It's natural to feel very concerned about an older friend or family member when many people are getting influenza or "the flu." Adults over sixty-five are more likely than any other age group to experience serious health complications as a result of the flu. If they have a limited income, they may also find it harder to afford treatment, whether it occurs during a normal seasonal outbreak or a global pandemic. Older adults face special challenges if they live in long-term care facilities where a virus can spread quickly among residents. Whether you live near your friend or relative or far away, you may need to act promptly to help your loved one avoid flu or minimize the potential risks.
Why older adults are at higher risk
Each year, typically in winter, the flu virus spreads around the world, although outbreaks can also occur in warmer months. Most people have a natural ability to resist the flu, known as an immunity, so they can often avoid or recover quickly from an infection. As we get older, however, our immune systems typically grow weaker, so it's often harder for older adults to fight flu. Older people also tend to have more chronic illnesses, which can further reduce their resistance to infection. Another complicating factor for older adults is that they often have reduced cough and gag reflexes, which results in more respiratory problems. The flu can make these problems worse.
While people over age sixty-five are at greater risk of complications from the seasonal flu, most older people who develop flu don't suffer long-term harm. Because they face a greater risk for complications, however, they need to be very careful during flu outbreaks. Some flu viruses are considered especially dangerous because they are new, or "novel," strains of the influenza virus, meaning that humans haven't had much exposure to them and their immune systems are not prepared to fight them.
Helping your friend or family member avoid flu
Older adults can get some protection against certain types of flu by having an annual flu shot or vaccination against the virus. To be effective, a vaccine needs to match the type of flu that's circulating. So the Centers for Disease Control and Prevention (CDC) recommends that adults over fifty have a flu shot each year, preferably in the fall. Unfortunately, there are no vaccines for some types of flu virus, so older adults need to protect themselves in other ways.
When talking with older friends or relatives, encourage them to take the following precautions:
- Wash your hands often with soap and water. An alcohol-based hand cleaner is also effective. Consider giving your older friend or family member a supply of pocket- or purse-sized hand sanitizer that will last through the flu season, especially if he or she has a limited income and might be reluctant to spend money on them.
- Avoid touching your mouth, nose, or eyes. It's easier for germs to enter the body in these areas.
- Sneeze (or cough) into your sleeve, not your hands, to prevent spreading germs. Encourage other friends, relatives, and visitors to follow this practice when they're around each other.
- Don't share utensils, drinking glasses, or food. Someone you share with might be coming down with the flu and not know it yet.
- Put your used tissues in a wastebasket. To reduce the possibility of re-use, you might give extra boxes of tissues to an older friend or relative who is on a tight budget.
- Stay away from people who are sick. Postpone visits with children or others who may be getting colds or other infections (including visits with you, if you aren't feeling well).
- Maintain good health habits. Encourage older people to get plenty of sleep, eat a healthy diet, stay physically active, manage their stress levels, and drink lots of water or other nonalcoholic fluids.
The CDC also recommends that older people get a pneumonia shot (the PPSV or pneumococcal polysaccharide vaccine) if they are over sixty-five or have a chronic health condition such as asthma or diabetes. The vaccine can help prevent complications that result from flu. Visit the CDC or call 800-CDC-INFO to learn more about who needs the pneumonia shot.
Flu and pneumonia shots are free for people who are enrolled in Medicare Part B and get the shots from doctors who accept Medicare. Visit Medicare for more information about flu-shot coverage.
If your friend or family member develops flu symptoms
Make sure that your friend or relative contacts a health care provider if he or she develops any flu symptoms, such as sore throat, coughing, fever, chills, headaches, body aches, diarrhea, vomiting, or extreme fatigue.
A doctor can determine whether an older adult with these or other symptoms needs treatment. If the doctor precribes drugs to ease the symptoms and help prevent complications, make sure the drugs work together with (and not contrary to) the medications your elder is currently taking.
Make sure your older friend or family member gets immediate medical attention if he or she experiences any of the following symptoms: difficulty breathing, shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting, dehydration, or worsening of an existing medical condition. If your relative has these symptoms and you're a long-distance caregiver who can't get her to an emergency room, call 911.
If your friend or family member lives in a nursing home
Older adults have a higher risk of developing the flu if they live in nursing homes, where the virus can spread quickly. And some long-term care facilities don't prepare adequately for a flu outbreak that could affect many residents.
Here are some questions to ask the staff at your older friend or relative's long-term care facility. (These questions have been adapted from a U.S. Department of Health and Human Services checklist on nursing-home preparedness for pandemic flu.)
- Do you have a written plan for dealing with pandemic flu?
- Have you named a pandemic-flu response coordinator for the facility?
- Have you drawn up a plan for evaluating and diagnosing residents who may have flu and for preventing the spread of the virus to others?
- Is your residents' contact information for families and guardians up-to-date?
- Have you created a plan for communicating with families, visitors, and others if flu is found at the facility?
- Have you made sure that residents and staff know how to prevent and control pandemic flu? For example, if you have flu education programs for residents (and staff), do you monitor attendance?
- Have you distributed informational materials about flu prevention and control (such as brochures and posters) to residents and staff members?
Every nursing home needs a plan for preventing the spread of pandemic flu. The government says that a plan might include confining symptomatic residents and their roommates to their rooms, placing symptomatic residents together in one area of the facility, or stipulating that staff members who work in areas or units with symptomatic residents don't work in other areas.
Talk with the director at the nursing home if you have questions about how it would cope with a flu outbreak. If the answers don't satisfy you, you may want to contact the long-term care ombudsman in your state, an advocate for patients' rights that every state is required to have under the Older Americans Act. Visit the National Long Term Care Ombudsman Resource Center to find a link to the advocate in your state.