Often when talking to a family about their resident’s care they will say things that they do not realize are signs of neglect, but I do. One of these types of issues is when a family complains of recurrent urinary tract infections (UTI). Recurrent UTIs are a red flag for neglect, can be very dangerous, and can cause falls leading to serious injury and death.
A UTI is an infection in the bladder or urethra but may also be in the kidney. UTIs cause pelvic pain, blood in the urine, back pain, nausea, vomiting, fever, and an increased urge to go to the bathroom. Understanding how residents may get UTIs because of neglect is very important to stopping them.
Many residents and nursing homes are incontinent – this means that they cannot control when they urinate or have a bowel movement. In most instances, these people will wear an adult diaper. Aside from protecting a resident’s dignity, it is medically important to get folks out of soiled diapers immediately. For women in particular, residents left in soiled diapers for extended periods can become infected with UTIs.
Additionally, UTIs raise concerns when a resident is catheterized. While there are certainly residents that require catheterization for good care, in my experience other residents are catheterized solely for purposes of convenience for the staff because the facility doesn’t have enough staff to properly toilet residents. To be clear, a nursing home cannot catheterize residents for convenience and it should be avoided when possible. Any time an object is inserted into the body there is the risk of infection – this does not change simply because it is a medical instrument like a catheter. To be clear, having a catheter even when necessary increases a person’s odds of developing an infection. This is why medical professionals avoid catheters wherever possible.
Since either being left in soiled diapers, or catheterization both lead to UTIs, when I hear of residents with recurrent UTIs I am concerned about neglect. UTIs can be an extremely dangerous condition for two main reasons.
First, and untreated UTI like any other infection can migrate into the blood. Once an infection migrates into the blood a person is suffering from “sepsis.” Sepsis is an overwhelming infection in the blood and is often lethal in the elderly.
Second, a resident suffering from a UTI typically experience hallucinations along with a consistent urge to go to the bathroom. This is a dangerous combination because they will assuredly forget to ask for help with using the bathroom. The consistent urge to urinate assures that even taking them to the bathroom will not alleviate the risk until the UTI is treated. These residents are at very high risk of falls which can lead to fractures and death.
If your loved one is suffering UTIs you can immediately call for a care conference to find out first what is the source of the UTIs, and second what are they doing to prevent them in the future. If you yourself have found your loved one sitting in wet and soiled diapers, bring that to the director of nursing’s attention and have addressed immediately. If your resident is catheterized, discuss with their physician whether or not the catheterization is absolutely required and if it is, then ask the director of nursing if they are following the proper protocols for catheter care. In this way you can be the best possible advocate for your loved one.