your doctor says otherwise
- Urinate as soon as you feel the need
- Rest if you feel unwell
- Take a pain reliever only if a pharmacist or doctor says it is safe for you
Medical treatments
A doctor or nurse may prescribe antibiotics. It is important to complete the full course even if you feel better. In some cases, a single dose is enough. For older adults with a catheter, the catheter may be removed or changed as part of treatment.
When is surgery considered?
Surgery is rarely needed for a UTI in older adults. It may be considered if there is a blockage, kidney stone, or other structural problem that keeps coming back.
Living with this condition
While recovering, drink plenty of fluids, rest, and keep taking any prescribed medicine exactly as directed. Monitor symptoms and watch for new confusion or fever.
Lifestyle tips
- Stay hydrated throughout the day
- Empty your bladder regularly and after sex
- Keep the genital area clean and dry
- Wipe from front to back after using the toilet
Diet and exercise
Eating a balanced diet and staying active can support your immune system. There is no special diet that cures a UTI, but drinking enough water each day is the most important habit.
Mental health and emotional wellbeing
A UTI can be uncomfortable and, for older adults, the confusion it causes can be frightening for both the person and their family. These symptoms usually improve as the infection clears. Reach out to your healthcare team if you feel worried or anxious.
Prevention
You can lower the chances of getting a UTI by drinking enough fluids, going to the toilet regularly, and practising good hygiene. For people with catheters, proper catheter care is important.
Vaccines
There is no vaccine currently available to prevent UTIs in older adults.
Screening programmes
Screening for UTIs is not recommended for people without symptoms. Urine tests should only be done when symptoms are present.
Complications
If left untreated
- The infection can spread to the kidneys (pyelonephritis)
- Bacteria can enter the bloodstream, causing sepsis
- In older adults, a UTI can lead to severe confusion, falls, or loss of function
- Repeated or poorly treated UTIs can cause long-term kidney damage
Long-term outlook
With the right treatment, most UTIs in older adults clear up within a few days. Confusion and other symptoms often improve quickly. It is important to seek care early, but the outlook is generally very good.
Find support
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Related conditions
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 31, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.