Signs of pneumonia in elderly people

Pneumonia is a condition that can cause serious health complications and can sometimes even be fatal, especially in those at higher risk, such as the elderly. However, it can also be challenging to spot pneumonia, because some of the signs and symptoms can be similar to those caused by other, less serious, conditions and infections. Diagnosing and treating pneumonia in the elderly as quickly as possible can make a big difference to a positive outcome and recovery.

In this article, we look at the most common causes, symptoms and signs of pneumonia in elderly people, so you can know what to look for if you have an older loved one. We also look at the different types of treatment that might be recommended and how minimise the chances of elderly people getting pneumonia in the first place.

Jump to:

• What is pneumonia?
• Signs of pneumonia in older adults
• Why are elderly people more at risk from pneumonia?
• What causes pneumonia in the elderly?
• How is pneumonia in the elderly treated?
• Preventing pneumonia in the elderly
• Peace of mind if your elderly loved one lives independently

What is pneumonia?

Pneumonia is inflammation of the lungs that is caused by an infection. Most healthy people can recover from pneumonia in a few weeks with treatment at home, but those at risk of serious illness may need hospital treatment.

The most common kind of pneumonia is caused by a bacterial infection, but there are other types of pneumonia, which are:

• Viral pneumonia, which can be caused by the flu or another kind of virus
• Aspiration pneumonia, which can be caused by breathing in harmful substances or foreign objects
• Fungal pneumonia, which is rare in the UK, but can affect some people with a weakened immune system
• Hospital-acquired pneumonia, which can happen if someone is in intensive care on machines that help them to breathe.

Signs of pneumonia in older adults

Pneumonia is a condition where signs can gradually develop over several days, but symptoms may also start suddenly, so it’s important to be aware of what to look out for.

Common signs of pneumonia include:

• A cough; either a dry cough or a cough that produces yellow, green, brown or bloody phlegm
• Having difficulty breathing or feeling breathless, even when resting
• Having a rapid heartbeat
• Having a fever, which may include both sweating and shivering
• Feeling unwell generally
• Chest pains, which get worse when coughing or breathing in or out
• Losing appetite.

Some less common symptoms of pneumonia include:

• Coughing up blood
• Nausea or vomiting
• Headaches
• Joint and muscle pain
• Fatigue
• Wheezing, even when resting
• Confusion or disorientation.

Many of the symptoms of pneumonia can easily be confused as relating to other conditions, such as flu or underlying conditions that are already known about. It’s important to seek medical advice if your elderly loved one shows signs of pneumonia and if any of their symptoms get worse.

Why are elderly people more at risk from pneumonia?

Pneumonia can affect people of any age, but it can often be more serious in older adults. Of those that die from pneumonia, over 85% of these are over the age of 75.

The reasons that it can be riskier for older people include:

Weaker immune system

As people age, their immune systems tend to naturally become weaker over time. This means that the elderly are often less able to fight off pneumonia or the infections that cause it, and can also mean they are more likely to have complications from pneumonia than other age groups.

Underlying health conditions

Some underlying health conditions can increase the risk of developing pneumonia and some medications for other conditions are also known to suppress the immune system. Older people are more likely to have one or more of these other health conditions and their bodies can find it much more difficult to fight off pneumonia.

More time spent in hospitals or care facilities

Older people are more likely than any other age group to need a stay in hospital or another care facility, and to remain there longer than most. This unfortunately means that they are more likely to be exposed to the bacteria and viruses that can cause pneumonia, as they can sometimes spread in these environments.

Issues with swallowing or impaired breathing

It’s common for elderly people to develop issues with swallowing (dysphagia) and this can increase the risk of breathing materials into the lungs. Along with this, many older people can have impaired breathing from other conditions, such as COPD, and this can also mean that they are less likely to be able to fight off the infections that cause pneumonia.

What causes pneumonia in the elderly?

Pneumonia is caused by an infection, and the source of this infection can depend on which type of pneumonia has developed.

Most people who are diagnosed with pneumonia have a bacterial infection, although it can sometimes be caused by a viral infection like the flu. Older people are especially at risk of this during flu season and if they haven’t had their flu vaccine.

Pneumonia can sometimes develop in the elderly who are in hospital or a residential care setting because infections and contagious diseases can spread more easily in these situations.

Pneumonia can sometimes be developed as a result of breathing in food particles or liquid by accident, instead of swallowing. This can sometimes cause an infection that leads to pneumonia.

How is pneumonia in the elderly treated?

Treatment for pneumonia will depend on the individual with the condition and their circumstances. For most people with pneumonia, treatment with antibiotics is often enough to help them recover in a few weeks. However, for those over the age of 65 or with other health conditions that affect their breathing, immune system or heart, or those that have tried antibiotics but haven’t recovered, they may need hospital treatment for pneumonia.

Along with being given strong antibiotics in hospital, those being treated as an in-patient may be given fluids and oxygen and may be sent for chest x-rays and other tests too.

Preventing pneumonia in the elderly

There is a vaccination called the pneumococcal vaccine, also known as the pneumonia vaccine, which helps to protect older people from an infection that can cause pneumonia. It is available on the NHS to adults aged over 65, along with others considered at high risk of pneumonia.

It’s also recommended that older people get their annual flu vaccine, as the flu can cause viral pneumonia in some. As the flu virus changes every year, the vaccination also does, so it’s important to get this every year if possible. This is also available on the NHS to over 65s and many pharmacies offer this, so an appointment at a GP surgery isn’t needed in order to have the flu vaccine.

Taking up a Covid-19 booster can also reduce the risk, as pneumonia can result from someone having Covid.

Smoking (along with passive smoking by breathing in someone else’s smoke) can damage the lungs and reduce their function, which increases the risk of pneumonia, along with several other serious health conditions. Therefore, if an older person smokes, stopping this can help bring down their risk of pneumonia.

Washing hands regularly with soap and water can help prevent bacterial and viral pneumonia as these organisms can live on surfaces for some time. Using regular handwashing and antibacterial gel can help prevent them from spreading.

Peace of mind if your elderly loved one lives independently

If you have an elderly friend or relative who lives independently, especially if they live alone, it’s natural that you might worry about their health and welfare when you’re not there to keep an eye on them. Perhaps you’re concerned that an older adult in your life is at risk of a fall, an accident, or health conditions, such as pneumonia.

One thing that could help provide peace of mind when you’re not around is a monitored personal alarm system.

This kind of system involves the elderly person wearing an alarm device, usually as a pendant around their neck or on their wrist, like a watch. If they have an accident or fall, feel unwell or have another emergency, they can simply press the alarm button and be connected to a 24/7 Emergency Resolution Team. The team can speak to the alarm wearer, and can get in touch with the nominated contacts or arrange emergency assistance, if needed.

This can offer real peace of mind to the loved ones of an older adult who lives independently, as well as helping the wearer to be confident going about their normal activities and knowing that help is at hand if it’s needed.