Blood in the Urine and Alzheimer’s Disease

WebMD Medical Reference in Collaboration with the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill Logo for UNC Chapel Hill, Cecil G. Sheps Center

Blood in the urine (or hematuria) isn’t always serious, but it can sometimes be a sign of a health issue.

Get medical help for your loved one right away if they also:

  • Have a fever of 101 F or more
  • Have pain when they pee
  • Have severe lower belly or lower back pain
  • Have shaking chills
  • Have blood clots in the urine
  • Can’t empty their bladder except for small amounts of pee, in spite of feeling that they have a full bladder
  • Have pulled out a catheter
  • Haven’t peed for 8 to 12 hours

Call their doctor if your loved one has:

Causes

Common causes of blood in the urine among older people, including those with Alzheimer’s disease, are:

A few medications can turn urine orange. This is normal, but it can be confused with bleeding. Foods such as beets, blackberries, and rhubarb can also make pee look red.

Home Care

Depending on the cause of the hematuria, their doctor may recommend some of these home care treatments:

If it hurts when they pee:

  • Encourage them to drink lots of fluids. Offer them drinks they like, and keep drinks where they can reach them. If they’re drinking enough, their pee should be a light yellow to clear color.
  • For temporary pain relief, give acetaminophen or any other pain medication a doctor has approved for them. If you do this, don’t give more than 3,000 milligrams per day. If they have liver disease, ask a doctor first.
  • Give them phenazopyridine (Pyridium), an over-the-counter drug that can help ease pain. Taking it often turns pee orange or reddish. This is normal, but it may make it hard to tell if there's blood in the urine. Only give them this if their doctor says it’s OK.

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If they have lower belly or lower back pain:

  • Acetaminophen may ease the pain for a while.
  • Put a heating pad on the uncomfortable area.

If they have a catheter:

  • Encourage them to drink lots of fluids.
  • Make sure there are no kinks in the catheter and that urine is going into the collection bag.
  • Watch them to make sure they don’t pull on the catheter. This can cause serious injury. If you see them pulling on it, have them wear clothing that covers it. Get them involved in something that will distract them and hold their attention.

If they keep rubbing or scratching the area:

  • Check the area for signs of irritation and infection, such as redness, swelling, rash, or abnormal discharge from the vagina or penis. Treat mild irritation with over-the-counter hydrocortisone cream, zinc oxide paste, or petroleum jelly. (Be sure to follow the instructions on the label.)
  • Gently remind them not to touch the area, but don’t scold them.
  • If this doesn’t work or they don’t understand or keep forgetting, try to distract them by involving them in something they enjoy.
  • If their skin is very irritated, call their doctor.

If they’re anxious about the blood:

  • Explain that blood in the urine is not unusual in older people and they’re not in any immediate danger.
  • It may help them worry less if you go with them to the bathroom and give them reassurance.

If they need to use the bathroom often or have trouble getting to the bathroom in time:

  • Make sure they know where the bathroom is and can get there easily.
  • Keep the bathroom door open to help them find it, and keep the path lit at night with night-lights.
  • Remind them or help them use the bathroom about once every 2 hours.
  • Install a raised toilet seat and grab bars.
  • If none of these work, have them use a bedside commode, urinal, or bed pan.

If they leak urine:

  • Keep them dry. Wetness can be uncomfortable and can cause skin irritation and damage.
  • Have them wear simple clothing that is easy to take off. Use Velcro straps and elastic waist bands instead of buttons and zippers.
  • Don't hold back on drinks. You might think someone is having accidents because they’re drinking too much, but this usually isn’t the case. Holding back fluids can cause dehydration and make urinary tract infections more likely. If your loved one has accidents at night, it's OK for them not to drink anything for 3 hours before bedtime, as long as they get plenty of fluids during the rest of the day.

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Prevention Tips

If your loved one has a history of kidney stones, encourage them to drink lots of fluids. Work with a doctor or a dietitian to see if a change in diet could help.

If they’ve had several urinary tract infections (UTIs):

  • Encourage them to use the bathroom about once every 2 hours.
  • Try cranberry juice or tablets, but make sure your loved one isn’t taking any medications that shouldn't be used with cranberry juice. The research on cranberry juice or cranberry supplements and UTIs is mixed, but they’re generally safe and may help.
  • Encourage a high-fiber diet to help avoid constipation.
  • Help them change often if they have accidents or wear a protective undergarment.
  • Always clean and dry the skin around the genitals thoroughly and apply a thin layer of a moisture barrier such as petroleum jelly.
  • When you clean the vagina, always wipe from front to back to keep bowel bacteria from being carried into the vagina.
  • Talk to their doctor about using a vaginal estrogen cream that can help prevent UTIs.

If they have a urine catheter:

  • Encourage them to drink lots of fluids.
  • Empty the catheter bag whenever it's more than half full.
  • Make sure there aren’t any kinks in the catheter tubing and that the collection bag always stays below the level of the bladder but off the floor.
  • Clean the outside of the catheter daily with soap and warm water. Always wipe away from their body.
  • Do not pull on or try to remove the catheter. This can cause pain and injury.
  • Tell their doctor if the catheter isn’t draining properly.

To protect yourself and your loved one, remember to wear disposable gloves to help them use the bathroom or when you clean up accidents. Wash your hands before and after helping them with bathroom needs.

WebMD Medical Reference in Collaboration with the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill Reviewed by Melinda Ratini, DO, MS on July 24, 2018

Sources

SOURCES:

Estrada C.R. (2008) Traumatic Hematuria. In: Myers J.A., Millikan K.W., Saclarides T.J. (eds) Common Surgical Diseases. Springer, New York, NY.

Kurtz, M., Feldman, A.S., & Cho, K.C. (2016). Etiology and evaluation of hematuria in adults.  Up-ToDate. Waltham, MA: UpToDate.

Memorial Sloan Kettering Cancer Center (2017). Caring for your urinary (Foley) catheter. Memorial Sloan Kettering Cancer Center.

Matthews, S.J., and Lancaster, J.W. (2011). Urinary tract infections in the elderly population. The American Journal of Geriatric Pharmacotherapy, 9(5), 286-309.

Terris, M.K. (2009). The significance of abnormal urine color. Stanford Department of Urology On-Line Articles for Patients.

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