Your loved one is suddenly disoriented, running a fever, or refusing to eat, and the nursing home staff tells you it’s just another urinary tract infection (UTI). But this isn’t the first time. It keeps happening. You’re starting to wonder: Is this just part of aging, or is something being overlooked?
Urinary tract infections are common in older adults, and not every case points to a problem with care. But when infections recur without explanation, go undetected until they've become severe, or seem to follow a pattern of inattention, they can be a sign of neglect.
Why Are UTIs So Common in Nursing Home Residents?
Older adults face a range of biological factors that increase the likelihood of UTIs. Weakened immune systems, reduced bladder control, catheter use, and limited mobility all increase the risk. For women, hormonal changes after menopause affect the urinary tract's natural defenses. For men, an enlarged prostate can interfere with complete bladder emptying. These are realities of aging, and a UTI is not always the result of neglect.
When Biology Alone Isn't the Full Story
The critical question isn't whether a UTI occurred. It's why it occurred, how quickly it was caught, and what the nursing home did — or didn't do — in response.
A facility that provides attentive, consistent care will still see UTIs among residents. What it won't do is allow preventable infections to develop through inattention or let diagnosed infections go untreated until they spiral into something more dangerous.
Proper hygiene care, adequate hydration, timely catheter changes, and routine monitoring are all standard expectations in nursing home environments. When staff are undertrained, understaffed, or simply not showing up to perform basic care duties, the gap between what a resident needs and what they receive can lead directly to infection.
What Does Neglect Actually Look Like in These Cases?
Neglect in a nursing home isn't always dramatic. Instead, it may look like:
- A resident left in soiled clothing for hours
- A catheter that hasn't been changed on schedule
- A staff member who didn't notice or document that a resident stopped drinking fluids
- An unanswered call button that delayed or denied resident assistance to the bathroom
These seemingly small failures compound quietly and can contribute to preventable UTIs.
Signs That a UTI May Reflect a Deeper Problem
Families should pay close attention when they notice any of the following patterns:
- Repeated infections without a clear medical explanation. One UTI is common. Three or more UTIs in a year, or infections that reappear shortly after treatment ends, warrant a direct conversation with your loved one’s doctor.
- Delayed diagnosis or treatment. Residents with cognitive impairment may not be able to report pain or discomfort. Staff are responsible for monitoring for behavioral changes, such as sudden confusion, agitation, or withdrawal, that signal infection.
- Poor hygiene or care conditions observed during visits. Soiled bedding, odors in the room, or a resident who appears unkempt are visible signs that basic care may be falling short.
- Staff dismissiveness when concerns are raised. Families who ask questions and receive vague, deflective, or inconsistent answers should trust their instincts and get the answers they deserve.
Any of these signs is a signal to get more information to help you keep your loved one safe.
How Serious Can an Untreated UTI Become?
The consequences of a missed or poorly managed UTI can be severe. In older adults, even a moderate infection can trigger a sudden cognitive decline that looks like dementia. The resident may experience disorientation, hallucinations, and agitation that clear up once the infection is treated. Without proper monitoring, these symptoms may be misread as behavioral issues rather than medical ones, delaying the care a resident urgently needs.
When a UTI Becomes a Medical Crisis
A UTI left untreated long enough can travel to the kidneys and bloodstream and cause sepsis. Sepsis is life-threatening, and its development in a nursing home resident is a significant red flag about the timeliness of care. Families who lose a loved one to sepsis that originated as a UTI may discover, in retrospect, that warning signs were present and ignored.
These Cases Are Not Hypothetical – We Represented the Family of a Nursing Home Resident Who Died From Sepsis Following a UTI
In one case our firm resolved, a 67-year-old woman recovering from a total hip replacement in a rehabilitation unit began showing clear signs of distress—shortness of breath, low oxygen saturation, and later confusion and agitation. Yet, staff did not promptly contact a physician or investigate the cause. When a doctor was finally called, treatment orders were handled slowly, including an eight-hour delay before the first dose of antibiotics was given. She was ultimately rushed to the hospital and diagnosed with sepsis caused by a severe UTI. She died within hours—an outcome our investigation tied to delayed care and inadequate monitoring that sufficient staffing could have helped prevent.
Our goal for this family and others we represent is to conduct a careful, evidence-based review of what the facility knew, when they knew it, and what they did — or failed to do — in response so that the people who are hurt or their survivors can make fair recoveries and the facility is held accountable.