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Nursing Assistant Monthly Pneumonia in older adults July 2012 Copyright © 2012 Delmar, Cengage Learning. All rights reserved. What is pneumonia? Pneumonia is an infection and/or inflammation of the deep tissues of the lung It can be caused by – Bacteria, viruses, fungi, exposure to toxic chemicals – Aspiration pneumonia is usually due to oral bacteria entering the lungs July 2012 Copyright © 2012 Delmar, Cengage Learning. All rights reserved. Pneumonia in older adults How does pneumonia affect the body? Pneumonia interferes with exchange of gases: Taking in oxygen Removal of carbon dioxide from the body July 2012 Copyright © 2012 Delmar, Cengage Learning. All rights reserved. Pneumonia in older adults Types of pneumonia One way to categorize pneumonia is by the setting where it occurs: Community-acquired pneumonia: usually but not always milder disease Hospital-acquired pneumonia: often, more resistant organisms Nursing home-acquired pneumonia: may involve resistant organisms, especially if recently hospitalized July 2012 Copyright © 2012 Delmar, Cengage Learning. All rights reserved. Pneumonia in older adults Signs and symptoms of pneumonia in older adults Often the first sign is a change in cognitive status or behavior Cough Weakness, fatigue Shortness of breath Achy chest Fever, chills (this may not occur in older adults) July 2012 Copyright © 2012 Delmar, Cengage Learning. All rights reserved. Pneumonia in older adults Preventing aspiration pneumonia Aspiration pneumonia is the most common type in nursing home settings Help to prevent it by: – Encouraging residents to move, ambulate, and change position – Turning bedbound residents frequently – at least every 2 hours • helps to expand all areas of the lung – Providing enough fluids, according to care plan – Good oral care July 2012 Copyright © 2012 Delmar, Cengage Learning. All rights reserved. Pneumonia in older adults Why is oral care important? Oral care reduces the number of bacteria in the mouth That is why residents without teeth still need oral care! – Always wear a fresh pair of disposable gloves – Use a soft bristled brush – Explain what you are doing – If a resident resists oral care, report this to the nurse – Observe and report the presence of white patches or anything unusual July 2012 Copyright © 2012 Delmar, Cengage Learning. All rights reserved. Pneumonia in older adults Aspiration pneumonia & mealtime Positioning – Have residents sit upright in a chair (wheelchair is not best) – If bedbound, sit the person as upright as possible Watch for and report signs of swallow difficulty – Facial expressions, grimacing, frowning when swallowing – Coughing, choking Some residents are “silent aspirators” – They may not seem to choke, but are silently aspirating secretions July 2012 Copyright © 2012 Delmar, Cengage Learning. All rights reserved. Pneumonia in older adults “Take-home” points You are the “eyes and ears” of the nurses! Aspiration is not always easy to detect Pay close attention to residents’ swallowing ability during meals Understand the health benefits of oral care Provide adequate fluids Physical activity helps prevent pneumonia by moving secretions Report any change in cognitive status, level of alertness, or behavior to the nurse July 2012 Copyright © 2012 Delmar, Cengage Learning. All rights reserved. Pneumonia in older adults