Pneumonia in Seniors

What Is Pneumonia?

Pneumonia is a lung infection. It can be bacterial, viral, or fungal in origin. We’ll be focused mostly on bacterial pneumonia in this article. Luckily there is a way to help seniors avoid getting bacterial pneumonia. The most effective way is through a vaccine.

The risk factors for getting pneumonia are:

• age; research shows that young children and seniors are most at risk
• lifestyle habits like smoking and alcohol consumption
• pre-existing medical conditions
• chronic diseases
• overall immunity function

These factors will affect your likelihood of becoming ill with pneumonia. In this article, we will try to answer your questions about the incidence of pneumonia in older adults so you can better help yourself and your loved ones.

Did You Know? The National Council on Aging reports that Medicare usually covers the pneumococcal vaccine and one flu shot every season. If you have a Medicare Advantage plan, check your policy and ask your in-network doctor or pharmacy for the vaccine.

Types of Pneumonia

These are the most common types of pneumonia:

• Viral pneumonia is often mild. Symptoms occur gradually. A bacterial infection, however, can develop at the same time or after an incident of viral pneumonia.
• Bacterial pneumonia is often severe. Symptoms can either develop gradually or come on suddenly and affect one or more lobes of the lung. This type of pneumonia can appear on its own or occur after you have a cold or the flu. The most common cause of bacterial pneumonia in the U.S. is Streptococcus pneumoniae.
• Fungal pneumonia is most often found in people with a weakened immune system or chronic health condition. It can be very serious, and, unlike the above two types of pneumonia, it is not contagious.

Other types of pneumonia are named based on the places they are acquired. Health care-associated pneumonia, acquired in an institutional environment like an assisted living facility or other health care settings, may be dangerous as patients are already battling an illness — also due to the high rate of antibiotic resistance. Community-acquired pneumonia is a type of pneumonia acquired in a community setting outside of a health care environment.

What Are the Symptoms of Pneumonia in Seniors?

As with many illnesses, symptoms can vary from one person to the next. Signs of pneumonia may mimic other disorders, too. The following, however, are the most common symptoms of pneumonia in seniors; they should prompt you to get immediate medical attention:

• Shortness of breath or difficulty breathing. You might hear wheezing when inhaling and exhaling.
• Persistent cough. Often, the coughs are wet and produce phlegm or green/yellow mucus.
• Fever. Persistent fevers above 101° F can be accompanied by sweating, shakes, and chills. A fever that lasts more than 24 hours should be evaluated by a doctor.
• Chest or rib pain when breathing or coughing. In older adults, heavy coughing can fracture ribs and potentially cause spinal problems, such as a slipped disk or vertebrae alignment issues. The rib pain often develops due to chronic coughing.
• Fatigue. Pneumonia can be draining and leave older adults feeling exhausted. Their ability to breathe effectively and exchange oxygen and carbon dioxide is limited by pneumonia.
• Confusion or disorientation. Seniors may seem addled. People may confuse this as a sign of dementia. Any change in mental status should be reported to a doctor or in a facility, to the charge nurse.

How Is Pneumonia in Seniors Treated?

In most cases, antibiotics are used to treat bacterial pneumonia, either orally or through an IV. If your pneumonia is caused by a virus, you’re usually advised to rest, drink fluids, and buy OTC medications to increase your comfort. Fungal pneumonia is treated with antifungal drugs.

For those who are more fragile or who have other health issues, treatment might include: hospital admission, supplemental oxygen therapy with a nasal cannula, or breathing treatments administered by a respiratory therapist. In serious cases, the patient might be put on a ventilator.

What Is the Survival Rate for Seniors Who Have Pneumonia?

Seniors are more susceptible to pneumonia than other adults and more likely to have complications develop from it. According to the Centers for Disease Control (CDC), pneumococcal pneumonia causes 150,000 hospitalizations annually in the United States.

The mortality rate of patients hospitalized for pneumonia is quite high with an average of 40,000 to 50,000 deaths each year. That can be alarming, but keep in mind that most seniors do recover.

A patient’s prognosis and recovery will depend on a variety of factors. Age is an important determinant; the older an individual is, the higher their likelihood of experiencing severe complications or death. The reasons for this are understandable. To start, seniors might not realize they have pneumonia early on and don’t get treated until the pneumonia is severe. They also are more likely to have weakened immune systems, pre-existing ailments, and other serious conditions.

What Is the Recovery Time for Pneumonia in Older Adults?

Recovery time for pneumonia depends on the patient. It can take much longer for a senior to get back to their regular level of independence and function. According to the American Lung Association, recovery can take a week at minimum, and a month or longer with higher-risk groups, such as older adults. Most will feel tired for about a month and need rest to make a full recovery and avoid relapse.

A study published in the International Journal of Chronic Obstructive Pulmonary Disease found that recovery time for seniors over 65 with pneumonia varied. Seniors might reach a level of clinical stability within one to two weeks of hospitalization; however, their complete recovery, which included the resolution of all symptoms and an ability to function, took longer. The biggest factors that affected recovery time were age, other comorbidities, and the severity of the illness. Some patients needed up to two months for a full recovery.

Ways to Prevent Pneumonia

The most effective way for older adults to prevent getting pneumonia and to reduce the severity of the condition if they do get sick is to get the pneumococcal vaccine. The CDC recommends adults 65 years or older get the PCV15 vaccine (followed by a dose of PPSV23 one year later) or the PCV20 vaccine (which doesn’t require a follow-up dose of PPSV23). These vaccines are designed to protect against the bacterial infection.

Unfortunately, the CDC found disparities among those who are getting the vaccines. The rate of vaccination is higher for white older adults and lower for people of color: Whites 70.1 percent, Blacks 54.8 percent, Hispanics 46.2 percent, and Asians 55.8 percent.

The lower level of minorities getting the vaccine is problematic. Black and Latino American communities already have a greater risk of developing asthma and diabetes, which increases the likelihood they will get pneumococcal pneumonia.

Be sure to also schedule vaccinations that protect you against viruses. That means staying current on your flu and COVID vaccines, too. Remember that illnesses from viruses can also lead to pneumonia. Lastly, be sure your grandchildren are up to date on their vaccinations.

The bacteria that most commonly causes pneumonia is spread by touching infected surfaces, coughing, and sneezing. In addition to getting vaccinated, you can reduce your risk of getting and spreading pneumonia through a few approaches. Besides the common-sense approach of staying away from those who have a bad flu and not sharing utensils with those who are sick, use good hygiene and live a healthy lifestyle.

• Be sure to wash your hands with soap and water before eating, before handling food, and after using the restroom. The CDC has a wonderful fact sheet about handwashing with step-by-step instructions. Use hand sanitizer in the absence of soap and water.
• Cough or sneeze into a tissue and throw away that tissue, which will help reduce the transmission of pneumonia and other germs. If you have no tissue, cough or sneeze into your elbow, not your hands.
• Eat healthy and nutritious foods, exercise regularly, and get enough rest.
• Stop smoking.
• Limit alcohol use.

Go to a doctor right away if you are a senior who is having difficulty breathing, if you are experiencing chest pain, a high fever, as well as a persistent cough. Pneumonia is serious in older adults, but the outcome can be good if you are diagnosed and treated quickly.