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 increasing confusion.

Regardless of the type of symptoms, pneumonia is more likely to lead to complications in older people – like trouble breathing, too little oxygen in the blood, heart failure or sepsis. 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),
• blood circulation problems with a drop in 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 body temperature (35 degrees Celsius/95 degrees Fahrenheit or lower).

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

Age is an important factor in the treatment of pneumonia. People who have pneumonia usually need treatment 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 the pneumonia is caused by bacteria, it is treated with antibiotics. To select the most suitable kind of antibiotics, it is particularly important to know whether the pneumonia developed at home, in a retirement or nursing home, or in a hospital. Many kinds of antibiotics can't successfully fight off the types of bacteria found in care homes and hospitals, so people whose pneumonia developed in those places are given antibiotics that can fight those bacteria off.

Another factor that is considered when selecting the medication is whether the person has taken antibiotics in the past three months. If they have, they are given antibiotics that are effective against multi-resistant bacteria.

Because people aged 60 and over are more likely to develop pneumonia, two vaccinations are recommended for them: the flu vaccination and the pneumococcal vaccination. In Germany, public health insurers 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. You will find in-depth information about the pneumococcal vaccination and other vaccinations that are recommended in Germany on infektionsschutz.de – a website of the German Federal Institute of Public Health (BIÖG), formerly known as the Federal Centre for Health Education (BZgA).

In people who have become very frail due to old age and chronic diseases such as heart or kidney failure, pneumonia can be so severe that they don't ever 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 best as possible. For example, some people wish to be able to pass away at home rather than going to a hospital.