Pneumonia in older people: What you should know

Pneumonia can lead to a fever and a cough with phlegm in older people. But these symptoms are often less severe than they are in younger people. And sometimes they don't occur at all, or other symptoms are more noticeable – such as diarrhea or worsening confusion.

Regardless of the type of symptoms, pneumonia more frequently leads to complications in older people. For this reason, it's advisable to go to your doctor or ask for a house visit early enough if you or those close to you have the impression that something is wrong. Possible signs of pneumonia may include:

• increasing confusion, apathy or temporary unconsciousness,
• shortness of breath and/or rapid breathing (more than 30 breaths per minute),
• a racing heart (pulse over 120 beats per minute),
• circulation problems with loss of blood pressure (an upper, systolic value of below 90 mmHg or a lower, diastolic value of below 60 mmHg), and
• a high fever (40 degrees Celsius, 104 degrees Fahrenheit, or higher) or very low temperature (35 degrees Celsius, 95 degrees Fahrenheit, or lower).

Older people with chronic underlying conditions such as COPD, heart failure, coronary artery disease, diabetes or chronic kidney disease should seek urgent medical attention if they have pneumonia.

Age is very a very important factor in the treatment of pneumonia. People who have pneumonia usually need to be treated in a hospital if they are over 65 years old, have an underlying disease or can't take care of themselves on their own at home.

If antibiotics are used, it's particularly important to know whether the pneumonia developed at home, in a retirement or nursing home, or in a hospital. Because other kinds of bacteria are found in care homes and hospitals, antibiotics are then used that can also fight off those germs.

Another factor that is considered when selecting the medication is whether or not you have had to take antibiotics in the past three months. If you have, an antibiotic that is effective against multi-resistant bacteria is used.

Two vaccinations are recommended for people over the age of 60 due to their increased risk of pneumonia: the flu vaccination and the pneumococcal vaccination. Statutory health insurers in Germany cover the costs of both vaccinations. The two vaccines can be injected on the same day. A new flu vaccination is given every year because flu viruses change from year to year. The pneumococcal vaccination is effective for several years, and a booster is recommended every six years. The Federal Centre for Health Education (Bundeszentrale für gesundheitliche Aufklärung, BZgA) provides detailed information in German about the pneumococcal vaccination and other recommended vaccinations at www.impfen-info.de.

In people who have become very frail due to old age and possible chronic diseases such as heart or kidney failure, pneumonia can be so severe that they won't recover. Treatment then no longer aims to cure the disease, but to relieve the symptoms as effectively as possible. Good nursing care and assistance help to make the final phase of life easier, taking personal wishes into account as much as possible. For example, some people wish to be able to pass away at home rather than having to go to a hospital.