As we get older we become more susceptible to infections. The immune system doesn’t work as well as it used to. It’s more difficult if you are also dealing with chronic health conditions such as diabetes, chronic obstructive pulmonary disease (COPD or emphysema), heart problems or cancer.
Infectious diseases account for one-third of all deaths in people 65 years and older. Early detection is more challenging in the elderly because the typical signs and symptoms, such as fever and an increased white blood cell count, are frequently absent. As we discussed in the previous blog post about pneumonia, a change in mental status or decline in function may be the only presenting problem in an older patient with an infection.
“Especially the ‘old old’ or people 85 and older,” says Linda Samia, PhD, RN, CNL, Associate Professor at USM’s School of Nursing. “The symptoms are often masked and can be ‘dismissed’ as just a sign of getting older or becoming more frail. It is critical to monitor older adults for these symptoms.”
Common symptoms of infection in elderly people
- Mental status changes (maybe more lethargic or confused)
- General malaise
- Diminished function resulting in falls
- Generalized weakness
- Decrease in appetite.
Six infections to watch out for in elderly people
- Urinary tract infection
- Skin infections such as MRSA and VRE
- Gastrointestinal infections such as c. difficile
General Infection Prevention
Even with a less than perfect immune system, many infections might be prevented by following Linda’s advice.
“If all older adults and the general public received the flu vaccine as recommended by the CDC, we would reduce the risk of influenza. The same goes for pneumonia and shingles. If the 65 and older population received the pneumococcal vaccine and the 60 and older population received the shingles vaccine we would dramatically reduce the risks for these infections.”
Wash your hands
“Good handwashing — a solid 20 seconds using warm water and soap is the best defense against the majority of infections. By humming the song “Happy Birthday” twice while washing, lathering and rinsing you will reach a full 20 seconds. Hand washing should occur after coughing, sneezing or blowing your nose; after using the bathroom; before and after preparing food; and before and after taking care of someone who is ill. If soap and water are not available use an alcohol-based hand sanitizer (at least 60%) alcohol. Good to carry this on you in case soap and water are not available.”
Preventing urinary tract infections
- Keep hydrated, especially by drinking 6-8 glasses of water a day unless a person has a fluid restriction.
- Empty the bladder frequently (every 4 hours).
- For women — after using the toilet, wipe from front to back.
Preventing skin infections
“Skin infections such as MRSA (Methicillin-resistant Staphylococcus aureusfacilities) and VRE (Vancomycin-resistant enterococcus) are best prevented by good hand hygiene. In health care facilities hand hygiene, protective equipment, and contact precautions to avoid cross-contamination from one patient to another are important. Keeping the skin moist and free of cuts also helps prevent these infections since the skin is our first line of defense.”
“C. difficile is most problematic in long-term care facilities and hospitals when older adults’ immune systems are further compromised by antibiotic use. Avoid unnecessary antibiotics. Practice good hand washing. Have private rooms for patients infected with C. dif. Wash all surfaces with chlorine bleach in contaminated areas. This can reduce the risk and spread of infection.”
Not all infections can be prevented, but following Linda’s recommendations could reduce the risk. If an elderly person is living in an assisted living facility or nursing home, preventing infections can be a bit more challenging.
“First, says Linda, “residents are more likely to be older and frailer with multiple underlying chronic conditions. These characteristics put a person at greater risk for infection. It is compounded by the close living arrangement in these facilities. People often share a room or eat in congregate dining rooms. Staff are moving from one person to another, so there is a greater potential for cross-contamination. Hand hygiene is key to preventing the spread of infection in these facilities. Staff, visitors and residents should all be practicing good hand hygiene.”
Besides washing our hands, no matter what our age, we can lower the risk of infections. Eat nutritious meals. Drink plenty of fluids. Get a good night’s sleep and be as physically active as possible.
If you or someone you care for has trouble following any of Linda’s recommendations, the caregivers at Advantage Home Care are available to provide a well-washed helpful hand. See the Advantage Home Care website for a list of services.
Our Aging in Place blog is written by Diane Atwood, who also writes the blog Catching Health with Diane Atwood.