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Pneumonia in the Elderly

Pneumonia is an infection of the lungs that can be serious in older adults. In the U.S., nearly 250,000 people are hospitalized with pneumonia each year, and about 50,000 die from the disease, according to the Centers for Disease Control and Prevention (CDC). Seniors are at high risk for complications and death. If you suspect your elderly loved one has pneumonia, see the doctor right away.

Pneumonia is a respiratory infection that causes inflammation in the air sacs in the lungs, called alveoli. The alveoli may fill with fluid or pus, making it difficult for oxygen to flow through the bloodstream. This may cause breathing problems along with cough, fever, chills, and other symptoms. Pneumonia can affect one or both lungs. When it affects both lungs, it’s called double pneumonia. The severity of the infection depends on age, overall health, and what caused the infection.

Signs and symptoms of pneumonia may include:

  • High fever

  • Chills

  • A productive cough with phlegm

  • Shortness of breath

  • Chest pain when breathing or coughing

  • Fatigue

Sometimes, symptoms of pneumonia may be different among elders. Some may have a low-grade fever while others have a normal temperature. Some may be less alert, show signs of confusion, or experience changes in mental awareness. Adults 65 and older are more susceptible to pneumonia than younger people are. Seniors with pneumonia are also at increased risk for hospitalization, complications, and death. Pneumonia in elderly adults can often be serious and progress quickly. In fact, pneumonia is the second leading cause for hospitalization in elderly adults, according to the American Lung Association (ALA).

Researchers and doctors don’t fully understand why pneumonia is more aggressive in seniors. They believe it has to do with the normal aging process, which weakens the immune system and decreases lung function. Older adults also often have other underlying health conditions that can make pneumonia more severe, including asthma, chronic obstructive pulmonary disease (COPD), and heart disease. 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. COVID-19 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.

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 (pleura). 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 (ARDS), 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

Treatment for pneumonia depends on what caused it. The goal is to eliminate the infection, prevent any complications, and treat symptoms to help your aging loved one feel better. Bacterial pneumonia is treated with antibiotics. It’s important to take all the medicine as prescribed by the doctor, even if your loved one starts to feel better after a few days. Not taking the full course of antibiotics as prescribed can cause the infection to come back and the bacteria to become resistant to the medicine. This will make it more difficult to treat your loved one’s pneumonia. Viral pneumonia doesn’t respond to antibiotics. If your aging relative’s pneumonia is from a virus, the doctor may prescribe antiviral medication. However, in some cases, rest and treatment to help relieve symptoms is all that’s needed. Viral pneumonia usually heals in a few weeks, but if your loved one’s symptoms start to get worse, it’s important to see the doctor. Bacterial pneumonia is a possible complication of viral pneumonia.

Your loved one may receive treatment for pneumonia at home or at a hospital, depending on the severity of the disease, their age, and overall health condition. Your senior relative may need to be hospitalized if they have other respiratory or heart conditions. They may also need to be treated at a hospital if they need help breathing or if they have severe symptoms, including:

  • Confusion

  • Rapid breathing

  • Low blood pressure

  • A very low or very fast heart rate

If your loved one is recovering from pneumonia after a hospital stay and needs help with daily activities, consider a short-term stay at a skilled nursing facility such as Summit Rehab at Mitchell Hollingsworth.

You can help your aging loved one prevent pneumonia by encouraging them to follow these steps:

  • Get the pneumococcal vaccine- Talk to the doctor about what type of pneumococcal vaccine is right for your aging parent.

  • Get the flu shot each year- Pneumonia can be a secondary infection after an initial bout of influenza. People who get the flu shot have a lower risk of developing pneumonia as a complication of the flu.

  • Wash hands thoroughly and often- Especially before and after preparing food, before eating, and after using the bathroom.

  • Practice good health habits- Stay physically active, and eat a diet rich in fruits, vegetables, whole grains, and lean proteins.

  • Manage chronic conditions- Conditions can include asthma, COPD, diabetes, and more.

  • Don’t smoke- If you’re a smoker, talk to your doctor about help with quitting smoking.




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