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The Dangers of Pneumonia In Seniors: Symptoms, Treatment, & Prevention
Lisa Reisman • Aug 28, 2019
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The Dangers of Pneumonia
Pneumonia is prevalent among seniors, and a major contributing factor of mortality. An article on Aging Care’s website tells us that 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 in the lungs caused by many different organisms, and a lot of the time it’s caused by common bacteria and viruses. Depending on a person’s exposure and history of medical illnesses, pneumonia can also be caused by unusual organisms. One can develop pneumonia by inhaling or swallowing infectious particles in the air. Although pneumonia is contagious, it’s most common in those above the age of 60, and the main way older people develop pneumonia 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 a bacterial infection in the bloodstream (sepsis) and fluid and infection around the lungs.”
Elderly and at Risk
The older community is frailer overall; however, being frail doesn’t mean an individual is susceptible to one disease over another. According to an article by Marlo Sollitto, frailty has been defined as a condition involving 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 also put the elderly at risk for developing pneumonia— this isn’t to say that young people can’t acquire the contagious infectious disease, but that it’s way worse in the older community who already have complications with their health history. The elderly community is often times exposed to surroundings with harsher bacteria. On that note, heath-care acquired pneumonia is a bacterial infection acquired from long-term care in a facility like a nursing home, hospital, or outpatient clinic, and it’s caused by bacteria that is more resistant to antibiotics. Being that our immune systems are what fight off infection, exposure to germs is something to watch out for if you or a family member is at risk for developing pneumonia. Health conditions like HIV/ AIDS, heart disease, diabetes, as well as bone marrow or organ transplants can lead to a weaker immune system.
Aspiration Pneumonia is another dangerous type of pneumonia occurring when a person inhales food, drink, or vomit. People with a brain injury, those who experience problems with swallowing, or use drugs and alcohol in excess are more susceptible to developing aspiration pneumonia because their gag reflex is compromised.
Seniors who have had any type of surgery are easy candidates for pneumonia as well because their bodies are already working harder to heal. Continuing on from aspiration pneumonia, the pain medications prescribed post-surgery can cause patients to take shallower breaths, which contributes to mucus gathering in the lungs.
Symptoms and Treatment
Pneumonia is caused by more than thirty types of organisms and can show through a variety of symptoms. However, the following symptoms can signal a bout of pneumonia:
-Malaise or feeling weak
-Cough
-Green or yellow sputum
-Pain in the chest
-Confusion
-Fever
-Chills
-Shortness of Breath
Many times, a person will assume or self-diagnose themselves with the flu, but it’s believed that the signs of pneumonia can differ from the general population. Dr. Joseph Mylotte, a professor of medicine at the School of Medicine and Biomedical Sciences at the University of Buffalo says, "The symptoms and signs are sometimes not as specific. They may be more sleepy and lethargic, or lose their appetites, or they may suffer from dizziness and fall. If there is underlying dementia, they might not be able to tell you how they feel. But it's all related to something going on in the lung."
Pneumonia of varying types is treated depending on which organism triggered the disease. A blood sample or analysis of phlegm can determine which type of pneumonia you have and how to treat it.
Viral pneumonia can be treated with antiviral medications but they’re not usually prescribed because they’re not as effective against viruses. Viral pneumonia often goes away on its own if the patient rests often, eats healthy, and supplements with plenty of fluids. If symptoms worsen, sometimes-bacterial pneumonia may have been developed and you should notify your doctor immediately.
Bacterial pneumonia is always treated with antibiotics. If a patient is being treated in the hospital, often times the hospital will follow “pay-for performance programs” and the guidelines they provide. These doctors often get paid more to follow the program’s guidelines. Additional guidelines for treatment can be found on the American Thoracic Society (www.thoracic.org) and the Infectious Diseases Society of America (www.idsociety.org) and are based on how and where the patient acquired the infection. Whether at home or in the hospital, patients are usually administered a once-a-day therapy. Effective antibiotic treatments include respiratory fluoroquinolones such as moxifloxacin, says Mylotte, although there are several antibiotic therapies that work as well as these.
Extensive treatment of bacterial pneumonia can be tricky because of antibiotic resistance— the organisms that cause pneumonia mutate and become resistant to treatment. A patient must finish their dose of antibiotics entirely to ensure recovery because stopping a proper dose of antibiotics actually encourages the resistance.
Prevent and Protect
The infectious disease that is pneumonia can be transmitted via the air or physical contact and often times a persons immune system can fight it off, however, preventing it’s transmission is key for those who have preexisting health conditions.
An article on A Place for Mom provides these helpful steps to ensure you’re more protected against pneumonia:
Pneumococcal Vaccine: This vaccine helps prevent twenty-three different strains of bacterial pneumonia (although there are many more strains of bacterial pneumonia out there). "It doesn't always engender a good immune response in adults, so it doesn't always work well," says Mylotte. He also points out the vaccine is effective for a shorter amount of time in older people. Experts recommend getting your first dose when you are in your 50s and your second dose at age 65, and then a new dose should be administered every five years.
Influenza Vaccine: This vaccine is just as important as the pneumococcal vaccine. It doesn't work as well in elderly people, says Mylotte, but if an older vaccinated person gets the flu, it is usually a milder case. Pneumonia is often a secondary infection after an initial bout of influenza; people who receive this vaccine have less risk of developing pneumonia as a flu complication. Older adults should get a flu shot every year.
Hand Washing: "I always tell people to wash their hands as much as they can. If your hands aren't raw in the wintertime, you are not doing a good job," says Mylotte.
Dental Hygiene: Pneumonia infections can occur around infected teeth, says Edelman, so dental work should be kept in good repair.
Good Health Habits: Exercise, rest and healthy eating can all increase resistance to pneumonia.
If you or a loved one currently has, or is at risk for developing pneumonia, make sure they stay away from sickly surroundings and seek medical attention immediately. Immediate intervention at the onset of the pneumonia can save lives and prevent it from spreading.
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