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Pneumonia and the Prevalence in Geriatrics: Lessening the Associated Morbidities with
Vaccination
Emily M. Helm
Dr. Brown
Abstract
Pneumonia is a widespread issue seen amongst the geriatric population. Much to people’s belief
it is also a major morbidity amongst the elderly. With pneumonia being a preventable illness
through vaccine and education of health maintenance, health care providers and professionals are
being encouraged now more than ever to stress the importance of the pneumococcal vaccine to
patients. Teaching patients and their families about risk factors, signs and symptoms associated
with pneumonia, how to treat it, and how to prevent it can all be helpful in lessening the death
rate of geriatric patients related to pneumonia and complications. Many studies have shown that
the reason for the pneumococcal vaccine not being administered as much as anticipated is related
to the lack of education patients are receiving. Nursing professionals are being urged to become
educated on the topic and you to must do your part to learn more about this white elephant in the
As people age, comorbidities and other ailments begin to arise. Through proper nutrition,
hydration, exercise, and adequate sleep, many people can prevent or lessen the effects of disease
or illness. However, there is one sickness that is prevalent in people over sixty-five years old
that is more difficult to prevent than other illness; this being pneumonia. As people get older,
their immune system begins to weaken, and they can become more susceptible to contracting
pneumonia. Understanding the illness, knowing how to prevent it, and then doing your part in
the medical field to educate patients can help lessen the rise of deaths in elderly patients
Pneumonia is most common among geriatric patients and children under two years old.
This is mostly related to inadequate immune systems, not being fully developed in babies and
toddlers and anatomical changes in the older years of life. Pneumonia is “a leading cause of
mortality among persons >65 years. In the United States, 500,000 adults are hospitalized
annually for community-acquired pneumonia” (Satchidanand et al., 2018). Therefore, the focus
or hospital acquired. It can be caused from bacteria, fungi, or a virus; with the most common
cause being bacterial related. “Pneumonia is inflammation of the lung parenchyma that is
usually caused by an infectious agent. In older adults, pneumonia can occur as a primary
diagnosis or as a complication of a chronic disease and is associated with a higher mortality rate
compared with pneumonia in younger adults” (Lawrence, 2017). Signs and symptoms
commonly seen with pneumonia include shortness of breath, chills and a fever, a cough either
PNEUMONIA AND THE PREVALENCE IN GERIATRICS 4
productive with phlegm or nonproductive, chest pain, and generalized weakness. However, “the
signs and symptoms of pneumonia may be altered in older persons, and serious pneumonia may
exist without symptoms being evident” (Eliopoulos, 2018). Sometimes older people may not
even know that they have pneumonia but may just feel run-down or suddenly worse following a
cold or the flu. Altered mental status, restlessness or confusion are also common in the elderly
when pneumonia is contracted do to the lungs not getting enough air to the brain, resulting in
hypoxia. Pneumonia can be very serious and result in hospitalization, shock, pleural effusions,
or even organ failure, most commonly being kidney or lung related. Being aware of the possible
side effects and making attempts to keep your or your family member’s health in good standing
can make the difference in preventing pneumonia or the escalation of this illness.
Prevention and older adult education may be the key to preventing the spread or worsening of
pneumonia. Through many studies and collecting data from prior pneumonia patients, it was
indicative that “oldest age, nursing home residence, history of prior pneumonia, stroke, chronic
pulmonary disease, heart disease, diabetes mellitus, smoking and conditions are factors
independently associated with increasing risk of all pneumococcal pneumonia in the population
over 60 years. Given its considerable prevalence, chronic illnesses such as chronic pulmonary or
heart disease and diabetes mellitus were the major contributors to pneumococcal disease burden
in this age group” (Vila-Corcoles et al., 2015). Treatment for pneumonia consists of antibiotics
But how do we prevent this illness before we have to treat it? The answer is not
definitive, but it starts with vaccinations and improving daily health. Educating the elderly on
washing their hands, avoiding others that may be sick, and preventing the spread of germs
PNEUMONIA AND THE PREVALENCE IN GERIATRICS 5
through hygiene is the first step. Smoking cessation is also important do to its direct effect on
the anatomy of the respiratory system and the overall health of the lungs. Educating the elderly
on getting rest and plenty of sleep, following a healthy diet with multivitamins, and encouraging
exercise or physical activity of any kind can be beneficial in the prevention of pneumonia also.
The last way to prevent pneumonia is to get vaccinated. Encourage patients and their family
members to get the pneumonia vaccine, as well as the influenza vaccine. A lot of times
pneumonia will follow the flu in elderly patients do to their immune system being weakened
from influenza. Therefore, getting the influenza vaccine can also be beneficial in the prevention
other adult immunization rates continue to be low. Limited public awareness about adult
vaccinations, fear of vaccinations, cost of vaccines and vaccination services, inadequate and/or
inconsistent payment for vaccines, and precedence of acute medical care over preventive
services contribute to decreased immunization among older adults” (Turbeville, Conner, 2018).
Through older adult education on this topic and encouraging primary care physicians to be
bigger advocates for the pneumonia vaccine, this illness can be lessened in the older population.
Benefit in Practice. The geriatric population is the largest population in the United
in America such as diabetes mellitus and congestive heart failure, the prevalence of pneumonia is
on the rise. You need to be pro-active in the attempt to lessen the amount of hospitalizations and
deaths associated with this illness. This can be accomplished by getting all medical
professionals on board with teaching patients the importance of smoking cessation, eating well
balanced meals, getting plenty of sleep as well as exercise, and getting the pneumonia and
influenza vaccines. A lot of times, the healthcare field is so focused on the influenza vaccine and
PNEUMONIA AND THE PREVALENCE IN GERIATRICS 6
its importance in preventing sickness in people of all ages, that they forget the importance of the
pneumonia vaccine. “Approximately 85% of all pneumonia and influenza deaths occur in
persons age 65 and older, making pneumococcus one of the leading causes of vaccine-
preventable illness and death in the United States” (Turbeville, Conner, 2018). This is a statistic
that seems to get swept under the rug. Many people in the geriatric population are going without
this vaccine just for the shear purpose of being unaware that it exists or forgetting the importance
“Although the evidence shows that most patients will receive vaccinations if
recommended by their health care provider, such recommendations are not routinely
Medicare beneficiaries, lack of awareness was the most common response cited for not
receiving the pneumococcal vaccine. Rangel and colleagues (2005) showed that lack of
possible that socioeconomic and educational levels play an indirect role as barriers to
Nurses must become knowledgeable about the pneumonia vaccine and the importance of
educating patients about receiving the vaccine. Much to many people’s beliefs, the vaccine is
cost effective, has very little side effects, and could be the difference needed in lowering the
death rate of the geriatric patient population associated with pneumonia. Encourage your place
of work and other medical professionals to do the same as well. “Improving immunization rates
prevents infections, minimizes hospitalizations, and results in overall improved patient care.
Providers should assess patients’ immunization history at each visit, conveying to patients the
pneumonia starts with you as a health professional, proper education for patients, and stressing
the importance of receiving the pneumococcal vaccine for the increasing geriatric population
References
Eliopoulos, C. (2018). Gerontological Nursing, (9th ed.) Philadelphia, PA: Wolters Kluwer.
Lawrence, P. (2017). Pneumonia in older adults. CINAHL Nursing Guide. Retrieved from
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Satchidanand, N., Servoss, T. J., Singh, R., Bosinski, A. M., Tirpak, P., Horton, L. L., &
older adults admitted to the icu with pneumonia. American Journal of Hospice &
Turbeville, K. B., & Conner, R. (2018). Increasing pneumococcal vaccinations in older adults.
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