pneumonia in older adults

Overview

Pneumonia is an infection in one or both lungs. It makes the tiny air sacs in your lungs fill with fluid or pus, which can make it hard to breathe. It can range from mild to very serious, especially for older adults.

Yes, pneumonia is common. It is especially common in older adults and is one of the main reasons older people are admitted to hospital.

Pneumonia can affect anyone, but it is most serious for adults aged 65 and older, especially those with long-term conditions like heart disease, diabetes, or lung disease, and those with a weakened immune system.

Symptoms

Common symptoms

• Cough
• Fever
• Chills or sweating
• Shortness of breath
• Chest pain when breathing or coughing
• Feeling very tired
• Loss of appetite

Symptoms in children

• Fast or difficult breathing
• Grumbling or grunting sounds
• Flaring of the nostrils
• Irritability or restlessness
• Poor feeding or drinking less than usual
• Cough and fever

Symptoms in older adults

• Confusion or sudden change in mental state
• Falling or feeling dizzy
• Low body temperature
• Loss of appetite and low energy
• Worsening of long-term conditions, such as heart failure or COPD
• Fewer or less typical symptoms like cough or fever

Causes

Main causes

• Bacteria – the most common cause
• Viruses – such as cold and flu viruses, and the virus that causes COVID-19
• Lung damage from inhaling food, liquid, or fumes
• Fungal infections – rare but possible, especially in people with weak immune systems

Risk factors

• Being 65 years or older
• Having a long-term condition such as COPD, asthma, diabetes, heart disease, or kidney disease
• Having a weakened immune system (for example, due to some medicines or illnesses)
• Smoking or heavy alcohol use
• Being in hospital or living in a care home
• Recovering from a recent cold or flu

When to see a doctor

See a doctor urgently if:

• If you have symptoms that are getting worse
• If you are feeling very short of breath or breathing fast
• If you have a high fever that will not come down
• If you become confused, very sleepy, or find it hard to wake
• If you cannot drink enough fluids or are vomiting

Book a routine appointment if:

• If you have a cough that lasts more than a few days
• If you feel worn out, have a mild fever, or have a reduced appetite
• If you have a health condition that puts you at higher risk and you develop cold or flu symptoms

Diagnosis

A doctor will ask about your symptoms and health history. They will listen to your chest with a stethoscope. They may also measure the oxygen level in your blood using a small clip on your finger.

Tests that may be done

• Chest X-ray – to look for signs of infection in the lungs
• Blood tests – to check for infection and how your body is responding
• A sample of phlegm – to help identify the cause of the infection
• Pulse oximetry – to check how well your body is getting oxygen

What to expect at your appointment

The check-up is usually quick and painless. You may be asked to breathe deeply or cough while the doctor listens to your chest. Some tests, like blood tests, may take a few days for results. You may not need all the tests, depending on your situation.

Treatment

Treatment depends on what is causing the pneumonia, how severe it is, and your overall health. Some people can get better at home, and others may need care in a hospital. Always follow the advice of your healthcare team.

Self-care at home

• Get plenty of rest to help your body fight the infection
• Drink enough fluids to stay hydrated – water, soups, and warm drinks are good choices
• Use over‑the‑counter fever reducers only if recommended by your doctor or pharmacist
• Avoid smoking and smoke-filled places
• Use a cool-mist humidifier or sit in a steamy bathroom to help ease coughing

Medical treatments

Bacterial pneumonia is often treated with antibiotics. Viral pneumonia may be monitored and managed with supportive care, and in some cases antiviral medicines are used. If your oxygen level is low, you may receive extra oxygen. In hospital, you may get fluids through a drip or more intensive breathing support if needed. Your doctor will decide the safest plan for you.

When is surgery considered?

Surgery is rarely needed for pneumonia. In very rare cases, pockets of pus (abscesses) in the lungs might need draining, but this is not a common treatment and only happens after other steps have been tried.

Living with this condition

Recovery takes time – weeks, sometimes even a month or more. Do not rush back to usual activities too quickly. Take small steps, rest when you need to, and let your body guide you.

Lifestyle tips

• Rest until you feel ready to be more active
• Stop smoking and avoid being around others who smoke
• Wash your hands often to avoid spreading or catching germs
• Stay away from people who are ill
• Get a good night’s sleep and try to reduce stress

Diet and exercise

Eat a balanced diet with plenty of fruit, vegetables, and protein. If your appetite is low, try eating smaller meals more often. Gentle exercise, like short walks, can help you regain strength, but only when you feel ready and your doctor says it is safe.

Mental health and emotional wellbeing

Feeling anxious, frustrated, or low after a serious illness is normal. It can help to talk about how you feel with family, friends, or your healthcare team. Do not hesitate to ask for support – your emotional health matters too.

Prevention

Yes, many cases of pneumonia can be prevented by staying up to date with recommended vaccines, practicing good hand hygiene, keeping well-fed and active, and avoiding smoking.

Vaccines

Vaccines help protect against some of the most common causes of pneumonia in older adults, such as the flu, COVID-19, and the pneumococcal infection. Ask your healthcare provider which vaccines are recommended for you and when to have them.

Screening programmes

There is no routine screening test for pneumonia. However, if you are in a high‑risk group, your doctor may check your health regularly and advise on ways to reduce your risk of infection.

Complications

If left untreated

• Breathing difficulties that may require oxygen or a breathing machine
• Infection spreading to the blood (sepsis)
• Fluid around the lungs that may need draining
• Lung damage in severe cases
• Worsening of existing conditions like heart failure or diabetes

Long-term outlook

With prompt medical care, most older adults recover from pneumonia and can return to their normal lives. Recovery can be slow, but it is normal. Many people feel back to themselves within a month or two. The earlier you seek help, the better the outcome tends to be.

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