How to Keep Older Adults Out of the Hospital During Flu Season

The flu might be a miserable weeklong illness and inconvenience for many people, but it can have serious consequences for older adults.

"It's not just sniffles or cold-like symptoms. It can turn into pneumonia or an even more severe illness for older adults that can lead to hospitalization and, unfortunately, sometimes their demise," said Leslie Ramirez, MD, a physician with Cedars-Sinai's Senior Advantage program, which specializes in caring for medically complex Medicare Advantage patients 65 and older.

Because the body's immune system weakens with age, Ramirez said, viruses like influenza can cause more serious illness in older adults. Once hospitalized, they're at even higher risk for developing bedsores and skin infections from lack of movement. And unlike younger people whose condition rapidly improves once an illness passes, it can take weeks for older adults to regain their strength.

"If they've been in the hospital for a while, when they return home, they can struggle getting in and out of bed, getting to the bathroom or sitting down and standing up," Ramirez said. "It complicates their care and increases the burden on the family members trying to help them."

The Cedars-Sinai Newsroomtalked with Ramirez about the most effective ways to help older adults avoid a hospital stay altogether.

What can cause an older adult with the flu to need hospital care?

The flu can trigger a huge inflammatory response in the lungs of older adults who may not be able to continue breathing on their own. They might need supplemental oxygen and fluids because we tend to eat and drink less when we're ill. Dehydration can be very harmful in older patients, causing their blood pressure to drop, as well as respiratory distress.

Older adults also are more likely to have multiple chronic health issues-heart, lung and kidney conditions-and an influenza infection can make all of those worse.

If an older adult gets the flu, how can they avoid a severe illness?

They should contact their provider as soon as they experience flu-like symptoms-fever, chills, body aches, maybe a sore throat or diarrhea-or get tested for the flu at a nearby urgent care. With a confirmed diagnosis, patients might be eligible for Tamiflu, an antiviral treatment that can help shorten the length of illness and decrease severity. But the medication must be started within five days of symptom onset.

It's also important to rest and drink plenty of water. Chicken noodle soup or broth also can help with hydration. Acetaminophen can help reduce a fever, ibuprofen can ease body aches and over-the-counter cough suppressants can help ease a cough. But always check with a provider before taking a new drug to ensure it won't interact with your current medications or chronic conditions.

Do you have any advice for caregivers or loved ones of older adults?

It's important to identify flu symptoms early-a fever above 100.4 degrees, chills, fatigue, body aches, an itchy throat. If you notice that an older loved one with the flu is starting to become more lethargic, very weak or confused-they don't know where they are or who they are, and they're usually very aware of their surroundings-those are big flags that the severity of their illness is increasing. Take them to the emergency department or call their provider immediately.

If they start complaining that they haven't gone to the restroom as much as they normally do, that could be a sign they're not drinking enough, or their kidneys aren't functioning well. If their cough worsens and they're having difficulty breathing or they're short of breath or they can't walk to the bathroom-those are all red flags.

How can older adults avoid the flu?

Wash your hands, especially if you're going to be eating or you've been in an environment that might not be clean. You might want to avoid crowded places like giant sporting events during flu season. I'm not advocating that people skip important life events like a wedding or gathering with family, but take precautions, such as masking or keeping your distance. Some people still choose not to shake hands.

And, of course, get the flu shot. The flu vaccine is available at local pharmacies and in our clinic at Cedars-Sinai. For those 65 and older, there is a high-dose flu shot because their immune system isn't as reactive as it used to be, and they need a stronger dose to mount a successful immune response. Younger family members also should consider getting vaccinated to reduce their risk of contracting influenza and passing it on to their older relatives. But remember, it takes two weeks to become fully protected. Keep that in mind if you want to time your flu shot ahead of Thanksgiving, the holidays or major travel.

Read more on the Cedars-Sinai Blog: Care Coordination for the Sandwich Generation

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