Pneumonia is a major cause of mortality among seniors. In fact, according to the Centers for Disease Control and Prevention (CDC), more people die each year from pneumonia than from automobile accidents. Despite the prevalence of this disease, many seniors and their caregivers don't know all the facts about pneumonia.
What Is Pneumonia?
Pneumonia is an infection of the lungs. The disease ranges from mild to severe, and in some cases, it can be fatal. Although pneumonia is contagious, the main way older people get it is actually from themselves.
“All of us carry bacteria in our throats and noses,” explains Dr. William Schaffner, medical director of the National Foundation on Infectious Disease and chairman of the Department of Preventive Medicine at Vanderbilt University School of Medicine. “Frail elders often can’t clear secretions from their lungs, and those secretions tend to go down into the bronchial tubes. The area fills with pus, mucous, and other liquids, preventing the lungs from functioning properly. This means oxygen cannot reach the blood and the cells of the body. Complications of pneumonia may include bacterial infection in the bloodstream (sepsis) and fluid and infection around the lungs.”
Why Are Elderly People at Greater Risk?
Older people are simply more frail than younger individuals are. Frailty doesn’t boil down to a single disease or diagnosis, though. One study defines this condition as a cumulative decline across multiple physiologic systems, which causes a decreased resistance to environmental stressors and increased vulnerability to adverse outcomes. For example, a common marker of frailty in seniors is muscular weakness, which can directly affect an elder’s ability to clear secretions from the lungs and avoid infection.
Weakened Immune Systems
Our immune systems weaken as we age, therefore seniors may have a harder time fighting off infections like pneumonia. In addition, some drugs, such as steroids and chemotherapy can suppress immune responses further.
Senior Health Conditions
Seniors may have other ailments, such as diabetes, Parkinson's disease, Alzheimer’s disease and heart disease, which put them at a higher risk for developing pneumonia. Lung conditions like cystic fibrosis, asthma, COPD (chronic obstructive pulmonary disease) and bronchiectasis contribute significantly to this risk as well.
Seniors who have surgery are more susceptible since their bodies are already working hard to heal. Pain medications are usually prescribed following surgical procedures, but they can cause patients to take shallower breaths, which contributes to mucus gathering in the lungs. The same applies to sedative medications and anesthesia.
Signs of Pneumonia to Look For
If any of the following symptoms present in a senior, it is crucial to see a doctor as soon as possible.
- Shortness of breath
- Chest pain
- Green, yellow or bloody sputum that comes up when coughing
- Feeling lethargic
- Suddenly feeling worse following a recent cold or bout of flu
- Blue lips or fingernails due to a drop in blood oxygen level
Treatments for Pneumonia
A doctor will determine if your parent has pneumonia using chest X-rays and a blood test. Bacterial pneumonia is typically treated with antibiotics, but if the infection is viral, the doctor will prescribe an anti-viral medicine. Make sure your loved one closely follows the doctor’s instructions for taking these prescriptions. Even if they begin feeling better before finishing the medicine, they should continue taking it as prescribed. If they stop too soon, the pneumonia may come back. Doctors may also administer fluids if they are dehydrated, oxygen if they are having trouble breathing, medication for pain relief, and additional medical support as needed.
“Milder cases of pneumonia can be cared for at home, but more severe cases, especially in patients with other underlying health conditions, may require hospitalization,” Dr. Schaffner says. Caregivers can help their loved ones through the healing process by ensuring they consume plenty of fluids and stick to a healthy diet.
Sepsis and Pneumonia
Sepsis and septic shock can result from an infection anywhere in the body. The most common infections that trigger sepsis among the elderly population are respiratory infections, such as pneumonia. Sepsis is a very serious illness, with an increased risk of fatality in the elderly. Signs of sepsis include change in mental status, a drop in blood pressure, and a change in respiratory rate. If signs of sepsis occur, it is important to seek medical care immediately. The key to preventing sepsis, is preventing the infection from occuring in the first place.
Since influenza predisposes elderly people to pneumonia, the number of cases tends to spike during flu season. Dr. Schaffner recommends that all people over age 65 get an annual flu shot as well as a pneumococcal vaccine. This one-time shot protects against the streptococcus pneumoniae bacteria.
Caregivers and other family members should also be vaccinated to avoid getting sick themselves and passing the illness to their loved ones. “The CDC recommends that anyone who has prolonged contact with an elderly person should get vaccinated,” Dr. Schaffner says.
In addition to staying current with vaccines, a healthy lifestyle also plays a critical role in preventing pneumonia. Quitting smoking, practicing good oral hygiene, exercising regularly, and maintaining a healthy weight through a nutritious diet can all help boost a senior’s immune system and stave off diseases. Of course, good handwashing habits are another strong defense.
It is important for caregivers to educate themselves on pneumonia and other conditions that commonly affect seniors. This information will prevent them from getting sick and provide added peace of mind that you are doing as much as you can to keep your loved one healthy.