What You Need to Know About Pneumonia in Seniors

Pneumonia is a Serious Illness

Did you know that adults over 65 are much more susceptible to pneumonia than those who are younger? It is important for people with elderly loved ones to know how to lower their risk in developing serious illness by helping them get the right kind of care. Pneumonia can be very serious and, in fact, is the most common cause of death in developing countries(Opens in a new window). It is ranked by the American Lung Association as the eighth leading cause of death in the United States. Each year, about 1.5 million people(Opens in a new window) in the US have to go to the emergency room with pneumonia, and about 55,000 people die from this illness.

What is Pneumonia?

An infection of the lungs, pneumonia can be viral, bacterial or fungal. Pneumonia happens when your lung tissue becomes inflamed and the air sacs fill with fluid or pus.

When someone has a mild case, with less severe symptoms, it is known as walking pneumonia. However, some more serious cases of pneumonia may require hospitalization for treatment and symptom management. There are four subtypes of pneumonia:

• Bacterial pneumonia is most often caused by Streptococcus pneumoniae. This type of pneumonia can affect anyone and in severe cases can lead to hospitalization(Opens in a new window). Doctors treat bacterial pneumonia with antibiotics.
• Viral pneumonia is caused by a virus. Common viruses that can lead to viral pneumonia include cold and flu viruses, RSV, and COVID-19. (Opens in a new window)This kind of pneumonia comes on more slowly than bacterial pneumonia, and involves sneezing, congestion, and wheezing. It does not usually require any specific treatment except symptom management, and often resolves on its own.
• Mycoplasma pneumonia is also called atypical pneumonia, or walking pneumonia. Caused by a specific bacteria called Mycoplasma pneumoniae, this type of pneumonia does not typically cause severe symptoms.
• Fungal pneumonia is caused by fungal spores. It is not contagious, but occurs when spores mix with the air and are inhaled(Opens in a new window). It can also happen when dormant fungal infection becomes active again. It primarily affects people with weaker immune systems, including adults over the age of 65. Fungal pneumonia can be treated successfully with anti-fungal medications, but if it is left untreated, it can become serious or even fatal.

What are some symptoms of pneumonia in the elderly?

Pneumonia symptoms(Opens in a new window) vary depending on the cause and severity of the pneumonia, as well as the age of the patient. In adults, bacterial pneumonia can cause a high fever, cough with yellow, green, or bloody mucus, fatigue, shortness of breath, rapid breathing, sweating or chills, rapid heart rate, chest or abdominal pain, diminished appetite, bluish skin, lips, and nails, and confusion or an altered mental state. Viral pneumonia can cause the same symptoms as bacterial pneumonia, but it also frequently has symptoms like a dry cough, headache, muscle pain, or extreme fatigue or weakness. However, people over the age of 65 may have less noticeable symptoms of pneumonia(Opens in a new window), but it may cause symptoms of ongoing health conditions to worsen. Older people may also experience low appetite, fatigue, and a sudden change in mental state.

Is pneumonia contagious?

This is a trickier question than you might think. Pneumonia itself is not contagious, but some of the causes of pneumonia(Opens in a new window) are. For example, Streptococcus pneumoniae is very contagious and can be spread by touching infected surfaces or through coughing and sneezing. Often, people in hospitals or long-term care facilities contract pneumonia through the spread of bacteria. This is called hospital-acquired pneumonia (HAP) or healthcare-associated pneumonia (HCAP).

Who has the highest risk of pneumonia?

While anyone can contract pneumonia, some are at higher risk than others. People with high risk factors(Opens in a new window) for pneumonia include:

• People over age 65 and under the age of two
• Those with a lung or heart condition
• People with a neurological condition that makes it hard to swallow
• Smokers
• Pregnant women
• Those with a weakened immune system
• People in the hospital or who live in a long-term care facility

Why are older people more likely to contract pneumonia?

There are several factors that make older people more susceptible to pneumonia(Opens in a new window) than younger people. First, they often have weak immune systems, and may not even notice signs of pneumonia like chills, shortness of breath and chest pain. What’s more, as we age, our lung capacity diminishes, which makes it harder to cough out mucus and clear infections. Older people who live in an assisted living facility or nursing home are at risk of community acquired pneumonia, because they are exposed to potentially infected residents, visitors and workers. People with dementia or Alzheimer’s disease may not be able to communicate that they are not feeling well, allowing pneumonia to worsen because it goes unnoticed.

What makes pneumonia dangerous for older people?

As people age, they are more likely to develop chronic conditions such as heart disease or COPD. When a person’s already weak immune system encounters even a mild case of pneumonia, underlying conditions can exacerbate and become life-threatening.

Can pneumonia be treated at home?

Mild cases of pneumonia can be treated at home, without medication, but severe cases need medical attention and, sometimes, hospitalization. Viral pneumonia is generally treated with rest and symptom management, however antiviral medication may be prescribed in certain cases. While antibiotics are typically necessary to treat bacterial pneumonia, there are some things you can do at home to make a person with pneumonia feel more comfortable and to help with their recovery.

Over the counter medicines can help, but caution should be taken when using cough suppressants, because coughing actually helps expel mucus from the lungs. It’s not advisable to completely suppress coughing, then, though it can be helpful to use a cough suppressant to help the person with pneumonia get some sleep. Before taking any over the counter medications or herbal supplements, talk to your healthcare provider to make sure these remedies will not interact with any of your prescribed medications.

There are also some natural remedies(Opens in a new window) that can ease pneumonia symptoms, including:

• Peppermint or eucalyptus tea can help with a sore throat, coughing and hoarseness, and ginger tea reduces nausea.
• Staying cool, using a cool, damp cloth, a fan and light bedding can reduce discomfort.
• Using a humidifier may make it easier to breathe.
• Staying hydrated helps replenish fluids that have been lost through sweating or vomiting. Additionally, drinking plenty of fluids can help thin and loosen mucus and phlegm.
• Propping a person up with pillows can improve his or her breathing.
• Eating certain foods can help a person with pneumonia to regain his or her strength, like chicken or lentil soup.

If you are caring for someone with pneumonia, make sure to use good hygiene practices. Always wash your hands before preparing food or touching the person who has pneumonia. Additionally, do not allow any visitors who have colds or coughs. Look for signs that pneumonia is improving, like a return to a normal temperature, less coughing or feeling like returning to normal activities. If the pneumonia does not seem to be improving, though, do not wait to seek medical attention.

What are the complications of pneumonia?

There are several different complications that can occur with pneumonia(Opens in a new window), which is why it is so important to monitor worsening symptoms and seek the care of a doctor when necessary.

• Bacteraemia happens when a bacterial infection enters the blood stream sometimes spreading to other organs.
• A lung abscess, a cavity filled with fluid, can develop in the lungs.
• Pleurisy occurs when the membrane protecting the lungs becomes inflamed and swollen. The fluid from this inflammation can become infected, which is called empyema.
• Acute Respiratory Distress Syndrome is a type of respiratory failure resulting from lung injury and requiring a mechanical ventilator and supplemental oxygen.

Fortunately, with the proper medical attention, pneumonia can be successfully treated, and these complications can be avoided. Taking preventive measures is also a good way to remain healthy and avoid pneumonia.

Can pneumonia be prevented?

While you cannot completely eliminate the risk of pneumonia for an older person, there are some things that can be done to help prevent it(Opens in a new window).

• Recognize the symptoms. Because older people often do not have the classic fever, chills, and cough of pneumonia, it is important to notice symptoms like weakness, confusion, delirium, or dizziness. Because it may be difficult to recognize symptoms of pneumonia in an older adult with pre-existing conditions, be vigilant about noticing changes in your loved one’s health, so that you’ll know when to see a doctor.
• Maintain good hygiene. Wash your hands frequently and encourage your loved one to do the same. If hand washing is not possible, use hand sanitizer to help prevent the spread of illness. Make sure your loved one is maintaining good dental hygiene, because oral and dental infections can sometimes lead to pneumonia. Be extremely cautious with the people who visit your loved one and help keep sick people from visiting. Routine illnesses like colds, flu and respiratory infections, along with more serious illnesses like measles and chickenpox, can all lead to pneumonia for an older person.
• Encourage your older loved ones to be immunized. It is advised that people at increased risk for pneumonia get the pneumonia vaccine(Opens in a new window), but it is also important to be vaccinated against other illnesses that can lead to pneumonia, like the flu and COVID-19.
• Avoid smoking. Encourage your loved one to quit smoking if that is an issue, and do not smoke around older people.
• Promote a healthy lifestyle. All people, but especially older people, need plenty of rest, a nutritious diet, and regular exercise to help keep the immune system strong.

How can in-home care services help when your older loved one has pneumonia?

About 20 percent of people with pneumonia(Opens in a new window) end up having to go back to the hospital within 30 days of being diagnosed. A person with pneumonia is also at a higher risk of additional conditions(Opens in a new window) that can make it more difficult to get well without help. However, having proactive, team-based home healthcare can help older people avoid rehospitalization and recover from pneumonia successfully. Home care, like the care provided by BrightStar Care, involves educating patients and their families about pneumonia and how to monitor symptoms, follow a care plan, take medication, improve wellness, and stay healthy. A team of specially trained home healthcare professionals can ensure that the patient understands the plan of care, the family feels comfortable with the patient’s self-management of the illness and the physician is kept in the loop. Because home healthcare professionals know how to look for and communicate changes in symptoms, they are able to stay ahead of the pneumonia and help prevent it from worsening.

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