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.
Treatment For Pneumonia In A Heart Failure Patient: What To Expect
An elderly person with pneumonia, who has pre-existing heart failure, presents a tricky situation to doctors.
My very elderly father, who has congestive heart failure, was diagnosed with pneumonia at an urgent care center. The doctor wanted him admitted to a hospital.
When my mother was diagnosed with pneumonia for the first time at an elderly age, she too, had congestive heart failure, but was not admitted, and instead, sent home with a prescription for antibiotics and recovered.
A few years later she developed pneumonia a second time and was admitted overnight in the observation unit, but discharged the next day with a prescription for antibiotics and recovered.
I anticipated that my father, whose heart was seemingly stronger than my mothers, would be discharged the next day with a prescription for antibiotics.
But he was discharged from the hospital seven days later.
Heres a summary of how the pneumonia treatment went down, due to the pre-existing heart failure.
The pneumonia treatment involved an IV infusion of fluids. Due to the pre-existing heart failure, my father was on Lasix, a diuretic that promotes fluid excrement from the body.
Early on in his admission, my fathers weight went up, which meant unwanted fluid retention.
It was not clear exactly how much of this was being caused by the IV infusion of fluids any fluid buildup in the lungs from the pneumonia or the pre-existing heart failure being worsened by the infection.
Peripheral edema. Shutterstock/AppleDK
It Might Feel Like A Cold
Walking pneumonia is how some people describe a mild case of pneumonia. Your doctor might call it âatypical pneumoniaâ because itâs not like more serious cases.
A lung infection is often to blame. Lots of things can cause it, including:
- Inhaled food
Walking pneumonia usually is due to bacteria called Mycoplasma pneumoniae.
You probably wonât have to stay in bed or in the hospital. You might even feel good enough go to work and keep up your routine, just as you might with a cold.
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Treatment Of Viral Infections
There are not as many choices for treating viral pneumonia. Oseltamivir , zanamivir , and peramivir have been the recommended drugs for influenza A or B infections, but some strains of influenza A are resistant to them. Generally, the use of these drugs is only recommended if they can be started in the first 48 hours of symptoms. Taken early, these medications may be effective in reducing the severity and duration of illness. However, treatment initiated even after 48 hours may benefit children with severe disease.
Intravenous immunoglobulins may be used in immunodeficient children who develop some viral pneumonias, as they have been shown to improve outcomes.
People with viral pneumonias are at risk for what are called “superinfections,” which generally refers to a secondary bacterial infection, usually caused by S pneumoniae, S aureus, or H influenzae. Doctors most commonly recommend treatment with amoxicillin-clavulanate, cefpodoxime, ceftriaxone, cefuroxime, or a newer fluoroquinolone if these secondary infections occur.
People with pneumonia caused by varicella-zoster and herpes simplex viruses are usually admitted to the hospital and treated with intravenous acyclovir for 7 days.
No antiviral drugs have been proven effective yet in adults with RSV, parainfluenza virus, adenovirus, metapneumovirus, coronaviruses, or hantavirus. Treatment is largely supportive, with people receiving oxygen and ventilator therapy as needed.
How To Prevent Pneumonia In The Elderly
Fortunately, pneumonia in the elderly can be prevented. Here are some ways to prevent it:
- Influenza vaccine. While the influenza vaccine doesn’t work as well in the elderly as in young people, it can afford some protection against viral pneumonia. If they do get a case of the flu, it is often milder and causes pneumonia to a lesser degree. The influenza vaccine is given yearly.
- Pneumococcal vaccine. This is a type of vaccine that protects against many different strains of bacteria that result in pneumonia. It is important to remember that the pneumococcal vaccine doesn’t last as long as it does in younger people. You should get your first shot around age 50 and a second shot at the age of 65. New vaccinations should be given every five years or so.
- Hand washing. Hand washing is important in the prevention of the spread of diseases like pneumonia.
- Good health habits. The elderly should try to get enough exercise and enough sleep, as well as eating healthy foods to improve their resistance to getting pneumonia. They should also stay away from people who are suffering from a cold or flu.
- Dental hygiene. Pneumonia can occur from the bacteria that gather around teeth that are infected. Teeth should be brushed and dental work should be taken care of by the dentist.
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Bronchitis Vs Pneumonia: Why Theyre Related And How Theyre Different
A pneumonia diagnosis is based on your medical history, a physical exam, and certain test results. Your doctor determines which type of pneumonia you have based on how you became infected, what your X-ray or lung exam reveals, and which kind of germ is responsible for your infection.
During a physical exam, your doctor will check your vital signs and listen to your lungs with a stethoscope. Decreased breath sounds is an indication of a lot of inflammation, says Michelle Barron, MD, a professor in the division of infectious diseases at University of Colorado School of Medicine in Aurora.
If your doctor suspects pneumonia, they may order further diagnostic tests, such as a chest X-ray to help determine the extent of the infection. Blood tests and an analysis of the patients sputum can pinpoint whats causing the pneumonia. Pulse oximetry measures the oxygen level in your blood .
Caring For A Senior With Pneumonia
When a senior comes down with any illness, in-home or in-hospital, they will need plenty of time to rest and recover. In this case, having a family member or professional caregiver around is a necessity. A caregiver can provide nursing care by ensuring the intake of prescribed medication, giving the senior cough medicine or pain relievers as needed, making sure they get plenty of sleep, and monitoring any changes in their condition.
If youd like to learn more about our elderly home care services, please feel free to for a consultation.
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Pneumonia Arising In Institutional Settings
- Hospital-Acquired Pneumonia. Hospital-acquired pneumonia is an infection of the lungs contracted during a hospital stay. This type of pneumonia tends to be more serious because patients in the hospital already have weakened defense mechanisms, and the infecting organisms are usually more dangerous than those encountered in the community. Hospital patients are particularly vulnerable to Gram-negative bacteria, which are resistant to many antibiotics, and staphylococci. Hospital-acquired pneumonia is also called nosocomial pneumonia.
- Ventilator-associated pneumonia . A subgroup of hospital-acquired pneumonia is VAP, a very serious infection contracted by patients on ventilators in hospitals and long-term nursing facilities.
- Nursing-home acquired pneumonia. Pneumonia acquired in a nursing home or other long-term care facility is the second most common type of infection in these facilities, and it is usually bacterial. This type of pneumonia is sometimes difficult to diagnose as older populations are less likely to report fever, chills, and chest pain. Chest radiography and physical exam are necessary. Sputum sample and antigen tests may be helpful.
The term “healthcare associated pneumonia” is also utilized for all the above types of pneumonia as a group.
Causes And Risk Factors Of Pneumonia
How do you get pneumonia? The majority of the germs that cause infection are spread from person to person through droplets, from coughing or sneezing.
- A weakened immune system due to human immunodeficiency virus or cancer
People who smoke are at higher risk for pneumonia, as are people on immunosuppressive medications, and people who are frequently in close, crowded spaces with others, such as college students and military personnel.
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Why Is Pneumonia More Common In The Elderly
Because of how common and deadly this disease can be to those in the later stages of their lives, it may seem as if pneumonia specifically targets seniors. However, there are many reasons for this. Risk factors for pneumonia include:
- Overall Health: Many seniors already suffer from other medical afflictions, meaning they have weakened immune systems and have a harder time fighting off infections
- Weaker Lungs: Pneumonia is caused by fluid buildup in the lungs, making breathing difficult and leading to violent coughing fits. Older adults generally have more difficulty coughing and clearing their airways, which means the infection can reach their bronchial tubes very easily. Coughing is the bodys natural way of expelling pathogens from the lungs, and without this ability, it becomes much easier to contract infections
- Comorbid Diseases: Certain conditions, such as diabetes, Parkinsons, heart diseases, and lung diseases , which often affect the elderly, are risk factors for pneumonia
- Chemotherapy or radiation therapy: These cancer treatments can lead to inflammation of the lungs. This is different from the infectious type of pneumonia, but may cause similar long-term health effects. Seniors who have recently undergone cancer treatment are therefore at a higher risk
The Symptoms Associated With Pneumonia
So, what are the things that can warn you of a pneumonia infection? The first thing you should know about is all the risk factors that we have already looked at. Seniors who are sick and those that have issues coughing are at a risk.
Also, those that have an immune system that is compromised and living under institutional settings are also at a very high risk of contracting the illness. When you know the risk factors, then you can easily put pneumonia into perspective. A senior may experience sudden cough fits, but that does not mean they are infected.
However, this is not to mean that such a senior is not likely to develop the issue as time passes on. When a cough is persistent, you should be concerned because it is a sign of disease that can precede pneumonia. Chest infection symptoms could be an indication of pneumonia onset.
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Blood Pressure Pneumonia And Lasixreatment
I was told by two doctors that pneumonia lowers blood pressure. So between the Lasix and the pneumonia, the doctors were faced with a tricky situation.
Fluid infusion is vital for treating pneumonia, but fluid infusion also adds to fluid overload, which is precisely what we want to prevent in someone with heart failure.
You can see just how really sticky this is getting. Its not cut and dry. Its a day by day thing.
The goal was to get my fathers weight back down to its baseline while effectively treating the infection and preventing dangerous fluid overload while getting his blood pressure back up to normal.
I was concerned that his reduced appetite would create a false illusion of fluid weight loss because he wasnt eating as much, so I encouraged him to eat as much as he could .
The Lasix ultimately had been pulled for only one dose. But it was something, along with the low blood pressure readings, that the doctor watched like a hawk.
The first night of his admission I was told some unnerving news: That if they couldnt get his blood pressure up with conservative measures, hed have to get a particular drug to do this but the drug would require a central line IV.
A specially trained nurse sets this up, and its done in the ICU, which meant that if my father needed this procedure hed have to be transferred to the ICU.
Thank goodness next day I was told this was no longer a consideration, and he remained in Intermediate Care.
Symptoms Of Pneumonia In Adults 65 And Over
- Weakness and fatigue
- Cough, especially a wet one that produces phlegm
- Shortness of breath
- Confusion or disorientation
Its easy to confuse these symptoms of pneumonia in adults 65 and over with those of a cold or the flu, or with the effects of aging, but they shouldnt be ignored. Report potential pneumonia symptoms to a doctor right away.
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Treatment And Medication Options For Pneumonia
A lot of treatment aspects, as well as outcome, depend on the person, as well as the type of pneumonia they have, says Dr. Barron. Sometimes youll be fine just resting, but if you have things like trouble breathing, you should get to a doctor right away.
Your doctor will outline a plan that’s specific to you, considering the type of pneumonia you have, the severity of the condition, your age, and your overall health. From there, you’ll know whether you can be treated at home or need to go to the hospital, and whether you require antibiotics.
What Stands Out About Yale Medicines Approach To Pneumonia
Pneumonia is a common infection in both children and adults and can often be easily treated. However, if specialized care is required, Yale Medicine physicians practice at both Yale New Haven Hospital and Yale New Haven Childrens Hospital.
Furthermore, our researchers are involved in developing ways to more quickly and accurately diagnose lung infections through the Yale Center for Pulmonary Infection Research and Treatment . We dont tend to think of pneumonia as a chronic condition. But some patients end up with longer-term problems, says Dr. Dela Cruz, director of the CPIRT. The center focuses on finding new potential treatment options and running clinical trials to better understand the disease.
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How Antibiotics Are Administered
If the doctor agrees to antibiotics treatment for pneumonia and dementia the drugs can be administered in two major ways.
1. Pills to swallow2. Injections
The strongest antibiotic types are given by an IV infusion or injection. This sends the medicine to the veins directly through a tube or needle.
Anyone subject to IV antibiotics may require frequent hospitalization and blood tests.
As an alternative, the person taking the drugs can work with a nurse at home who will be administering the antibiotics when necessary.
In some cases, restraining the person taking the medicine may be inevitable.
This is because dementia in the middle and later stages can make an individual confused thus, may not understand why they need the IV and want to get rid of it.
Can Pneumonia Be Prevented Or Avoided
There are many factors that can raise your risk for developing pneumonia. These include:
People who have any of the following conditions are also at increased risk:
- chronic obstructive pulmonary disease
- sickle cell disease
You can help prevent pneumonia by doing the following:
- Get the flu vaccine each year. People can develop bacterial pneumonia after a case of the flu. You can reduce this risk by getting the yearly flu shot.
- Get the pneumococcal vaccine. This helps prevent pneumonia caused by pneumococcal bacteria.
- Practice good hygiene. Wash your hands frequently with soap and water or an alcohol-based hand sanitizer.
- Dont smoke. Smoking damages your lungs and makes it harder for your body to defend itself from germs and disease. If you smoke, talk to your family doctor about quitting as soon as possible.
- Practice a healthy lifestyle. Eat a balanced diet full of fruits and vegetables. Exercise regularly. Get plenty of sleep. These things help your immune system stay strong.
- Avoid sick people. Being around people who are sick increases your risk of catching what they have.
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Occupational And Regional Pneumonias
Exposure to chemicals can also cause inflammation and pneumonia. Where you work and live can put you at higher risk for exposure to pneumonia-causing organisms.
- Workers exposed to cattle, pigs, sheep, and horses are at risk for pneumonia caused by anthrax, brucella, and Coxiella burnetii .
Inhalation or respiratory anthrax is a life-threatening infectious disease caused by inhaling the spores of the bacterium Bacillus anthracis. Although the spores are dormant when breathed in, they germinate when exposed to a warm, moist environment, such as the lungs. Not all particles are small enough to pass into the alveoli, or air sacs, but those that do begin to multiply and may spread to the lymphatic system. When the spores germinate, several toxins are released. Particles illustrated are not to scale.
- Agricultural and construction workers in the Southwest are at risk for coccidioidomycosis . The disease is caused by the spores of the fungi Coccidioides immitis and Coccidiodes posadasii.
- Those working in Ohio and the Mississippi Valley are at risk for histoplasmosis, a lung disease caused by the fungus Histoplasma capsulatum. This fungus grows well in areas enriched with bird or bat droppings.
Types Of Walking Pneumonia
Walking pneumonia is one of more than 30 different types of pneumonia. It can be divided into a few different subtypes, including:
This type of pneumonia tends to be mild, and most people recover without treatment. Its caused by the bacterium Mycoplasma pneumoniae . The Centers for Disease Control and Prevention estimates that there are about of M. pneumoniae infections each year in the United States.
This type of walking pneumonia is caused by Chlamydia pneumoniae bacteria. While it can cause a serious infection, most people experience only mild illness or no symptoms whatsoever. Its common among school-age children and young adults.
Legionnaires disease is one of the most serious types of walking pneumonia, as it can lead to both respiratory failure and death. Its caused by Legionella, a type of bacteria found in freshwater that can contaminate water systems in buildings. People can get this disease if they inhale airborne droplets of water that contain the bacteria.
Walking pneumonia symptoms are typically mild and look like the common cold. People may start noticing signs of walking pneumonia between 1 and 4 weeks of being exposed to the pathogen that caused the disease.
Symptoms of walking pneumonia can include:
- loss of appetite
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