Private duty caregivers, beware!
Older patients may not know they have pneumonia
Because the majority of private duty home care patients are elderly and therefore more susceptible to illness than the young, private duty caregivers need to be alert for signs of impending disease.
A recent study pointed out that "there is a high rate of morbidity and mortality associated with pneumonia in the elderly. These high rates have continued to impede the efforts of health care professionals, despite significant improvements in therapeutic options and public health practices.
One-sixth of the 6 million pneumonia cases that are reported each year occur primarily in those individuals 65 years and older requiring hospitalization for pneumonia. Over 90% of all deaths from pneumonia occur in this older population. Currently, individuals over 65 comprise 12% of the population, and by the year 2050 this will increase to 25%.
By 2020, there will be 65 million individuals over the age of 65 years, all at high risk for pneumonia. The prevalence of both disability and comorbid diseases increase with age and are associated with increased risk of pneumonia. Therefore, the elderly constitute a growing proportion of those at risk."1
Death rates from pneumococcal pneumonia are estimated at three to five times greater among the elderly population than in young adults. Money spent to fight bacterial pneumonia in older people is estimated in excess of $1 billion. The study emphasizes that in older patients, there may be little or no coughing, fever, or other classic signs of respiratory infection. Indeed, there is increasing evidence that in old age, pneumonia may be latent and coming on without chill.
What the private duty professional can do
The private duty caregiver can significantly reduce the likelihood of patients developing pneumonia by being alert to changing behavior patterns, following good hygiene practices, and making sure the patient is eating a healthful, balanced diet.
Numerous studies have indicated that malnutrition may play almost as great a role as certain chronic diseases in older patients developing pneumonia. If the food you are asked to prepare isn’t healthful — and if your patient loses appetite or refuses to eat — you should notify the attending physician immediately. As nutritional supplements, especially vitamin C, have demonstrated value, you can suggest your patients consider them.
Despite the depressing nature of the statistics quoted in the study, it concludes that overall, health status appears much more important in determining the risk of illness and death from pneumonia in the elderly than does their age alone.
Reference
1. Cassiere H. Severe pneumonia in the elderly: Risks, treatment, and prevention. Medscape Respiratory Care 1998; 2:2.
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