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  • There are many health challenges in the elderly that are unique to this population. As a body ages, the risk for falls, fractures and specific illnesses increase. Even if a person has been relatively healthy for most of their life, decreased mobility and the effect of aging on the organs make certain risks a reality. When working with elderly patients, it is critical that they are as mobile as possible. Decreased mobility can lead to falls from lack of balance or stiffness, bedsores and, in certain cases, pneumonia.

    Pneumonia is a serious, but treatable illness at any age. In the elderly, however, it can be deadly and must be treated early and aggressively. It is characterized by an abnormal inflammation of the lungs. As the lungs become inflamed, liquid can build up in the lung tissue and the infection can spread to the whole body. The contagious part of the disease is actually the bacteria or virus that caused the illness and that can be passed by unclean hands or airborne droplets from sneezes or coughs, the same transmission as the flu or the common cold.

    There are several elevated risk factors in the elderly for developing pneumonia. Patients with compromised immune systems or chronic illnesses are susceptible. Other elevated risk factors include a diagnosis of Alzheimer’s disease, a history of smoking or chronic lung disease, swallowing difficulties due to muscle weakness (generally seen with Parkinson’s disease, stroke or dementia), poor dental hygiene and a history of pneumonia or hospitalization.

    The elderly are also more susceptible because they are often undernourished, further weakening their immune systems. If they are housed in a community setting, the spread of germs and illnesses is always a reality and even if they are not, breathing stagnant air can increase the risk of respiratory illnesses. Due to bone and muscle loss, elderly patients are often cold and don’t want to open the windows to let air circulate, so HEPA air filters are always a good idea for residences.

    Elderly patients may not know they are sick or put off visiting the doctor until it is too late. They may be used to not feeling well or simply not want to go through the hassle of a doctor appointment. Most often, elderly patients are on a great many medications to treat other illnesses or ailments and occasionally the combination of drugs in their system may even mask the severity of the illness initially. In the case of patients with dementia, they may not be able to effectively communicate symptoms, so it is critical to monitor the health of these patients and intervene at the first sign of illness. In fact, pneumonia is the leading cause of death in patients with severe dementia and one of the leading causes of death in general for the elderly, early detection is essential.

    Important symptoms to note are increased coughing; especially coughs that are more productive, shallow breaths, chest pain, chills and/or sweating that may or may not be accompanied by fever and a bluish tint to the lips. Since there are two forms of pneumonia; bacterial and viral, symptoms can differ from patient to patient. Some pneumonia is characterized by a productive, wet cough and others by a dry, hacking cough. Headache and muscle pain are other symptoms not to be ignored, but elderly patients often overlook them since they are common with aging. In patients with dementia or Alzheimer’s disease, it is important to monitor heart rates, changes in weight and abdominal pain and diarrhea, as they are symptoms that are not easy for the patient to recognize.

    One of the main reasons elderly patients are at a higher risk of developing pneumonia is that they spend too much time in bed. Being upright allows the lungs to expand more easily and cough, so any type of activity, even walking to the bathroom and back to a chair is better than lying in bed. Every attempt to get the patient walking or sitting upright should be made to reduce the risk of developing pneumonia.

    The treatment of pneumonia differs based on the initial cause. It can be treated with antibiotics, supplemental oxygen, and other drugs depending upon the type of pneumonia. Recovery in the elderly is almost always longer than other patients. Hospital stays of 7 – 10 days are not uncommon, and recovery can take longer depending on the patient. Relapses are common, so aftercare is essential to monitor progress and look for symptoms of recurrence.

    Proper nutrition, dental hygiene, treatment of common illnesses and maximum mobility are all good steps in preventing the occurrence of pneumonia. Careful monitoring of the elderly is critical, especially in the case of dementia or Alzheimer’s disease to ensure that the patients are not presenting with any symptoms. As with any illness, there is no guarantee that a patient will not get sick, but proper prevention and early detection are essential in ensuring that the duration and severity are minimized.

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