Quick Answer

Pneumonia and lower respiratory tract infections are the leading cause of death in nursing home residents. Thirty-three out of every 1000 residents will become infected with pneumonia. Respiratory infections represent about one-third (⅓) of all nursing home infections.

Respiratory Infections Explained

Respiratory infections in nursing home residents can affect the nose, throat and lungs and often start out as minor illness and quickly become more severe.

In many cases, respiratory infections in nursing home residents are first diagnosed as conditions like:

  • Cold
  • Flu
  • Sinus infection
  • Bronchitis
  • Laryngitis

These conditions can develop into something more severe like pneumonia. If left untreated, they can lead to life-threatening illnesses.

Respiratory Infections Are Contagious

Nursing homes are a breeding zone for infection. Residents share common surfaces and spaces for dining and social activities. Additionally, lots of visitors, staff and suppliers come and go from nursing homes while the residents stay in the same shared space. This presents a perfect opportunity for an infection to spread rapidly.

There are multiple ways infections can spread in nursing homes. The frequency and variety of visitors to the nursing home is one (non-neglect). Another is how well the nursing home is maintained and cleaned regularly, especially during flu season (neglect).

Respiratory infections like pneumonia are difficult to diagnose early in the elderly because they don’t always present a fever at the onset of the infection. The best way to detect the infection is through an x-ray, which is not always available.

Common Respiratory Infection Causes

Respiratory infections have multiple possible causes and can be passed between residents, nonresidents, staff or visitors. The following factors put nursing home residents at risk of developing respiratory infections.

Tuberculosis

When a respiratory infection comes from residents, it’s often from tuberculosis—a highly contagious bacterial infection. Fifty-seven percent of tuberculosis deaths globally were people over the age of 50. More than half of those deaths were people over 65. Patients with diabetes are at triple the risk for tuberculosis.

Reactivation of tuberculosis in the elderly is common and this occurs when old tuberculosis lesions become active again.

Infections Pass Between Visitors, Staff and Residents

Respiratory infections in nursing home residents are frequent because of nonresident visitors or staff. Many nursing home residents receive visitors, who may carry contagious bacteria and viruses that get passed on to residents. Doctors and staff working with other patients and hospitals can easily transmit infections as well.

The correlation between nursing home staff and patients that contract respiratory infections is high. Staff in nursing homes often work with multiple patients and move from room to room, making it easy to transmit germs from patient to patient.

Respiratory infection frequency drops drastically the more patients and staff receive their flu shot.

Shared Surfaces and Spaces

Respiratory infections spread through large respiratory droplets, direct or indirect contact and airborne droplet nuclei. The most common way the infection spreads is through human to human contact. If staff members have not been properly trained in hygiene practices, they can directly contribute to an outbreak. When simple protocols like washing hands are not followed by staff, non-staff and visitors, the infection can spread rapidly.

Common Respiratory Infections Among Residents

Different types of respiratory infections are caused by different bacteria or viruses. The most common respiratory infections are caused by:

  • Influenza viruses
  • Mycobacterium tuberculosis
  • Pneumococci
  • Respiratory syncytial virus (RSV)
  • Parainfluenza virus
  • C. pneumonia

While influenza outbreaks can occur anytime during the year in a nursing home, they are more common during the winter months. Influenza also ranks among the most commonly reported cause of outbreaks of infectious disease in nursing homes.

90% of influenza deaths are in people aged 65 and older.

Symptoms of Respiratory Infection in Residents

Respiratory infections can interfere with normal breathing as they typically affect the upper respiratory system, which extends from the sinuses to the vocal cords. Respiratory infections may also affect the lower respiratory system, from the vocal cords to the lungs.

Common symptoms of respiratory infection in the elderly include:

  • Sinus pain
  • Coughing
  • Headache
  • Phlegm
  • Swollen lymph nodes
  • Ear inflammation
  • Congestion
  • Loss of smell
  • Post-nasal drip
  • Sneezing
  • Fatigue
  • Fever
  • Wheezing
  • Hoarseness
  • Irritated tonsils

Upper respiratory infections can result from a common cold or ear infection. Lower respiratory infection can result from bronchitis or pneumonia.

Inadequate oral care significantly increases the risk for developing pneumonia.

Respiratory Infection Outcomes

Nursing home residents who contract respiratory infections can make a full recovery if treated properly. Proper treatment requires that nursing home staff follow clean and healthy protocols and monitor patients closely for signs. A low fever or sniffles can quickly turn into something more if not addressed immediately.

Re-infection can also occur when there are multiple residents infected at the same time. The frequency of visitors and the time of year are also heavy factors in respiratory infection. If a resident is re-infected it could be a sign that the environment is not being kept clean or the staff is not following clean protocols.

Chronic infections occur when there are other diseases or diagnoses, like diabetes, or when staff is neglecting to follow cleanliness protocols like washing hands after working with a resident. Staff neglect can also result from not monitoring residents properly for symptoms. This neglect can often lead to a lack of proper treatment. This leads to respiratory infections like pneumonia and can to be life-threatening.

Lawsuits Regarding Respiratory Infections in Nursing Home Residents

Without proper care, respiratory infections in nursing home residents can quickly become severe or life-threatening.

Sadly, one fatal case involved an 82-year-old resident who had fluid buildup in the lungs. When the nursing staff failed to adequately treat the fluid buildup, the resident developed an upper respiratory infection. Left untreated, the patient eventually passed away from aspiration pneumonia, which is when food or other substances are inhaled into the lungs.

If you believe a loved one has suffered from neglect or abuse that resulted in respiratory infection or death, please complete a free case evaluation.