Senior Flu Prevention and Taking Care of the Elderly
Last Updated: April 2, 2013
Getting the flu can be a nasty experience, no matter what your
age or general health, and each year flu shots are a major public
health initiative. But, because of the risks to the elderly, senior
flu prevention is especially important.
According to the Centers for Disease Control (CDC), each year
more than 200,000 people will be hospitalized because of the flu,
and 36,000 of them will die.
"Disproportionately it's the elderly," explains Debra
Beauchaine, MN, ARNP, and geriatric services director at Virginia
Mason Medical Center in Seattle. Seniors in their seventies and
eighties are at higher risk from the flu than seniors in their
sixties, because of declining immunity to illnesses as they
Seasonal (or common) flu is one of the most highly contagious
illnesses. It is spread by "respiratory drops"-coughing and
sneezing. Someone may touch something with the flu virus on it-such
as door knobs, telephones or shopping cart handles-then unwittingly
touch their mouth or nose.
And it's not enough to simply stay away from other people who
feel sick. "People may be contagious one day before they develop
any symptoms, and for up to five days after becoming sick,"
Beauchaine says. "That's part of the problem; people don't realize
they have the virus before they actually feel sick."
Flu symptoms include fever, chills, runny or stuffy nose,
headache, sore throat, cough, extreme fatigue, and muscle aches.
Nausea, vomiting and diarrhea are sometimes present, but rarely
Flu season typically runs from October through the end of
February, but some years it runs into March and April as well. It
is estimated that 10 to 20 percent of the U.S. population contracts
influenza each year. Once someone gets the flu, the only real
"cure" is to rest and drink plenty of fluids, although a doctor may
prescribe Tamiflu® or Relenza®, both anti-viral medications which
can keep the influenza virus from spreading inside the body and
shorten the duration of symptoms. Both must be taken within 48
hours of the onset of flu symptoms, and neither is a substitute for
a flu vaccination.
While otherwise healthy adults can be laid low by the flu for a
full week, senior citizens are at risk for becoming much sicker.
"They are more vulnerable, once they get the flu, to develop
complications," Beauchaine says. "Because the flu is really a
pretty severe illness, they may not have as much of what we call
'physiological reserve' as a younger adult. So, seniors will feel
very sick from a case of the flu and that puts them at greater risk
Dr. W. Paul McKinney, associate dean of the School of Public
Health at the University of Louisville, explains that one of the
more serious complications is primary viral
pneumonia or a secondary bacterial pneumonia. Most
hospitalizations and deaths from the flu are a consequence of
pneumonia and other respiratory disorders. Also, if a senior has
any chronic health conditions, such as congestive heart failure,
chronic lung disease, even diabetes or renal failure, those could
be exacerbated by the flu. And another common complication of the
flu is dehydration, so drinking plenty of fluids is especially
vital for the elderly.
Staying away from work or crowded places while sick is important
to prevent spreading the flu to others. But that's not an option
for seniors living in nursing homes or assisted living
facilities, making senior flu prevention that much harder at
these communities. "When you congregate large numbers of people in
close quarters, transmission is a lot easier," McKinney says.
However, Beauchaine points out that nursing homes usually
require all employees to be vaccinated, which is the single most
effective way to guard against getting the flu. And, it's important
to get a flu shot every year, because the virus changes slightly
from year to year. Getting a flu shot one year and not the next,
will not protect someone from that year's particular strain.
"They should make every reasonable effort to get vaccinated
early in flu season," McKinney says, but don't do it too early in
the season, because occasionally the immunity will wear off before
flu season ends, especially if the season lasts into March or
According to the U.S. Department of Health and Human Services,
seniors covered by Medicare Part B pay no coinsurance or deductible
for their flu shot, as long as they receive the shot from a
What if a senior is otherwise healthy and doesn't feel they are
"There is no reason a healthy senior should defer a vaccine,"
A University of Michigan study found that boosting elderly flu
vaccinations could save as many as 6,500 lives over ten years. In
fact, research from Johns Hopkins University shows that annual flu
shots reduce the number of deaths among hospital patients by one
While vaccination is the most important senior flu prevention,
it's only 70 to 90 percent effective, so some people who receive
the vaccination will still get the flu.
So, for at-risk populations, it's especially important that
everyone around them also gets vaccinated. That includes everyone
involved in taking care of the elderly. And like nursing homes,
some hospitals, such as Seattle's Virginia Mason, require all
employees to be vaccinated.
The CDC's target groups for vaccination keep expanding, recently
adding children aged 2-5, and lowering the seniors' age range from
age 65+ to 50+. The CDC estimates 218 million Americans fall into
the at-risk groups that should be vaccinated. "That's over
two-thirds of this country," McKinney says. "This year we'll have
100 million doses of the vaccine, so we won't even be able to
vaccinate 50 percent."
According to McKinney, the U.S. should not face a vaccine
shortage this year. "Unless someone is in a very remote, isolated
area, there shouldn't be a problem getting the vaccine," he
While it's not possible to get the flu from the standard
injectable flu vaccine, which is made from a killed virus, some
people will experience a sore arm for one to two days, and possibly
a fever. (The newer nasal spray vaccine is made from a live
attenuated virus and recommended only for healthy, non-pregnant
people between the ages of five to forty-nine.)
Although some people believe certain foods or vitamins can ward
off illness, Beauchaine says that while they may make you healthier
in general, they aren't effective for senior flu prevention.
During flu season, practicing good hygiene can help people avoid
catching or spreading the flu. Wash hands frequently, especially
after touching door knobs and stair rails in public places. Always
cover nose and mouth when coughing or sneezing, and immediately
wash hands afterward. And, of course, stay away from people who are
sick. People taking care of the elderly especially need to follow
this type of common sense senior flu prevention.
Finally, don't confuse influenza with avian flu. While bird flu
gets a lot of press these days, it is extremely rare, occurring
when a human has direct contact with infected poultry or surfaces
contaminated by secretions or excretions from infected birds.
Vaccines to protect against bird flu are being developed, but are
not yet available.
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