Stages Of Pneumonia In Elderly
Pneumonia has four stages, namely consolidation, red hepatization, grey hepatization and resolution.
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What Is The Prognosis And Recovery Time Of Pneumonia Can You Die
Most people with pneumonia improve after three to five days of antibiotic treatment, but a mild cough and fatigue can last longer, up to a month. Patients who required treatment in a hospital may take longer to see improvement.
Pneumonia can also be fatal. The mortality rate is up to 30% for patients with severe pneumonia who require treatment in an intensive care unit. Overall, around 5%-10% of patients who are treated in a hospital setting die from the disease. Pneumonia is more likely to be fatal in the elderly or those with chronic medical conditions or a weakened immune system.
Which Types Of Doctors Treat Pneumonia
In some cases, primary care physicians, including pediatricians, internists, and family medicine specialists, may manage the care for patients with pneumonia. In more severe cases, other types of specialists may be involved in treating the patient with pneumonia. These include infectious-disease specialists, pulmonologists, critical care specialists, and hospitalists.
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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 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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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:
Not All Doom And Gloom
Even with the high rates of illness and death throughout the country, experts say were at a much different place in the pandemic compared to previous surges. For starters, the vaccine formulas developed in 2020 continue to hold their ground against new variants like omicron, most notably after a booster dose.
Medical conditions that increase risk for severe COVID-19
- Cancer
- Weakened immune system
- Overweight and obesity
This list is not exhaustive but includes many of the chronic conditions that affect older adults.
Recent research out of the United Kingdom shows that protection against death with omicron is about 95 percent in adults 50 and older who are boosted. Similarly, a study led by CDC researchers found that boosters were about 90 percent effective at preventing COVID-19associated hospitalizations during the early days of the omicron era.
Its very clear, particularly with omicron, that the third shot adds a huge amount of additional protection, Wachter says especially for older adults. If youve had three shots, you have brought your risk down to that of a relatively young, healthy person.
So far about 65 percent of eligible adults aged 65 and older have received their booster dose for adults 50 and older, that number drops to about 56 percent, federal tallies show.
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Preventing Pneumonia In The Elderly
- Wash their hands frequently: Everyone knows this piece of advice, but not everyone follows it. They should though, because frequent handwashing can greatly lower the risk of infections, including pneumonia.
- Get vaccinated: Getting the pneumococcal pneumonia vaccine lowers seniors risk of getting bacterial pneumonia. Doctors recommend people get a first dose in their 50s, a second dose at age 65 and an additional dose every five years. An annual flu vaccine can also lower risk of pneumonia, because pneumonia sometimes develops as a complication of the flu.
- Avoid people who have a cold or the flu: It may feel rude, but safety comes first. Make plans to see them when theyre feeling better. If you must be around people who are sick, wear a medical face mask to protect yourself.
- Keep their teeth clean: Infected teeth are a prime place for a pneumonia infection to strike. Practice good oral hygiene and visit the dentist regularly to prevent that from happening.
- Keep their homes clean: Dust, mold and mildew can hurt the lungs and increase risk of pneumonia. Seniors may need help from a loved one or a professional cleaning service to keep their homes free from these irritants.
- Live a healthy life: Some of the practices used to treat pneumonia, like getting lots of rest, eating healthy and staying hydrated, can also help fend off illness in the first place. Getting regular exercise and choosing not to smoke cigarettes is also important.
Questions To Ask Your Doctor
- I have a chronic condition. Am I at higher risk for pneumonia?
- Do I have bacterial, viral, or fungal pneumonia? Whats the best treatment?
- Am I contagious?
- How serious is my pneumonia? Will I need to be hospitalized?
- What can I do at home to help relieve my symptoms?
- What are the possible complications of pneumonia? How will I know if Im developing complications?
- What should I do if my symptoms dont respond to treatment or get worse?
- Do we need to schedule a follow-up exam?
- Do I need any vaccines?
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Signs Of Pneumonia In Elderly Adults
If any of the following symptoms present in a senior, it is crucial to see a doctor as soon as possible. However, its important to note that older individuals may experience different symptoms of infection compared to younger individuals.
- Coughing
- Green, yellow or bloody sputum that comes up when coughing
- Feeling lethargic
- Suddenly feeling worse following a recent cold or bout of flu
- Confusion or changes in behavior
- Loss of appetite
- Blue lips or fingernails due to a drop in blood oxygen level
Be aware that it is possible for seniors to contract a milder version of pneumonia . Symptoms of walking pneumonia can be so mild that a senior or their caregiver may not even notice them.
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How To Prevent Pneumonia In Seniors
Contracting pneumonia is no walk in the park for seniors, especially when they suffer from another comorbidity like Alzheimers or a heart issueor even a weakened immune system. Its best to try to help your loved one prevent contracting pneumonia. Here are a few tried-and-true methods for preventing pneumonia, whether youre a senior or a caretaker for one:
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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.
How Long Youll Take Them
A course of antibiotics for uncomplicated pneumonia treatment is usually for five to seven days. One course will usually be enough to cure your pneumonia. In some cases, you may need more than one course of antibiotics if your infection doesnt start improving or it seems like its not responding to the medications.
Stay in touch with your doctor to ensure your infection is clearing up. Youll likely start to feel better and have some symptom relief one to three days after you start your pneumonia treatment, but it may take a week or more for your symptoms to go away completely.
Taking your medication as prescribed, especially for antibiotics, is incredibly important. Even if youre feeling better, you need to take the entire course.
Do not stop taking antibiotics early, even if your symptoms improve, as the infection would not be fully treated and could become antibiotic-resistant. This will make treatment more complicated. If youre experiencing side effects, talk to your doctor. Only stop your medication if your doctor tells you its OK to do so.
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Therapeutic Strategies To Manage Cap In Elderly Patients
Antimicrobials are the cornerstone of therapy for CAP in any population, including the elderly. In addition, some nonantibiotic strategies may be important when treating CAP in elderly populations. In older patients, the pneumonia process often extends beyond the lung parenchyma, presenting as a systemic disease with higher severity of illness. This is supported by the finding that many elderly CAP patients present with primarily nonpulmonary symptoms, such as mental status changes or renal dysfunction. Owing to this fact, the following discussion will focus on both the antibiotic and nonantibiotic therapies for elderly patients with CAP. The therapeutic strategies reviewed next are an update from our prior work published in Aging Health, and the discussion is designed to serve as a review of the most relevant literature since the initial publication in 2006 .
Can Pneumonia Be Prevented
Immunisation against the pneumococcus and having the annual flu virus immunisation are advised if you are at greater risk of developing these infections.
See the separate leaflets called Pneumococcal Immunisation and Influenza Immunisation for further details.
Cigarette smoke damages the lining of the airways and makes the lungs more prone to infection. So stopping smoking will lessen your risk of developing lung infections.
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How Is Pneumonia Treated
When you get a pneumonia diagnosis, your doctor will work with you to develop a treatment plan. Treatment for pneumonia depends on the type of pneumonia you have, how sick you are feeling, your age, and whether you have other health conditions. The goals of treatment are to cure the infection and prevent complications. It is important to follow your treatment plan carefully until you are fully recovered.
Take any medications as prescribed by your doctor. If your pneumonia is caused by bacteria, you will be given an antibiotic. It is important to take all the antibiotic until it is gone, even though you will probably start to feel better in a couple of days. If you stop, you risk having the infection come back, and you increase the chances that the germs will be resistant to treatment in the future.
Typical antibiotics do not work against viruses. If you have viral pneumonia, your doctor may prescribe an antiviral medication to treat it. Sometimes, though, symptom management and rest are all that is needed.
Most people can manage their symptoms such as fever and cough at home by following these steps:
If your pneumonia is so severe that you are treated in the hospital, you may be given intravenous fluids and antibiotics, as well as oxygen therapy, and possibly other breathing treatments.
Is Pneumonia Contagious
Most types of bacterial pneumonia are not highly contagious. Even though it is possible to spread bacteria from one person to another, pneumonia typically occurs in people with risk factors or weakened immune defenses when bacteria that are normally present in the nose or throat invade the lung tissue. Any kind of bacterial or viral pneumonia has the potential to be contagious, but Mycoplasma pneumoniae and Mycobacterium tuberculosis are two types of bacterial pneumonia that are highly contagious. Breathing in infected droplets that come from patients who are coughing or sneezing can spread the disease to others.
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What Causes Pneumonia
There are more than 30 different causes of pneumonia, and theyre grouped by the cause. The main types of pneumonia are:
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Bacterial pneumonia. This type is caused by various bacteria. The most common is Streptococcus pneumoniae. It usually occurs when the body is weakened in some way, such as by illness, poor nutrition, old age, or impaired immunity, and the bacteria are able to work their way into the lungs. Bacterial pneumonia can affect all ages, but you are at greater risk if you abuse alcohol, smoke cigarettes, are debilitated, have recently had surgery, have a respiratory disease or viral infection, or have a weakened immune system.
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Viral pneumonia. This type is caused by various viruses, including the flu , and is responsible for about one-third of all pneumonia cases. You may be more likely to get bacterial pneumonia if you have viral pneumonia.
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Mycoplasma pneumonia. This type has somewhat different symptoms and physical signs and is referred to as atypical pneumonia. It is caused by the bacterium Mycoplasma pneumoniae. It generally causes a mild, widespread pneumonia that affects all age groups.
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Other pneumonias. There are other less common pneumonias that may be caused by other infections including fungi.
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.
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Dysphagia Dystussia And Aspiration Pneumonia In Elderly People
Satoru Ebihara1, Hideki Sekiya2, Midori Miyagi1, Takae Ebihara3, Tatsuma Okazaki4
1 Department of Rehabilitation Medicine, Toho University Graduate School of Medicine, Tokyo, Japan Department of Oral Surgery, Toho University Faculty of Medicine, Tokyo, Japan Department of Geriatric Medicine, Kyorin University School of Medicine, Tokyo, Japan Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
Contributions: Conception and design: S Ebihara Administrative support: None Provision of study materials or patients: S Ebihara, T Okazaki Collection and assembly of data: All authors Data analysis and interpretation: All authors Manuscript writing: All authors Final approval of manuscript: All authors.
Correspondence to
Keywords: Dysphagia dystussia aspiration pneumonia
Submitted Jan 16, 2016. Accepted for publication Jan 26, 2016.
doi: 10.21037/jtd.2016.02.60