Issues That Are Especially Significant When Treating Elderly Patients With Pneumonia
Functional assessment. It is useful to quantify the level of function of your elderly patients with use of Barthel’s index and or the hierarchial assessment of balance and mobility . The former scores 15 factors that are rated by the patient as follows: can do by myself, can do with help of someone else, and cannot do at all. The total score can range from 0 to 100 . A score 40 defines those who are severely dependent, whereas a score of 4160 indicates marked dependence. The hierarchical assessment of balance and mobility separates mobility into 3 categoriesmobility, transfers, and balanceand constructs a hierarchical range of abilities in each section.
Referral to geriatric assessment team and restorative care. Elderly patients who are functionally impaired should be referred for geriatric assessment. Some of these patients may require admission to a geriatric rehabilitation center after the pneumonia has resolved. Studies have shown that geriatric assessment teams do improve the care of the elderly, resulting in a reduction in the number of patients who need discharge to long-term-care institutions . However, such assessment with only limited follow-up has not been effective .
Hedlund et al. , in a study of 97 patients with pneumonia, found that a low triceps skin-fold thickness, low body mass index, and high acute physiology and chronic health evaluation II score correlated with death within 6 months.
Rsv In Older Adults And Adults With Chronic Medical Conditions
RSV infections can be dangerous for certain adults. Each year, it is estimated that more than 177,000 older adults are hospitalized and 14,000 of them die in the United States due to RSV infection. Adults at highest risk for severe RSV infection include
- Older adults, especially those 65 years and older
- Adults with chronic heart or lung disease
- Adults with weakened immune systems
When an adult gets RSV infection, they typically have mild cold-like symptoms. But RSV can sometimes lead to serious conditions such as
- More severe symptoms for people with asthma
- More severe symptoms for people with chronic obstructive pulmonary disease
- Congestive heart failure
Older adults who get very sick from RSV may need to be hospitalized. Some may even die. Older adults are at greater risk than young adults for serious complications from RSV because our immune systems weaken when we are older.
RSV season occurs each year in most regions of the U.S. during fall, winter, and spring. If you are at high risk for severe RSV infection, or if you interact with an older adult, you should take extra care to keep them healthy:
There is no vaccine to prevent RSV infection yet, but scientists are working hard to develop one. If you are concerned about your risk for RSV, talk to your healthcare provider.
Complications Of Pneumonia In Elderly Adults
Older adults are at risk for complications of pneumonia, including:
- Bacteremia, a potentially fatal infection that enters the bloodstream from the lungs and can spread to other organs
- Pleurisy, an inflammation of the membrane that covers the lungs . Pleurisy may require surgery or drainage of the infected fluid in the lungs
- Lung abscess, a pus-filled cavity that can develop in the infected lung area
- Acute respiratory distress syndrome , which occurs when pneumonia severely injures the lungs, leading to respiratory failure. ARDS may require the use of a mechanical ventilator to help with breathing
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Where Can You Acquire Pneumonia
You can get pneumonia from a variety of different places, which include:
- Community-acquired pneumonia . This is pneumonia that you get outside of a hospital or healthcare facility. Its estimated that CAP is the third most common cause of hospitalization in people ages 65 years and older.
- Healthcare-associated pneumonia. This is pneumonia that you acquire while in a healthcare facility. Older adults who are hospitalized or in a long-term care facility may be at an increased risk for this type of pneumonia.
- Aspiration pneumonia. This happens when you inhale things like food, saliva, or vomit into your lungs. Older individuals with swallowing disorders can be at higher risk for developing this type of pneumonia.
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.
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Tips For Pneumonia Prevention
Fortunately, there are many ways to protect older adults against this type of life-threatening infection.
Talk about your older adults vaccination status with their doctor, especially before cold and flu season gets into full swing.
2. Monitor vitals closelyIf your older adult experiences regular bouts of pneumonia, monitor their vital signs closely to watch for signs of infection.
Major changes in blood pressure that might signal a problem are easy to spot with regular bp monitoring.
Low oxygen saturation levels can be measured with a basic pulse oximeter and respiration rate can be observed.
All of this information can be recorded and shared with their doctor to help with a diagnosis.
3. Support a healthy immune systemEating a healthy, nutrient-rich diet, getting regular exercise, and maintaining a good sleep routine will strengthen your older adults immune system and help them ward off infection.
4. Dont smokeNot smoking is very important for health. It will do as much for helping prevent pneumonia as it will to prevent heart disease and cancer.
Who Is At Risk For Pneumonia
There are a handful of factors that increase a persons risk for developing pneumonia.
- Age people over age 65 and children under the age of 2 are more susceptible
- Smoking smoking damages the lungs and makes smokers more vulnerable
- Certain medical conditions adults with suppressed immune systems or chronic illnesses like heart disease, COPD, and diabetes are at higher risk
- Hospitalization breathing assistance can increase lung exposure to bacteria or virus
- Difficulty swallowing older adults who experience trouble swallowing due to neurological conditions like Parkinsons, stroke, and dementia are at increased risk of aspiration pneumonia
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Outcomes Of Pneumonia Among Residents Of Long
Pneumonia is the leading cause of death among nursing home residents. The mortality rate of LTCF residents with pneumonia is close to that of patients with hospital-acquired pneumonia , and is higher than is seen in elderly persons with CAP. In 1 study that compared 71 hospitalized subjects with pneumonia who were admitted from nursing homes with 93 hospitalized patients with CAP who were admitted from home , the in-hospital mortality rate, as well as the 1-year mortality rate of the hospitalized patients from LTCFs with CAP, was twice the mortality rate CAP patients admitted from home .
Mortality rates are higher for patients who require hospitalization than for patients who are treated in the nursing home . The most important predictor of both in-hospital and long-term mortality in nursing home patients with lower respiratory tract infection is functional status, measured as independence with activities of daily living., A poor activities of daily living score is also more common in patients with recurrent pneumonia, as well as those who require admission to the hospital for diseases other than pneumonia. Functional deterioration may also be a long term consequence of pneumonia in LTCF patients.
The costs of pneumonia in nursing home patients were prospectively evaluated in 36 nursing homes in Missouri. The estimated mean total cost per episode treated in the hospital was $10,408, whereas an episode treated in the nursing home cost approximately $3789.
Bacterial Pneumonia In Older Adults
The incidence of pneumonia increases with age, and is particularly high in patients who reside in long-term care facilities . Mortality rates for pneumonia in older adults are high and have not decreased in the last decade. Atypical symptoms and exacerbation of underlying illnesses should trigger clinical suspicion of pneumonia. Risk factors for multidrug-resistant organisms are more common in older adults, particularly among LTCF residents, and should be considered when making empiric treatment decisions. Monitoring of clinical stability and underlying comorbid conditions, potential drugdrug interactions, and drug-related adverse events are important factors in managing elderly patients with pneumonia.
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What Causes Pneumonia In Elderly Adults
Pneumonia is caused by bacteria, viruses, fungi, and other organisms. In the U.S., pneumonia in the elderly is usually caused by bacteria or a virus.
Pneumococcal pneumonia is the most common type of bacterial pneumonia, affecting more than 900,000 Americans each year, according to the ALA. This type of pneumonia is caused by a germ called Streptococcus pneumoniae. It can occur on its own or after someone has a cold or the flu.
These groups are at increased risk for bacterial pneumonia:
- Adults 65 and older
- People with a weakened immune system
- Patients recovering from surgery
- People with other respiratory conditions or viral infections
Viruses can also cause pneumonia. The influenza virus is the most common cause of viral pneumonia in adults. Pneumonia caused by the influenza virus can be severe and even deadly, especially in people with other health conditions such as heart or lung disease.
Coronavirus disease 2019 can also cause a severe type of double pneumonia that may lead to long-lasting lung damage. It may take several months to recover. Pneumonia associated with COVID-19 can sometimes be fatal, especially in high-risk populations like elderly adults.
Why Is Sepsis So Serious For People Who Are Aging
Sepsis is a very serious illness for anyone at any age, but it can be particularly devastating for seniors. Older severe sepsis survivors are more than three times more likely to see a drop in cognitive abilities that can make it impossible for them to return to their previous living arrangements. This often results in admission into a chronic healthcare facility. As well, the risk of dying from severe sepsis or septic shock rises as you get older.
Sepsis doesnt affect just the patient, researchers have discovered. The stress of having a family member who is so ill can take a toll on spouses or partners too, especially if they are the primary caregivers. For example, a study published in 2012 found that the wives of older sepsis survivors were at greater risk of developing depression, as much as three to four times the average. Depression can be very serious, affecting quality of life and even the ability to function independently.
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Health Conditions And Age Can Increase Risk Choose A Topic To Learn More
People living with asthma are at higher risk for pneumococcal pneumonia, compared to healthy adults in the same age range.
People living with chronic lung disease are at higher risk for pneumococcal pneumonia, compared to healthy adults in the same age range.
People living with chronic heart disease are at higher risk for pneumococcal pneumonia, compared to healthy adults in the same age range.
People living with diabetes are at higher risk for pneumococcal pneumonia, compared to healthy adults in the same age range.
People taking immunosuppressive medicines are at higher risk for pneumococcal pneumonia, compared to healthy adults in the same age range. This includes some medicines that treat psoriatic arthritis, rheumatoid arthritis, Crohnâs disease, or ulcerative colitis, among others.
People living with certain malignant cancers are at greater risk for pneumococcal pneumonia, compared to healthy adults in the same age range.
People living with chronic renal failure are at higher risk for pneumococcal pneumonia, compared to healthy adults in the same age range.
People living with a non-functioning spleen are at higher risk for pneumococcal pneumonia, compared to healthy adults in the same age range.
People living with HIV are at higher risk for pneumococcal pneumonia, compared to healthy adults in the same age range.
A Prompt Diagnosis For Proper Treatment
If you suspect your loved one may have pneumonia, you should call a doctor right away. Earlier diagnosis can lead to faster treatment that promotes better outcomes especially for seniors who are at a higher risk of developing serious complications.
A doctor will conduct a physical exam and may order imaging tests to confirm the diagnosis. Treatment will depend on whether the pneumonia is caused by bacteria, viruses, or other types of infection.
Bacterial pneumonia comes on gradually or suddenly and is typically treated with antibiotics.
Viral pneumonia usually develops over several days and may be accompanied by flu-like symptoms. Antibiotics are not effective against viruses, so viral pneumonia is generally treated with supportive care such as increased fluid intake, over-the-counter medications, and rest.
Older adults who experience severe pneumonia symptoms or have other health problems may need to be hospitalized. While in the hospital, treatment may include intravenous antibiotics, respiratory therapy, and oxygen therapy. Doctors will also watch for signs of complications.
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Stages Of Pneumonia In Seniors
Anyone can get pneumonia with symptoms ranging from mild to severe. Seniors may be more likely to get pneumonia and experience serious complications. Due to these higher risks, senior care providers need to recognize early pneumonia symptoms in seniors.
They also should understand the four stages of pneumonia so they can seek prompt treatment from a qualified healthcare provider.
What Other Treatments May Be Recommended
Additional treatments that may be used for pneumonia include:
- Fluids. Its important to make sure that you have adequate fluid intake when youre sick with pneumonia. If youre hospitalized, you may receive fluids by IV.
- Oxygen therapy. If youre hospitalized with pneumonia, oxygen therapy may be used to make sure that youre receiving enough oxygen.
- Rest. Getting plenty of rest can help your body respond to the infection. If you must perform daily activities, try not to overdo it and dont hesitate to ask for help, if necessary.
- Use heat and humidity. Drinking warm beverages or broths and using a humidifier may help to loosen mucus in your throat and chest.
- Over-the-counter medications. These can help ease symptoms like fever and discomfort. Examples include things like acetaminophen , ibuprofen , and naproxen .
with an increased risk of hospitalization and mortality when compared to other age groups. Symptoms can also be atypical and can quickly worsen.
Because of this, seeking prompt medical attention is essential in promoting a positive outlook.
The recovery period for pneumonia can vary based on the severity of your illness. Its possible that your symptoms may get better after a period of days or weeks.
However, in some people, the recovery period may be longer.
In order to improve outcome, its important that older adults whove had pneumonia pay close attention to the following during their recovery period:
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Bacterial Vs Viral Pneumonia Symptoms
Bacteria and viruses are the most common causes of pneumonia. Fungi and parasites can sometimes cause it.
When the cause is bacteria, the illness can come on either slowly or quickly. It tends to be more serious than other types.
When a virus causes your pneumonia, youâre more likely to notice symptoms over several days. Early signs will look like the flu — such as fever, dry cough, headache, and weakness — but get worse in a day or two.
What Causes Pneumonia
Pneumonia is caused by an infection of the lung. Most infections are caused by bacteria or viruses, although often a cause is never found. It can be triggered by a cold or the flu, which allows the germs to gain access to the lungs.
In severe cases of the coronavirus , breathing difficulties can develop into pneumonia. COVID-19 pneumonia is a serious illness that can be life-threatening.
Bacterial pneumonia may be caused by the pneumococcal bacteria, called Streptococcus pneumoniae. This is one of the most severe and potentially life-threatening types of pneumonia. Other types of bacteria that cause pneumonia are Haemophilus influenzae and Moraxella catarrhalis.
Viral pneumonia is caused by different viruses. The most common are the influenza virus, human adenovirus and the respiratory syncytial virus. It is thought about half of pneumonia cases are caused by a virus.
Another common cause of pneumonia is infection by mycoplasma, a kind of bacterium. Pneumonia caused by mycoplasma organisms is usually milder, but recovery can be longer.
Other organisms, such as fungi, can also cause pneumonia. This is more common in people whose immune systems are not working properly, such as those with HIV infection or people being treated for cancer.
Some people are more likely to get pneumonia or develop a more severe illness, including:
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Who Is At Risk
Anyone of any age can contract pneumonia, but those at a higher risk are:
People 70+ years young People with medical conditions such as diabetes, cancer or a chronic disease affecting the lungs, heart , kidney or liver Tobacco smokers Indigenous Australians Infants aged 12 months and under3
Its important to remember that no matter how healthy and active you are, your risk for getting pneumonia increases with age. This is because our immune system naturally weakens with age, making it harder for our bodies to fight off infections and diseases.