In elderly institutionalized patients, delirium and altered behaviour is nonspecific.
It requires a work-up to rule out other causes.
Diagnosis of UTI: reliable clinical signs/symptoms AND positive urine culture result.
Do NOT send urine for culture or perform urine dipstick testing in asymptomatic patients.
Asymptomatic bacteriuria in the institutionalized elderly is common. Antibiotic therapy in these cases offers no benefit and increases harm. (e.g. side effects from antibiotics, antibiotic resistance, Clostridium difficile infection).
Guideline adapted from Providence Health Care