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Pneumonia and Elders: Why They are More Susceptible

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Pneumonia is a major cause of mortality among seniors aged 65 and older. In fact, according to the Center for Disease Control and Prevention (CDC), more people die each year from pneumonia than from automobile accidents. Despite this fact, many elderly people and their caregivers don’t know all the facts about pneumonia, and as a result could be at serious risk.

AgingCare.com spoke with Dr. William Schaffner, president-elect of the National Foundation on Infectious Disease and chairman of the Department of Preventive Medicine at Vanderbilt University School of Medicine about pneumonia’s impact on the elderly.

Pneumonia is an infection of the lungs. The disease can range from mild to severe, and in some cases may be fatal. Although pneumonia is contagious, the main way older people get it is from themselves. “All of us carry bacteria in throats and noses. Frail elders often can't clear secretions from their lungs, and those secretions tend to go down into bronchial tubes. The area fills with pus, mucous, and other liquids and cannot function properly. This means oxygen cannot reach the blood and the cells of the body. Complications of pneumonia may include bacterial infection in the bloodstream and fluid and infection around the lungs,” Dr. Schaffner explained.

Why are elderly people at greater risk?

Dr. Schaffner says there are several main reasons as to why elders are more susceptible:

  • Older people are simply more frail than other individuals. A frail elder can't clear secretions from their lungs. Those secretions tend to go down into bronchial tubes causing the infection.
  • Elders tend to have weaker immune systems, and therefore cannot fight off the infection.
  • Seniors may have other ailments – such as diabetes, Parkinson’s disease, chemotherapy or HIV – which put them at a higher risk for pneumonia.
  • Seniors who have surgery are susceptible. Elders who are experiencing pain, or being given pain medication, tend to take shallow breaths, which results in mucus gathering in the lungs.

Signs of pneumonia to look for in your elderly parent

People with pneumonia often complain of coughing, fever, chills, shortness of breath, chest pain or green or yellow sputum that comes up when coughing. Other indicators include a change in the elderly person’s personality or consciousness, feeling lethargic, or having had a recent cold or flu.

What are the treatments for pneumonia?

A doctor will determine if your aging parent has pneumonia using chest X-rays and a blood test. Bacterial pneumonia is typically treated with antibiotics. If the infection is viral, the doctor will treat it with an anti-viral medicine. Make sure your elderly parent takes antibiotics as the doctor prescribes.

Your parent may start to feel better before finishing the medicine, but they should continue taking it as prescribed. If they stop too soon, the pneumonia may come back. Doctors may also give the patient fluids if they are dehydrated, oxygen if they are having trouble breathing, as well as provide pain relief and medical support.

“Milder cases of pneumonia can be cared for at home, but the more severe the case – and depending on whether your parent has other underlying health conditions - hospitalization may be required,” Dr. Schaffner says. Caregivers can help their elderly parents by ensuring they have an adequate intake of fluids and a healthy diet.

Preventing pneumonia

Flu predisposes elderly people to pneumonia, so the number of pneumonia cases tend to spike during flu season -- but the illness can occur at any time throughout the year. Dr. Schaffner recommends that all people over age 65 get an annual flu shot, as well as a pneumococcal vaccine, a one-time shot that protects against the pneumococcus, or pneumonia bacteria.

Caregivers should also be vaccinated, to avoid getting sick themselves and passing the illness to their elderly parents.

“The CDC recommends that anyone who has prolonged contact with an elderly person should get vaccinated,” Dr. Schaffner says. He also recommends that caregivers educate themselves on pneumonia, which provides peace of mind that they are doing as much as they can to prevent their elderly parent from getting pneumonia.

Regular exercise is also key to keeping seniors healthy, he says.


Dr. William Schaffner is Chairman of the Department of Preventive Medicine and Professor of Infectious Diseases in the Department of Medicine at the Vanderbilt University School of Medicine in Nashville, Tennessee and President-Elect of the National Foundation for Infectious Diseases.

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kmac4u said
Nov 18, 2009

I had an experience with one of my parents who 87 at the time. While my mother was taken to the hospital for a different reason - once there the doctor told me that she also has severe pneumonia. I told the doctor how surprised I was because she wasn't coughing, congested or had a fever. He told me that it was not uncommon. Often the elderly don't exhibit the signs we would flag but rather can be almost symtomless (perhaps more
lethargic) and yet still have pneumonia.
Kathy McLain

KJL said
Nov 18, 2009

Thank you, I appreciate this article.

I have a question though. My 84-year-old dad is one of those elderly people mentioned who have trouble clearing out their lungs. He doesn't talk loudly, doesn't drink enough water and sometimes sounds like he's got flem in his throat. (He's generally in good health, his seizures controlled well by Keppra and his tendency to clot controlled by Plavix)

As a preventative measure towards good lung health, especially in the winter months, would it be a good idea for him to do a daily breathing exercise of some kind?

I have Expand-A-Lung at home (still in the box), and he could use that. It's supposedly adjustable, to fit different fitness levels. Or would such a device be too much for an 84 year old? (I doubt he would do a daily deep breathing exercise on his own without some 'device' sitting on his TV tray to remind him. I don't live with him so I'm not always there.)

N1K2R3 said
Nov 18, 2009

Give antibiotic meds while waiting for the tests results .

mizunderstood10 said
Nov 18, 2009

This makes me wonder because my mom (who is 91) coughs a lot at night and depending on the day can be somewhat lethargic. I just thought it was "good day" vs. "bad day". She has a heart condition and Alzheimer's. From what Kathy said, it could be pneumonia and I don't know it. I would hate for her to have pneumonia and me not get her to the doctor. Thanks for listening. Any advise would be really welcome. :)

robert888 said
Jul 19, 2010

Except for losing his energy, my dad had no symptoms of pneumonia.Then a few days ago he got a fever and we took him to the hospital. From a CT scan of his lungs he had pneumonia spots on both sides of his lungs and the doc said parts had probably been there for years! He's now in the hospital...and antibiotics have been started.

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