Kristen Mauk

Portrait of a happy old couple sitting on quay by sea

For seniors, getting old is the new black. You can ask them yourself. Because according to a recent survey, 68% of seniors never feel offended for being treated like one, while 70.3% feel being called ‘old’ is hardly offensive. The truth is, getting old is blessing – not a curse.

For starters, age brings wisdom. By the time the grey hairs start popping up, you’ve had your fair share of experiences. You’ve likely travelled around a bit, held a few jobs, been through good and bad relationships, started a family, and made some life-changing decisions. But when it comes down it, you’re all the wiser for it. Going forward you can make better, more informed decisions, and even give your two cents to the younger generation.

As you mature, so too will your relationships. You’ll likely cut out the friendships that didn’t mean much, and work on the ones that do. Essentially, you’ll start seeking quality, not quantity, across all areas of your life – which isn’t a bad philosophy to live by. Plus, who said getting old isn’t fun?

Take LATA 65 for example, an art organisation in Portugal that’s destroying age stereotypes in the street art scene. By giving senior citizens the tools and knowledge to create their own stencils, the organisation’s goal is to connect the older and younger generations through art, as well as help the elderly get out and about to engage in contemporary culture.

But that’s just one example of how seniors are making the most of their retirement. What else are they getting up to?

How Aussies are living it up in their golden years

Gone are the days of knitting, card games and staying put. Seniors these days are proving to be one the most lively and radical bunch of seniors to date. According to the Golden Years Report, 85% of seniors consider themselves happy, while 80% are doing the things they really want to do.

In fact, most feel younger than they actually are. This can be attributed to being more physically active, learning new things, travelling to new places, having new experiences, being sociable, and having hobbies.

Seniors are also busting ‘old age’ stereotypes. For example, as technology becomes more prominent in our lives, Aussie seniors are no longer relying on others to show them the ropes. Instead, many are now technically savvy and spend plenty of time online. They also have no problem dressing like younger generations, speaking the same lingo (#YOLO), or even getting tattoos.

While they might not be huge spenders, today’s retirees are also spending more money than earlier generations. So instead of slowing down and disappearing modestly into retirement, they’re choosing to fork out just as much money (sometimes more) on their later lifestyles. And why not? Retirement isn’t an expiry date – it’s an excuse to live life to the fullest.

It’s safe to say, Australian seniors are reinventing the concept of ‘getting older’. They’re not confined to the activities and stereotypes usually associated with old age, and are instead open-minded, tech-savvy and progressive. They’re not just comfortable with the modern world, they’re enthusiastically making the most of it. So if there’s one take home message here, it’s this – there’s still plenty to look forward to.

Background

Urinary tract infections (UTIs), also called cystitis (inflammation of the bladder), are common among older adults and are more frequent in women. They are a primary cause of urinary incontinence and delirium. Catheter-associated urinary tract infections (CAUTIs) are more common among older adults (Fakih et al., 2012) and is mainly attributed to the use of indwelling urinary catheters. Many indwelling catheters are thought to be unnecessary (Cochran, 2007) and one study noted that physicians were often not aware of the purpose for which their patients had a catheter inserted (Saint, Meddings, Calfee, Kowlaski, & Krein, 2009). UTIs have been show to increase morbidity and mortality, length of hospital stay, and cost of hospitalization (Kleinpell, Munro, & Giuliano, 2008). CAUTI is considered preventable and is not reimbursed by Medicare. Therefore, hospitals will largely assume the financial costs for preventable infections of this type.

Risk factors/Signs and symptoms

Several risk factors are associated with UTIs in general. These include being female, having an indwelling urinary catheter, the presence of urological diseases, and hormonal changes associated with menopause in women. Signs and symptoms of UTIs include urinary frequency and burning or stinging felt during voiding. Pain may be felt above the pubic bone, and a strong urge to void but with small amounts of urine expelled. The most significant risk factor for CAUTI is prolonged use of an indwelling catheter. In hospital-acquired UTIs, 75% are associated with the use of an indwelling catheter (CDC, 2012). In women, signs and symptoms of CAUTI may be more severe than those reported by women by patients in the community who do not have an indwelling catheter. Lethargy, malaise, onset or worsened fever, flank pain, and altered mental status have been associated with CAUTI (Hooton et al., 2010).

Diagnosis

A thorough assessment should be done of the patient’s urinary output, including amounts, color, odor, appearance, frequency of voiding, urgency, and episodes of incontinence. A urine specimen should be obtained if UTI is suspected. Laboratory results will show the type of organism causing the infection, and the sensitivity will tell what medication the organism is susceptible to. These results should be reported promptly to the physician or nurse practitioner caring for the patient and so that a diagnosis and treatment plan can be made.

Treatments

Prevention of UTIs is considered a primary nursing strategy. Elderly female patients can be instructed to make lifestyle modifications such as: increasing their fluid intake; emptying the bladder after sexual intercourse; practicing good perineal hygiene, including wiping front to back after toileting; getting enough sleep; and avoiding stress (PubMed Health, 2011). Although many of these common sense strategies are recommended by primary care providers, there is a lack of scientific evidence to support some of them. Many UTIs will clear up on their own, particularly if the person increases oral fluid intake during early symptoms. However, with many older adults, antibiotic treatment may be needed. In general, a course of three 3 days for healthy adults is thought to be sufficient, but for more resistant bacteria, a longer course more than five 5 days may be needed (PubMed Health, 2011). For those with repeated or chronic UTIs, a low dose of antibiotics taken for 6– 12 months may be indicated (Hooton et al., 2010). If the underlying cause is CAUTI, treatment will be more aggressive. Monitor the patient’s temperature at least every 24 hours (Carpenito, 2013). Encourage fluids. Evaluate the necessity of continuing an indwelling catheter if one is in place.

Alternatives to indwelling catheters should be considered for appropriate patients. Intermittent catheterization, if appropriate, is preferred over indwelling catheter use, especially for long- term maintenance of bladder management (CDC, 2009; Hooton et al., 2010). Condom catheters may be an appropriate choice for some males. If an indwelling urinary catheter is necessary, the catheter should be removed as soon as possible, per the physician or nurse practitioner’s orders, to reduce the risk of CAUTI.

Adapted from Mauk, K. L., Hanson, P., & Hain, D. (2014). Review of the management of common illnesses, diseases, or health conditions. In K. L. Mauk’s (Ed.) Gerontological Nursing: Competencies for Care. Burlington, MA: Jones and Bartlett Publishers. Used with permission.

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