Pneumonia In Elderly: Causes, Treatment, And Recovery

Pneumonia in elderly (age 65 or older) is a global issue and of utmost concern. Understanding pneumonia symptoms, its causes, prevention, diagnosis, treatment, complications, recovery time and survival rates can be very useful while caring for older people with pneumonia.

Pneumonia is a lung infection commonly caused by bacteria, viruses, fungi or other species. This infection triggers fluid outpouring in the affected portion of the lungs, which affects either one or both of the lungs. Blood flow to the infected portion of the lung decreases, which means that bloodstream oxygen levels can decrease.

Pneumonia infection is very frequent and potentially serious. Elderly people (age 65 or older) are more susceptible to pneumonia than younger individuals and are more likely to die from this disease.

Older patients with pneumonia that requires hospitalization are more likely to develop complications that require longer stays in the hospital. Pneumonia in elderly people occurs quickly and the prognosis is poor and elderly people are susceptible to severe pneumonia. The mortality rate is as high as 20% for serious pneumonia.

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Pneumonia in elderly is the second most common reason for medicare recipients to be hospitalized. There is a high mortality rate, especially among the elderly.

What Are The Pneumonia Symptoms In Elderly?

Like many diseases, signs and symptoms vary from person to person and can also mimic other disorders. In general, the following are common signs and symptoms of older people with pneumonia:

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  • Productive cough (wet and moist with mucus)
  • Fever
  • Tiredness
  • Chest Pain
  • Pain in the rib cages
  • Difficulty breathing
  • Chills
  • Diarrhoea
  • Nausea and vomiting
  • Confusion

As mentioned, the pneumonia symptoms vary from person to person and change based on the health level of the infected person. Those with chronic disease have the most difficult time, but even in the healthiest of our elders, pneumonia can be deadly.

What Are The Pneumonia Causes?

General causes of pneumonia in the elderly includes:

  • Bacteria infection by Streptococcus pneumoniae and Mycoplasma pneumoniae
  • Viruses which includes; influenza A and B viruses, coronaviruses, rhinoviruses, parainfluenza viruses, and adenoviruses.
  • Fungi especially those found in the soil and bird droppings

How Can Pneumonia In Elderly Be Diagnosed?

A case of pneumonia in elderly may be confirmed by simple diagnostic tests. A physician listening to the lungs of a patient can hear bubbling noises; rales and rattling sounds called rhonchus, signalling lung infection and inflammation.

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The medical information provided in this article is provided as an information resource only. This information does not create any patient-physician relationship and should not be used as a substitute for professional diagnosis and treatment.

A test of pulse oximetry calculates the levels of oxygen in the blood.

A chest x-ray or CT scan is often the definitive diagnosis which shows the doctor where the infection is and the severity of the disease.

Sometimes the phlegm and blood of the patient will be examined by a physician to determine what organism is responsible for the infection.

How Can Pneumonia In Elderly Be Prevented?

There are various ways pneumonia can be prevented. They include;

  • Getting vaccinated
  • Maintaining good hygiene
  • Building your immune system
  • Avoiding smoke

Pneumonia Treatment

pneumonia in elderly

It is according to the organism that caused the disease, that the patients are treated. The medical provider of your loved one can determine this by analyzing a phlegm or blood sample.

Take any medications that your doctor prescribes. If bacteria are responsible for your pneumonia, you will receive an antibiotic. It’s important to take all the antibiotics until it’s gone, although in a couple of days you’ll likely start feeling better. If you stop, you risk the infection returning, and you increase the chances of future treatment resistance of the germs.

In addition; get enough rest, drink hot/warm beverages, bath with hot water, drink lots of fluid, and avoid smoke.

Stages Of Pneumonia In Elderly

Pneumonia has four stages, namely; consolidation, red hepatization, grey hepatization and resolution.

  1. Consolidation Stage: Occurs within the first 24 hours. Cellular exudates containing neutrophils, lymphocytes and fibrin replace alveolar air. Capillaries in the surrounding alveolar walls become overcrowded. Infections spread to the hilum and pleura quite quickly. Pleurisy occurs marked by coughing and deep breathing.
  2. Red Hepatization Stage: At this point, the consistency of the lungs resembles that of the liver. The lungs become hyperaemic. Alveolar capillaries are engorged with blood. Fibrinous exudates fill the alveoli. This stage is characterized by the presence of many erythrocytes, neutrophils, desquamated epithelial cells and fibrin in the alveoli.
  3. Grey Hepatization Stage: Occurs 2-3 days after Red Hepatization. This is an avascular stage. The lung appears to be grey-brown to yellow due to fibrinopurulent exudates, red cell disintegration and hemosiderin. The exudate pressure in the alveoli causes capillary compression. Leukocytes migrate into congested alveoli.
  4. Resolution Stage: This phase is marked by the resorption and regeneration of the pulmonary structure. A large number of macrophages enter the alveolar spaces. Phagocytosis of the bacteria-laden leucocytes occurs. Consolidation tissue re-aerates and fluid infiltration cause sputum. Fibrinous inflammation may spread to and across the pleural area, causing rubbing to be detected via auscultation and leading to sputum.

Pneumonia In Elderly Recovery Time

Recovery from bacterial pneumonia in elderly is slow and therefore takes time. Most people feel better and can return within a week to their normal routines. It may take a month or more for other people. For about a month, many people are still feeling tired. To maintain progress towards full recovery and to avoid recurrence, adequate rest is necessary. Don’t hurry to recover! Talk to your doctor if you can return to your normal routine.

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Sometimes, the pneumonia that seemed to be gone can return. Watch for any new or worse symptoms when caring for a senior with pneumonia and report them to a doctor immediately.

If you have taken antibiotics, after finishing the whole prescription, the doctor will want to make sure that your chest X-ray is normal again.

Pneumonia In Elderly Survival Rates

While a person who contracts pneumonia usually needs 7 to 10 days to recover, if at all, the duration may be much longer for the elderly with pneumonia.

There is a high mortality rate for elderly people with pneumonia. As much as 30% of people treated in a pneumonia hospital die from it.

Elderly people have a more difficult time recovering from pneumonia compared to a younger person who develops the disease.

Complications of Pneumonia In Elderly

Possible complications can occur in the elderly. Respiratory failure can occur requiring a respirator or ventilator. Sepsis can occur. Sepsis is a condition in which the body’s inflammation is uncontrolled, which can lead to widespread organ failure.

A severe form of respiratory failure, acute respiratory distress syndrome (ARDS) can occur.

Lung abscesses that are rare but serious can occur in pneumonia complications. They occur when inside or around the lung pus pockets form. These may need to be drained with surgery sometimes.

How Does Congestive Heart Failure Lead To Pneumonia?

Research shows that 20 percent of people in the pneumonia hospital also have heart problems, and researchers are investigating why. Some possible reasons include heart-entry bacteria, the stress of the disease that increases the chance of a heart problem, or your body does not send enough oxygen to your organs. The chances of having a pneumonia-related heart problem are higher if you are an older person, are in the hospital or have a heart condition already.

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Your doctor may search for heart failure by listening to your heart, testing your blood, or examining X-ray, electrocardiogram, echocardiogram, CT scan, or MRI results. Many medicines and procedures can help you with heart failure management.

Overview Of Pneumonia In Elderly (Infographic)

Overview Of Pneumonia In Elderly (Infographic)
Image Credit: Shutterstock

Frail elderly people who are already susceptible to infection should be kept away from anyone with the flu or a bad cold. Naturally, it is always preferable to treat pneumonia in the elderly. But if you believe that your loved one has pneumonia, it can be a life-saving event for rapid intervention.

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