Prioritising urinary health to keep our clients well

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With many of the people we support being either elderly or disabled, urinary health is an important area for our live-in carers to be aware of. We know that problems with the urinary tract (UTI) can develop quickly for some people, particularly if they are older or frail, and if infections of the bladder, urethra or kidneys are left un-diagnosed they can rapidly escalate and require hospital treatment.

Our approach to promoting urinary health is to assess our clients to see who is most at risk of urinary tract infections (UTIs) and ensure prompt detection and treatment. We also promote general urinary health for all of our clients through measures like good levels of hydration, and we will look at all of these elements in this blog.

Who develops urinary tract infections and why?

Any of us can develop a urinary tract infection at any point in our lives, although women are generally more prone to UTIs than men as bacteria can reach the bladder more easily in women than men. Older people are more likely to develop UTIs due to a weaker flow of urine that results in the bladder not emptying fully. If you are a man who is experiencing urinary problems, these can sometimes be due to an enlarged prostate that makes emptying the bladder fully more difficult, leading to a build-up of bacteria. Read our blog ‘Time to talk about male cancers’ for more information on prostrate problems.

Numerous health conditions can impact upon a person’s urinary health, from cancer to dementiaParkinson’s to a stroke. Many of our clients have persistent problems with urinary health as a result of these conditions and others, as well as from being frail, more immobile or finding remaining hydrated difficult, for example if a person has a swallowing problem.

We know that UTIs can cause sudden acute confusion known as delirium, which can be particularly noticeable in a person who is living with dementia. Given that many people living with dementia cannot always describe how they are feeling, any sudden changes in behaviour or demeanour should be investigated quickly to rule out a UTI.

Symptoms of urinary tract infections

Urinary tract infections are classified as lower, which are infections of the bladder and/or the urethra (the tube that carries urine out of the body), or upper, which are infections of the kidneys and/or the ureters (the tubes that connect the kidneys to the bladder). Upper UTIs are more serious and can lead to kidney damage if they are untreated.

Symptoms of lower UTIs include:

  • Pain or burning when peeing
  • Needing to pee suddenly or more often than usual
  • Smelly or cloudy urine
  • Blood in your urine
  • Lower tummy pain
  • Loss of bladder control (incontinence)
  • A mild temperature

Symptoms of upper UTIs include:

  • A high temperature, or feeling hot and shivery
  • Feeling sick or being sick
  • Pain in the lower back or sides of the abdomen

Diagnosing and treating urinary tract infections

If you or a person you support are concerned you have a urinary tract infection, it’s important to speak to your GP urgently. Diagnosing a UTI is normally done through a urine sample, and treatment is commonly a course of antibiotics.

Because upper urinary tract infections can be more serious, these sometimes require diagnosis and treatment in hospital.

Trial of innovative UTI home testing kits

Spotting symptoms early and getting treatment are two key elements of ensuring that a person who develops a urinary tract infection can recover as quickly as possible without complications. Given the pressure on NHS services, it can sometimes be difficult to get an urgent diagnosis, especially in the evening or at weekends.

It was the need to address this situation that led us to trialling innovative UTI home testing kits for some of our clients who are most susceptible to UTIs. One of our clients who benefited from this trial was Leokadia, a lady we support who has a history of UTIs and is at risk of developing frequent infections, as well as needing support with her moving and handling.

The ‘One Step’ test Leokadia benefited from was able to be conducted in her own home, with a rapid and reliable result being shared with her GP who then prescribed antibiotics for Leokadia without the need for the doctor to conduct a home visit.#

Positive outcomes for the people we support

For Leokadia, UTIs don’t just impact upon how she is feeling, they can cause a massive upheaval for her if ill-health and physical decline mean she needs to go to hospital. The UTI home testing kit was simple and easy both for our clients and live-in home care workers to use, and had clear benefits for client’s health and well-being.

Leokadia’s daughter said of the UTI home testing kit trial:

“The UTI testing kits are a fantastic idea, especially for people in my mother’s situation who show no obvious symptoms when they have a UTI until they collapse and have to be hospitalised. In my mother’s case, early detection of a UTI has enabled us to receive the appropriate antibiotics and to deal with the UTI early before more serious symptoms presented themselves.”

The benefits of our UTI home testing kit trial

By detecting Leokadia’s UTI quickly, hospital admission was averted. We also avoided additional care costs for her local authority, as they may have needed to provide additional help and support to Leokadia’s live-in care worker if Leokadia’s condition had deteriorated further.

The trial of these kits is now over, but we are delighted with the results and hope we may be able to implement their use again in the future. It is always our primary aim at Promedica24 to keep our clients safe and well, and early detection of illness is a vital part of fulfilling that aim.

Hydration: How our live-in carers support ongoing good urinary health

Of course, it’s always preferable to prevent a UTI before it develops, and a key way our live-in home care workers aim to do this is through supporting our clients with their hydration. Many older and disabled people often struggle to drink enough or may forget to drink, especially if they live on their own, and a key role for our live-in carers is to ensure that good levels of hydration are maintained at all times.

The NHS Eat-well Guide recommends at least 6-8 cups or glasses of fluid a day. The Eat-well Guide says:

“Water, lower fat milks and lower sugar or sugar-free drinks, including tea and coffee, all count. Fruit juice and smoothies also count towards your fluid consumption, but they contain free sugars that can damage teeth, so limit these drinks to a combined total of 150ml a day.”

Our live-in carers ensure that they take time to find out which drinks their clients like, support clients to shop for their favourite beverages, and learn how each client likes their drinks served to ensure that they can enjoy drinking. We are also experienced in supporting clients who have difficulties with drinking their regular drinks, perhaps because of the development of dysphagia (swallowing problems) and can modify drinks in line with SALT (Speech and Language Therapy) guidance to ensure drinks remain both safe and enjoyable.

Our recent blog, ‘Reinforce, Focus, Energise – Let’s Improve Hydration!’, alongside our blog, ‘The importance of hydration for a healthy lifestyle’ have lots of advice for improving a person’s hydration.

Additional tips to promote good urinary health

Alongside remaining hydrated, other ways our live-in home care workers support our clients to maintain good urinary health include:

  • Enabling the person to get to the toilet when they need to. This is particularly important if the person has mobility problems or they are confused about where the toilet is. Holding onto urine when you have the urge to pee isn’t healthy for the urinary system.
  • Ensuring the person is wiping from front to back when going to the toilet.
  • Enabling the person to maintain good personal hygiene with regular washing.
  • Encouraging the person to try and empty their bladder fully when peeing.
  • Helping the person to choose cotton underwear and loose-fitting clothing to avoid unnecessary sweating and discomfort around their groin.
  • Having any ongoing urinary health issues investigated – For example, if a man is having persistent urinary problems that are consistent with a possible prostrate problem.

How Promedica24 can support you and your family

If you or your loved one have care and support needs and are finding that urinary health issues are impacting upon quality of life, live-in care is the ideal solution to helping you find a better balance of health and well-being. To find out more about how Promedica24 can help you and your family, please visit https://www.promedica24.co.uk, get in touch with our team on 0800 086 8686 or email: care@promedica24.co.uk.

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