Pneumonia in older age

Older adults may have cough, fever, chills or phlegm, but some mainly develop weakness, sleepiness, confusion, poor appetite or a change in usual function. Existing heart, lung, kidney or immune problems can reduce the body's reserve during an infection. Recovery is individual and depends on the cause, severity, general health, hydration, mobility and how promptly treatment begins. Ask the clinician to explain what improvement should look like for this person rather than relying on a fixed prediction.

Follow the treatment plan and keep the person hydrated if they can safely drink. Encourage rest with gentle movement when advised, regular meals or suitable nourishing alternatives, and prescribed breathing or oxygen support. A family member or carer can track alertness, breathing, temperature, fluid intake and ability to walk. Arrange review if the person is not returning towards their usual function or if medicines cause concerning effects.

Seek emergency help for severe breathing difficulty, blue or grey lips, new confusion, collapse, inability to drink, or a sudden marked decline. Urgent assessment is also needed when the person becomes unusually hard to wake, develops severe chest pain, or has signs of sepsis such as rapidly worsening illness with very low alertness. Do not wait for a high fever in an older person.

Ask which symptoms are expected during recovery, what level of supervision is needed, and when follow-up should occur. Clarify how existing conditions and medicines affect the plan, and ask whether influenza or COVID-19 testing or prevention is relevant.