Best Way To Treat Pneumonia In Elderly

Is There A Vaccine For Pneumonia

There isnt a vaccine for all types of pneumonia, but 2 vaccines are available. These help prevent pneumonia caused by pneumococcal bacteria. The first is recommended for all children younger than 5 years of age. The second is recommended for anyone age 2 or older who is at increased risk for pneumonia. Getting the pneumonia vaccine is especially important if you:

• Are 65 years of age or older.
• Smoke.
• Have certain chronic conditions, such as asthma, lung disease, diabetes, heart disease, sickle cell disease, or cirrhosis.
• Have a weakened immune system because of HIV/AIDS, kidney failure, a damaged or removed spleen, a recent organ transplant, or receiving chemotherapy.
• Have cochlear implants .

The pneumococcal vaccines cant prevent all cases of pneumonia. But they can make it less likely that people who are at risk will experience the severe, and possibly life-threatening, complications of pneumonia.

Pneumonia In Seniors: Symptoms Causes And Treatment

Pneumonia is an infection that occurs in the lungs. It isnt a condition that is unique to just the elderly, but they do have a higher chance of worrying complications and even death. This is because the older we get, the more likely our immune system will weaken. This is further exacerbated by any pre-existing chronic health conditions that the elderly are also more likely to have.

Symptoms in older adults can be more subtle, especially if they also overlap with other conditions. It is, therefore, more important to look out for the early signs to prevent a delay in getting a proper medical diagnosis and adequate treatment.

What Is Pneumonia?

Pneumonia is a respiratory infection that affects the alveoli, or tiny air sacs, located in the lungs. This results in inflammation and can cause the lungs to fill with liquids like pus. This is problematic as it affects the bodys ability to circulate oxygen around the body, affecting many important bodily processes. The infection can either affect one or both lungs at a time. Having pneumonia in both lungs, or double pneumonia doesnt present with more or worse symptoms. The severity of the condition depends on the bodys ability to fight it off, the cause of the infection as well as the age of the individual.

Symptoms of Pneumonia

The symptoms of pneumonia will vary from person to person depending on their age and overall health. The most common signs include:

Peppermint Eucalyptus And Fenugreek Tea

Many warm herbal teas can help soothe a scratchy throat, but herbs may be more beneficial.

A 2011 study found that herbs, including peppermint and eucalyptus, had a soothing effect on the throats of people with upper respiratory tract infections. These herbs may help break up mucus and ease the pain and inflammation caused by pneumonia.

A review from 2018 notes that fenugreek seeds might help break down mucus. A tea made from ground fenugreek seeds may therefore ease a persistent cough.

Eucalyptus and tea tree oils may also help relieve coughs. People can use these in a diffuser. However, they should try limiting their exposure at first, to ensure that the use of oils does not worsen their symptoms.

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Treatment For Pneumonia In Seniors

Treatment will differ depending on the type of pneumonia. Normally, a doctor will prescribe antibiotics, anti-virals, or other medications. However, if the symptoms are severe enough, admittance to the ICU may be required. Emergency treatment may consist of being given a respirator, bronchodilators, fluids, and round-the-clock monitoring for the length of the hospitalization.

How Soon After Treatment For Pneumonia Will I Begin To Feel Better

How soon you will feel better depends on several factors, including:

• Your age
• The cause of your pneumonia
• The severity of your pneumonia
• If you have other at-risk conditions

If you are generally healthy, most symptoms of bacterial pneumonia usually begin to improve within 24 to 48 hours after starting treatment. Symptoms of viral pneumonia usually begin to improve within a few days after starting treatment. A cough can last for several weeks. Most people report being tired for about a month after contracting pneumonia.

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What Are The Complications Of Pneumonia

Anyone can experience complications from pneumonia. However, people in high-risk groups are more likely to develop complications, including:

• Breathing difficulties: Pneumonia can make breathing difficult. Pneumonia plus an existing lung disorder can make breathing even more difficult. Breathing difficulties may require a hospital stay to receive oxygen therapy or breathing and healing assistance with the use of a breathing machine .
• Fluid buildup in the lungs : Pneumonia can cause a buildup in the fluid between the membranes that line the lungs and the inside of the chest cavity. It is a serious condition that makes breathing difficult. Pleural effusion can be treated by draining excess fluid with a catheter, chest tube or by surgery.
• Bacteria in the bloodstream : The bacteria that cause pneumonia can leave your lungs and enter your bloodstream, spreading the infection to other organs. This condition is treated with antibiotics.
• Lung abscess. A lung abscess is a pus-filled cavity in the lung that is caused by a bacterial infection. It can be treated by draining the pus with a long needle or removing it by surgery.

How Is Pneumonia Diagnosed

Pneumonia in older adults can be difficult to diagnose. Your doctor will first request your medical history in which you may be asked things such as:

• your symptoms
• medications or supplements that youre taking
• your smoking history
• whether youve received your pneumococcal or influenza vaccinations

Your doctor will then perform a physical examination. Theyll check vital signs, including blood pressure, heart rate, and blood oxygen levels. They may also use a stethoscope to listen for crackling sounds in your lungs.

In order to make a diagnosis, your doctor may also order the following:

• Blood tests. These tests involve taking a blood sample from a vein in your arm. The results can help indicate the presence of an infection.
• Imaging. Your doctor order imaging technology such as X-ray or CT scan to visualize your chest and lungs.
• Culture. Cultures can be taken from sputum or pleural fluid to help determine what type of germ may be causing your infection.
• Pulse oximetry. Pneumonia can affect the amount of oxygen that you can take in. This test measures the amount of oxygen in your blood.

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How To Treat Pneumonia In The Elderly

The best treatment for pneumonia is to use antibiotics to kill the bacterial or fungal organisms. The anti-microbial medication of choice depends on which organism is causing the infection, the chance that the organism is resistant to the basic antibiotics, and the underlying condition of the patient’s health.

About 80 percent of community-acquired pneumonia can safely be treated at home with just the use of oral antibiotics. Empiric treatment is given when the exact organism and its sensitivities are not known. When the exact cause of the pneumonia is identified, the exact antibiotic against the microorganism can be used and the treatment can become more tailored. About 20 percent, pneumonia must be treated in a hospital with IV antibiotics.

If the pneumonia is due to a virus, no antibiotic is available to treat this type of infection. Sometimes, antiviral medication can be used to treat the pneumonia. These types of medications are best given early in the course of the disease and include medications like Tamiflu and Relenza. Fungal pneumonias are treated with anti-fungal medications.

What Can I Do At Home To Feel Better

In addition to taking any antibiotics and/or medicine your doctor prescribes, you should also:

• Get lots of rest. Rest will help your body fight the infection.
• Drink plenty of fluids. Fluids will keep you hydrated. They can help loosen the mucus in your lungs. Try water, warm tea, and clear soups.
• Stop smoking if you smoke and avoid secondhand smoke. Smoke can make your symptoms worse. Smoking also increases your risk of developing pneumonia and other lung problems in the future. You should also avoid lit fireplaces or other areas where the air may not be clean.
• Stay home from school or work until your symptoms go away. This usually means waiting until your fever breaks and you arent coughing up mucus. Ask your doctor when its okay for you to return to school or work.
• Use a cool-mist humidifier or take a warm bath. This will help clear your lungs and make it easier for you to breathe.

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What Is The Survival Rate For Elderly That Have Pneumonia

According to the Centers for Disease Control around a million people in the United States go to the doctor or an emergency room for treatment of pneumonia. Of those who seek treatment, 50,000 die each year.

With community-acquired pneumonia 10 percent who are admitted are placed in an ICU unit. Even in ICU, the death rate of people with pneumonia can reach 25 percent.

Survival depends on many factors. Age is an important factor and more elderly people succumb to pneumonia than any other adult group. Overall health is another important factor as those with existing health issues face a harder time fighting off pneumonia.

How To Diagnose Pneumonia In The Elderly

There are tests that can be done to tell if an elderly person has pneumonia. The doctor can simply listen to the individual’s lungs for rattling sounds and rales that are typical of pneumonia and lung inflammation. A chest x-ray or CT scan will show areas of pneumonia, called consolidation. A pulse oximetry test checks for the level of oxygen in the system, which tends to be lower if the person has pneumonia. In some cases, the mucus or blood can be cultured to identify the specific organism that is causing the pneumonia.

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Box 1 Common Stratification Scores To Assess Severity And Need For Hospitalization In Patients With Community

Pneumonia severity index score

• A total of 20 parameters are evaluated at the time of clinical presentation and consist of:

• Three demographics

• Five comorbid conditions

• Five physical examination findings

• Seven laboratory/imaging variables .

CURB-65

Pneumonia severity index score and CURB-65 .

BP: Blood pressure CURB: Confusion, urea nitrogen, respiratory rate, blood pressure and age of 65 years or older.

How Is Pneumonia Spread From Person To Person

Pneumonia is spread when droplets of fluid containing the pneumonia bacteria or virus are launched in the air when someone coughs or sneezes and then inhaled by others. You can also get pneumonia from touching an object previously touched by the person with pneumonia or touching a tissue used by the infected person and then touching your mouth or nose.

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How Do The Lungs Work

Your lungs main job is to get oxygen into your blood and remove carbon dioxide. This happens during breathing. You breathe 12 to 20 times per minute when you are not sick. When you breathe in, air travels down the back of your throat and passes through your voice box and into your windpipe . Your trachea splits into two air passages . One bronchial tube leads to the left lung, the other to the right lung. For the lungs to perform their best, the airways need to be open as you breathe in and out. Swelling and mucus can make it harder to move air through the airways, making it harder to breathe. This leads to shortness of breath, difficulty breathing and feeling more tired than normal.

What Should Pneumonia Patients Avoid

You may experience worse symptoms from smoking. You are also more likely to develop pneumonia and other lung problems in the future if you smoke. Keeping your fire lit or in areas with dirty air is another recommended alternative. Until your symptoms subside, you should avoid going to school or work.

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What Is The Recovery Time For Pneumonia In The Elderly

A simple Google search for that question makes us think that an elderly person can recover from pneumonia in in as little as two weeks but it may take two months or longer to recover completely.

A study that appeared in the Patient Related Outcome Measures Journal shed some light on the vast difference between a short recovery and a long one.

They begin by understanding the health status of the elderly person who is afflicted with pneumonia. For those that are in good health, expect a recovery time of about three weeks. In that period, shortness of breath, weakness, and fatigue are common. If the elderly person has existing health conditions, especially those that involve the respiratory system, such as COPD the recovery period can take as long as 60 or more days and be far more challenging.

Besides Vaccination What Else Can I Do To Prevent Bacterial And Viral Pneumonia

Receiving all recommended vaccinations is one of the best ways to prevent pneumonia. Additionally, there are several other ways to prevent pneumonia, including:

• Quitting smoking, and avoiding secondhand smoke. Smoking damages your lungs.
• Washing your hands before eating, before handling food, after using the restroom, and after being outside. If soap is not available, use an alcohol-based hand sanitizer.
• Avoiding being around people who are sick. Ask them to visit when they are feeling better.
• Not touching or sharing objects that are shared with others. Germs can be transferred from object to you if you touch your nose or mouth without washing or sanitizing your hands first.
• Eating a healthy diet, exercise, and get enough rest. Healthy habits keep your immune system strong.
• Getting treated for any other infections or health conditions you may have. These conditions could weaken your immune system, which could increase your chance of infections.
• Avoiding excessive consumption of alcohol.

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Keep The Home Mould Free And Clean

A seniors home should be clean in all aspects. Ventilation is also very important. Ensure there is adequate fresh air circulating within the home. A senior person may require some extra help with cleaning their homes regularly due to differences in capabilities that they may be having.

Any mildew, mould, or musty smell needs remedying after careful examination. Stay alert for any changes that could come suddenly. Also, look out for the onset of confusion and fatigue in an elderly person. If an older person gets sick, get them medical care as early as possible and follow up so that you can confirm that the recovery is normal.

Severe Cases Of Pneumonia In Seniors

Pneumonia can be very severe or mild. However, when it comes to seniors, pneumonia infection is almost always very severe. What is the difference between pneumonia and walking pneumonia? The mild version of the disease usually termed as walking pneumonia. This is because those affected only feel a little sick and the infection is not severe to require one to be hospitalized.

When it is severe, one may need some emergency medical care. It may be necessary for the patient to receive some form of oxygen therapy so as to help with the decreased capacity of the lungs.

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Rapidly Managing Pneumonia In Older People During A Pandemic

Carl Heneghan, Jeff Aronson, Richard Hobbs, Kamal Mahtani

Please Check NICE guidance for all prescribing recommendations.

3rd April: NICE guidance updated

For general advice on managing COVID-19 symptoms, see also the NICE COVID-19 rapid guideline on managing symptoms in the community.

RationaleThe current COVID-19 pandemic has highlighted the risk faced by older adults, who are more susceptible to complications, including acute respiratory distress syndrome, usually as a result of pneumonia. Comorbidities, impaired immunity and frailty, including a reduced ability to cough and to clear secretions from the lungs, can all contribute to this complication. Older people are therefore more likely to develop severe pneumonia, suffer from respiratory failure, and die.

Viruses are thought to cause about 50% of cases of pneumonia. Viral pneumonia is generally less severe than bacterial pneumonia but can act as a precursor to it. Preventing any pneumonia in older adults is preferable to treating it.

Identification of the early stages of pneumonia in older patients can prove difficult. Traditional symptoms and signs, including fever, may be absent. Limited evidence suggests that many tests that are useful in younger patients do not help diagnose infections in older adults. The onset of pneumonia in elderly people can often be rapid, and the prognosis is poor in severe pneumonia: as many as one in five will die. The older you are, the more prevalent severe pneumonia becomes.

What Are The Symptoms Of Pneumonia In Seniors

Because there are many types of pneumonia , symptoms of infection will differ from person to person. Of course, the severity of the disease can also vary. A mild bout of the disease is often called walking pneumonia, since those affected by it only feel slightly ill and can continue their daily lives without issue. However, this is much less common in the elderly, who usually have severe symptoms, and may need emergency oxygen treatment in the worst of cases.

Common signs of pneumonia in seniors include:

• Difficulty breathing, or shortness of breath
• Harsh coughing fits that produce phlegm
• Pain in the chest or ribs
• Pale, clammy skin
• Confusion, disorientation, and difficulty focusing
• Unusual fatigue and feeling weak
• A high fever, along with sweating, shaking, and chills.

Sometimes, the symptoms may be confused for the flu. Some symptoms may not appear, while others will be apparent. This can make it difficult to identify pneumonia with confidence, but any changes in energy, appetite, behaviour, or breathing should be taken seriously and brought to the attention of a medical professional or caregiver.

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