Pneumonia in Elderly

Risk Factors, Symptoms, Treatment and More

The risk of developing pneumonia in elderly is higher if the elderly often suffer from chronic illness or weakened immune systems and, in turn, have a more difficult time recovering.

Pneumonia in elderly is often cited as the fifth leading cause of death in the elderly and the most common cause of death in persons with severe dementia.

It can go unrecognized in seniors as they may be asymptomatic due to other medical issues or typical age-related changes in the lungs (ie. decreased productive cough for bringing up liquid/sputum from the lungs).

Seniors are often used to feeling unwell and may not report symptoms to their physicians.

Other factors such as poor nutritional intake and decreased physical activity further impact the elderly in this regard.

In general, the more health problems a person has, the more likely they will develop pneumonia and the more likely it is to be fatal.

What is Pneumonia?

Pneumonia is an abnormal inflammation of the structures of the lungs most often caused by bacteria, viruses and less often caused by fungi or parasites. The lungs can become inflamed, liquid can build up in the tissue of the lungs and infection can spread to the whole body.

Pneumonia in elderly itself is not contagious but the underlying cause (eg. bacteria or viruses) can be contagious, particularly for people with compromised immune systems. If transmitted, pneumonia may be passed in the same way as influenza or the common cold: by people's hands and by tiny droplets from their mouths and noses.

What are the Risk Factors for Pneumonia?

Underlying illnesses such as Alzheimer's disease, emphysema, cystic fibrosis, diseases of the immune system, smoking and alcoholism increase the risk of pneumonia. Hospitalization puts seniors at high risk for pneumonia elderly.

Other risk factors for pneumonia in elderly:

• Chronic heart, lung, spleen or kidney disease
• Any medical condition that impairs the immune system
• Diabetes
• Alcoholism
• History of smoking (damages the lining of the respiratory tract that helps to remove bacteria)
• Swallowing difficulty due to muscle weakness from a stroke or Parkinson's disease
• Difficulty initiating swallowing due to advanced dementia
• Decreased ability to cough
• Poor dental hygiene leading to higher amounts of potentially harmful bacteria in the mouth (which can then go into the lungs)
• Previous history of pneumonia
• Hospitalization

Symptoms of Pneumonia

As mentioned above, seniors can often be asymptomatic due to age-related changes, other medical issues or a regular feeling of decreased wellness. This can make it difficult for elderly to differentiate additional symptoms to having pneumonia.

Symptoms of bacterial pneumonia:

• Coughing producing rust-colored or greenish mucus
• Chest pain
• Profuse sweating
• Shallow, quick breaths
• Quickened pulse
• Fever
• Confusion or even delirium
• Chills/chattering teeth
• Increased body temperature
• Lips may become blueish in color due to decreased oxygen in bloodstream

Symptoms of viral pneumonia elderly:

• Fever
• Muscle pain
• Dry cough to start moving to some mucus with blood in it when more severe
• Headaches
• Weakness
• Blueness of the lips
• Breathlessness

Symptoms of other forms of pneumonia elderly (less common):

• Chill and fever that could be accompanied by vomiting and nausea
• Severe bouts of coughing
• Occasional presentation of reduced heart rate
• Night sweats
• Weight loss
• Abdominal pain and diarrhea

Why are Hospitals More Risky for Developing Pneumonia?

The biggest reason seniors are at higher risk of developing pneumonia in hospitals is because of spending too much time in bed. They may also have more difficulty with deep breathing due to pain, fatigue, medications or surgical incisions.

The simplest way for a senior to reduce the risk of developing pneumonia in the hospital is to GET OUT OF BED.

Getting seniors up into a chair, walking, moving to and from the bathroom and completing any functional activity such as getting dressed or grooming at the sink will be beneficial. Being in an upright posture allows the senior's lungs to expand more easily and makes it easy to cough and clear those lungs.

If your elderly parent does develop pneumonia while in the hospital, they may be given an incentive spirometer. This is a small plastic device designed to help take deep breaths. Encourage your loved one to use it often.

Treatment of Pneumonia

Treatment of pneumonia depends on the cause. Once the cause is determined, your loved one may receive the following treatments:

• Antibiotics
• Respiratory treatment to remove secretions (may include oxygen)
• Coughing and chest pain should not be suppressed with drugs unless approved by a physician as it is usually important to clear the lungs
• Antiviral medications for rare form of viral pneumonia
• Corticosteriods are sometimes used to treat aspiration pneumonia

Aspiration Pneumonia

Aspiration is a term used to describe anything other than air entering the lungs, including mouth secretions which may contain bacteria.

Elderly aspiration pneumonia is often caused by difficulties swallowing. Difficulties swallowing may lead to mouth secretions, food, pills or other particles going into the lungs and causing infection. Issues with swallowing are common in conditions such as stroke, dementia and Alzheimer's. Swallowing may also be affected by intoxication.

How Long Does it Take to Recover from Pneumonia?

Recovery often takes 7 - 10 days but can take longer. Relapses are common.

Ways to Decrease Risk of Pneumonia

• Good dental care and ongoing care of teeth and mouth
• Keep active and involved in physical activity
• Proper nutrition
• Avoid or lower doses of drugs that will decrease alertness (benzodiazepines, narcotics, mm relaxers, antihistamines, other anticholinergic medications)
• Get the Pneumovax shot (vaccine for bacterial pneumonia) once very 5-8 years
• Appropriate treatment of underlying illnesses
• Stop smoking (smoking damages your lungs and decreases your body's natural ability to fight pneumonia)

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