Unfortunately, some of the nicest weather and foliage during the year are accompanied by an onslaught of allergens. As pollen fills the air, people afflicted by seasonal allergies begin to groan.

The 2018 National Health Interview Survey found that 19.2 million Americans over age 18 had been diagnosed with hay fever (allergic rhinitis) in the past 12 months. While allergies are often considered a condition that presents earlier in life, seniors are not exempt from bothersome allergy symptoms. In fact, research suggests that age-related changes to the immune system may leave older adults at greater risk for autoimmune diseases, infections and allergic inflammation. To complicate matters further, seniors often have chronic diseases and take multiple medications that can make it difficult to diagnose, manage and treat their seasonal allergies.

Tips for Managing Allergies in the Elderly

Christopher Randolph, M.D., Fellow of the American Academy of Allergy, Asthma and Immunology (AAAAI) and allergist/immunologist in private practice in Connecticut, offers the following suggestions to help caregivers make allergy season more bearable for their aging loved ones.

  1. Look for Allergy Symptoms
    Allergies don’t discriminate between the young and the old. Dr. Randolph says that people falsely assume the elderly do not get seasonal allergies when they are just as likely as anyone else to be affected when spring blooms begin to appear. In fact, adult-onset allergies are not unusual. Caregivers should be on the lookout for traditional signs like sneezing, coughing, congestion, runny nose, wheezing and itchy, watery eyes so they can nip them in the bud.
  2. Inform Their Doctor
    Dr. Randolph points out that it can be difficult for a physician to diagnose allergies in older individuals, especially during short appointments when they’re focused on detecting and managing larger health issues. Allergy symptoms can easily take a backseat to more weighty symptoms like pain, depression and changes in mental state. Patients with Alzheimer’s disease or other types of dementia may not be able to articulate their discomfort either. If you suspect that your loved one may have allergies, don’t hesitate to inform the doctor of your concerns.
  3. Be Aggressive
    “Allergies have a larger impact on the lives and health of the elderly,” explains Dr. Randolph. It makes sense; allergy symptoms, such as a nasal congestion, cough and an irritated throat, can be extremely dangerous for seniors with pre-existing cardiovascular problems or lung disease. This is why Dr. Randolph feels that allergies in the elderly should be treated as rapidly and aggressively as possible.
  4. Avoid First-Generation Antihistamines
    Certain antihistamines, the class of drug most commonly prescribed to treat allergies, can be dangerous for seniors. Two popular first-generation antihistamines include diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton). According to the AAAAI, potential side effects of these over-the-counter medicines include anxiety, confusion, sedation, drowsiness, urine retention, dry mouth and eyes, and dizziness.
    In addition to these side effects being irritating, they can contribute to dangerous falls and even urinary tract infections (UTIs). Furthermore, Dr. Randolph says that antihistamines can potentially cause changes in mood or behavior in the elderly and may lead to dangerous interactions with other commonly prescribed medications.
    Instead of reaching for an over-the-counter antihistamine, speak with your loved one’s doctor or pharmacist about alternative allergy treatments first. They will likely recommend a nasal steroid or some form of topical medication. If these options still aren’t relieving your loved one’s allergy symptoms, ask about using a second- or third-generation antihistamine, such as cetirizine (Zyrtec), loratadine (Claritin) or fexofenadine (Allegra). While the AAAAI recommends these allergy medicines for seniors since they cause fewer side effects, it is still important to provide a complete list of all medications a loved one is taking so their doctor or pharmacist can rule out potential drug interactions.
  5. Try Drug-Free Solutions
    Seasonal allergies are triggered by increases in allergens in the environment, such as mold spores and tree, grass and weed pollen. Minimizing exposure to these allergens is an obvious way to avoid bothersome allergic reactions. This is not always easy, but a few lifestyle changes can help.
    Getting outside to breathe in the fresh air, exercise and soak up a little sun is very important for seniors, but doing so during allergy season can leave them feeling worse afterwards. Weather forecasts these days typically include a pollen count or allergy forecast. The AAAAI’s National Allergy Bureau collects air samples from stations around the United States and examines them microscopically to report local pollen counts and mold spore levels. Use this information to try to avoid outside activities when outdoor allergens are particularly high.
    If you and your loved one must go out, remember to wear sunglasses to avoid eye irritation. As soon as you come home, make a point of washing your hands, showering and changing into fresh clothes to avoid introducing allergens into the house. Saline nasal sprays can also help rinse allergens out of sinuses and nasal passages, thereby minimizing symptoms. If you and your loved one enjoy opening the windows for fresh air, try to do so only on low pollen days as well.
    Make sure your air conditioning unit is serviced regularly and equipped with a High Efficiency Particulate Air (HEPA) filter that can remove allergens from the air to keep them from circulating around the house. If your loved one also has indoor allergies to things like dust, dust mites and pets, they may benefit from using an air purifier.

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Sources: FastStats: Allergies and Hay Fever (https://www.cdc.gov/nchs/fastats/allergies.htm); Allergy and Aging: An Old/New Emerging Health Issue (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5362176/); Medications and Older Adults (https://www.aaaai.org/conditions-and-treatments/library/allergy-library/medications-and-older-adults)