If your person with dementia keeps getting urinary tract infections, one right after another, you are not imagining it and you are not doing anything wrong. There are real reasons behind it. Four of them, actually.
And they matter, because UTIs are notorious little troublemakers in dementia care. They do not just cause discomfort. They cause sudden confusion, new fears, and challenges that seem to show up overnight. So let us play detective and hunt down why they keep coming back.
Reason 1: The brief stays on too long
As dementia progresses, many people become incontinent. And sitting in a wet brief, even for a little while, gives bacteria exactly what they love: warmth and moisture.
The fix: try taking your person to the bathroom and changing the brief every two hours. Set a timer on your phone so your tired brain does not have to carry it. Fresh and dry is your best defense.
Reason 2: Wiping is not what it used to be
Your person may still go to the bathroom on their own, but the wiping part gets fuzzy. They may not wipe fully, or they wipe back to front, which sweeps bacteria exactly where you do not want it. And plain toilet paper often is not doing the whole job anymore.
The fix: swap in wet wipes instead of toilet paper. They clean more completely with less effort, which matters when the steps of a task are getting harder to hold onto. And when you are helping, always wipe front to back.
Reason 3: They stand up before the bladder is empty
Here is the sneaky one. Your person sits down on the toilet, forgets what they came in there to do, and immediately stands back up. The bladder never fully empties, and leftover urine sitting in the bladder is basically a welcome mat for bacteria.
The fix: stay in the bathroom with them and keep them company. Chat about something they love to remember: “Tell me about the horses on the farm.” “What were the pigs like?” While they are talking, they stay seated, and the bladder gets to finish its job. You are not hovering. You are hosting a tiny talk show with excellent results.
Reason 4: Not enough fluids
People with dementia forget to drink, and dehydration causes a whole myriad of problems, UTIs included. There simply is not enough fluid moving through to flush things out.
The fix: offer water or something hydrating multiple times a day. A favorite cup helps. So do juice, popsicles, watermelon, and soup. It all counts.
The product I wish more caregivers knew about
Here is something I discovered recently and wish someone had handed me years ago: Uqora, a whole line of urinary health products.
The one that made me sit up is their emergency kit, which comes with test strips. If you have ever tried to get your person with dementia to the doctor just to find out IF they have a UTI, you know that battle. A test strip at home tells you whether something is brewing and how urgent it is, so you can call the doctor with real information instead of a hunch. They also make a drink that helps flush the urinary system when a UTI hits, and a prevention kit with a daily supplement designed to help stop UTIs before they start.
I highly recommend the whole line. From my Amazon storefront, you can grab the Uqora emergency kit here and the prevention kit here.
Come learn with me on Monday
Bathroom care is one of the hardest parts of caregiving, and it is exactly what I am teaching next. Join me LIVE for my Creative Personal Care Techniques training on Monday, September 28 at 7 PM Eastern. We will cover the creative, dignity first approaches that make bathroom care, bathing, and dressing so much easier for both of you. Cannot make it live? The recording will be available the next day.
You are already doing the detective work most people never think to do. Four small changes, and those relentless UTIs finally get a lot less relentless.
💜 Joanna
The “post-wipe pee” is a real deal at our house. I’ve resorted to standing alongside/behind her so after I give my person her own TP to wipe and talk her through that. Once she tosses her used TP into the toilet bowl, I followup by holding my own wad of TP between her legs from the back, while she pulls up her own “panties.” Then I finally toss my wad into the toilet bowl once she’s almost pulled them all the way up, and help her with the last few tugs, then her pants. I can actually feel through my wad if she’s still peeing because it will start to feel warm. It has prevented new dry briefs from getting immediately wet before we’re out of the bathroom. It also helps keep the toilet seat dry in case she decides to sit back down once she’s dressed. This trick has really worked well here.
Thank you for sharing this, Liz! I love how you found a routine that works for both of you. 💜 Sometimes it’s these little adjustments that can make personal care so much easier and less stressful. I’m sure another caregiver reading this may find your idea helpful too!