Preventing Infections in the Elderly

Did you know that according to the American Academy of Family Physicians (AAFP), "many signs and symptoms of infection that are common in younger adults, particularly fever and high white blood cell count, present less frequently or not at all in older adults." In addition, "changes caused by infection in the elderly are subtle, and nonspecific complaints may be the only indications. Elderly patients with infections commonly present with cognitive impairment or a change in mental status. In fact, frank delirium occurs in 50 percent of older adults with infections."

According to the AAFP, infectious diseases account for one third of all deaths in people over the age of 65. More than 90% of all deaths from pneumonia occur in people over 65. Even a common infection such as influenza is far more deadly to the elderly than to others. The recent upswing in the appearance of drug-resistant bacteria such as Methicillin-resistant Staphylococcus Aureus (MRSA) is of particular concern to the elderly as they are more likely to be exposed to such organisms in hospitals and other health care settings.

Most common infections of the elderly

• Skin infections — particularly herpes zoster, shingles, and staph infections
• Bacterial pneumonia
• Urinary tract infections (UTI)
• Influenza

Preventing the spread of infections

Most of the infectious diseases mentioned above are preventable. Encourage your parent to pay close attention to skin care. According to Dr. Noah Scheinfeld, a dermatologist with St. Luke's Roosevelt Hospital Center in New York, the integrity of the skin declines with age, which allows easier entry of pathogens into the skin. Combine that with the suppressed immune system that is typical in the elderly and this is a population that is very prone to serious skin infection.

There are vaccines for shingles, flu and bacterial pneumonia that are very effective. The pneumococcal vaccine has been shown to reduce the risk of death from bacterial pneumonia by as much as 80%. Influenza vaccines for the most common strains of influenza have been shown to be anywhere from 30% to 70% effective among the elderly.

UTIs can be prevented by limiting the use of urinary catheters, and the use of effective topical therapies for women and medications or surgical procedures for men suffering with prostate issues. Make sure you have discussed with your parent's physician the maximum length of time a catheter should be in place before being changed, and make sure the nursing staff adheres to this schedule.

Many of the infections that affect the elderly, especially in long-term care settings, involve direct hand-to-hand contact. Practicing good infection control methods such as proper hand washing or the use of hand-sanitizing gels whenever you are around an elderly person is essential. Insist that all health care workers wash their hands before treating your parent, and remember to do so yourself.