Treatment for pneumonia in older adults

Pneumonia is an infection or inflammation in the lungs that can make breathing and oxygen exchange harder. In an older person, it may cause cough, fever, chills, or phlegm, but it can also appear as unusual sleepiness, confusion, weakness, reduced appetite, or a fall. A clinician may check breathing, oxygen level, hydration, and mental alertness, then decide whether tests or hospital care are needed.

The cause matters. Bacterial pneumonia may need antibiotics, while viral illnesses such as influenza or COVID-19 need a different plan. Antibiotics do not treat viruses. Recovery can be uneven, so a family member or carer should watch for changes even when symptoms initially seem mild.

Follow the prescribed treatment exactly, encourage suitable fluids and nutrition, and allow rest with gentle activity as strength returns. Keep a written record of medicines, temperature changes, breathing symptoms, and alertness. Check that the person can drink, take medicines, and move safely. A clinician may arrange follow-up to reassess breathing and recovery.

Do not give leftover antibiotics or cough medicines without checking first, especially if the person has kidney disease, swallowing difficulty, or several regular medicines. Vaccination and hand hygiene can reduce the risk of some respiratory infections; ask the healthcare team what is appropriate.

Get urgent medical help for severe breathlessness, blue or grey lips, chest pain, new confusion, unusual difficulty waking, collapse, inability to keep fluids down, or rapidly worsening weakness. Contact a clinician promptly if fever persists, cough worsens, phlegm changes, or the person is drinking and passing urine much less than usual. Sepsis is a serious complication that requires immediate assessment.

What is the likely cause, and how will we know treatment is working? Does this person need hospital assessment? Which medicines should be paused or adjusted? What breathing or alertness changes should prompt an immediate call?