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Bacterial Pneumonia in Older People


Acute illnesses are especially dangerous for human health as they occur suddenly and have a substantial effect on the body. For this reason, patients who were hospitalized with this type of disease need a quick response, an accurate examination, and constant care. Bacterial pneumonia is an illness for which older people have high susceptibility; thus, its research helps to understand acute diseases and features of nursing care (Palleschi, Galdi, & Pedone, 2018). Consequently, pathophysiology and susceptibility factors of bacterial pneumonia in the elderly will be considered then a synergy model will be applied in this paper to determine the features of most effective treatment and care.

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Characteristics of the Causes and Course of Bacterial Pneumonia in the Elderly

Characteristics and Variables

Bacterial pneumonia is an infectious disease that affects a person’s lungs by causing inflammation. Common symptoms include coughing, difficulty breathing, sputum production, chest pain, and fever (Miyashita & Yamauchi, 2018). Older people usually have less physical and muscle strength to fight diseases, weaker immunity, and age-related ailments. For this reason, representatives of this group may not identify typical symptoms from chronic diseases, age-related changes, or cognitive impairment, and anorexia, malaise, and confusion may be atypical symptoms (Miyashita & Yamauchi, 2018). The main variables that increase susceptibility to pneumonia are the person’s age, comorbidity, lung disease, and reduced physical activity (Palleschi, Galdi, & Pedone, 2018). All these features lower the people’s immunity and make their body more vulnerable to infections.

Factors That Influence Rehabilitation

The physiological factors also affect the recovery of a patient with bacterial pneumonia. However, psychological features and social factors are also added to them (Palleschi, Galdi, & Pedone, 2018). The physiological determinants directly affect the treatment process as it requires a comprehensive selection of medications and nutrition to reduce the risk of all concomitant diseases. The presence of mental dysfunctions can limit the ability to follow the rules of treatment and self-care.

Depression and sociological factors affect the patient’s desire to participate in the treatment and fulfill the nurse’s appointments. Sociological aspects also can affect the quality of post-hospital care if the patient cannot follow nutritional rules or if there is no support for every-day procedures. For example, according to studies, patients with poor quality of life are less likely to undergo rehabilitation to a previous level after acute illness (Bornet, Truchard, Rochat, Pasquier, & Monod, 2017). Therefore, physiological, social, and psychological factors have almost the same effect on the rehabilitation of elderly patients.

Synergy Model for Person-Centered Care

Patients’ Characteristics

The synergy model is one of the most successful patient care options as it takes into account the personal characteristics of patients and the competency of nurses. Two characteristics of the patient that have an impact on the treatment of pneumonia in the elderly are participation in caring and resource availability (Slota, 2018). Both features are interconnected, since resources imply personal, material, and social aspects that affect the possibility of care. For example, mental illness can interfere with adequate decision-making and implementation of recommendations, which, in the absence of social support, can be impossible. Also, the lack of money for proper nutrition and the purchase of medicines, even if participation is desired, makes it limited or impossible.

Nurses’ Competency

The main features of nurses have to correspond to patients’ needs. Consequently, these characteristics are caring practices and collaboration (Slota, 2018). The first competency includes an understanding of all the patient needs and their satisfaction, such as medicines, nutrition, physical activity, and communication. A second competency is necessary for older people who are affected by various factors. For example, interacting with a patient’s family can push them to participate in his or her recovery, and contacting social centers can provide financial and moral support after discharge. In this way, the patient and the nurse can achieve synergy and help the elderly recover.

The Process and Methods of Rehabilitation

The Educational Program

A nurse who is focused on the needs of the patient can better understand the options for caring and speed up the healing process. One of the strategies in rehabilitation should be the education of patients about their condition, care, and treatment. For example, elderly patients with pneumonia experience difficulty in oral intake, which negatively affects their nutrition. For this reason, Momosaki (2017) emphasizes that the nurse should choose one of the training options for swallowing depending on the patient’s condition, such as a pose or method, and train him or her. Besides, part of the education is the care of the oral cavity because elderly patients often neglect this procedure, which can create the accumulation of bacteria, which will cause a relapse of pneumonia (Momosaki, 2017).

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Physical mobility is also essential as it reduces the possibility of complications, such as pressure sores or muscular dystrophy. For elderly patients, these complications are especially characteristic, since only 4% of them move during hospitalization (Palleschi, Galdi, & Pedone, 2018). Therefore, education on rehabilitation measures, including drug rehabilitation, should be part of the care.

Pharmacological Treatment and Nutrition

However, drug treatment and nutrition are integral elements of the rehabilitation of elderly patients. The common medicines for the treatment of bacterial pneumonia are narrow-spectrum antimicrobial drugs, such as β-lactam, ceftriaxone, or clindamycin (Miyashita & Yamauchi, 2018). Besides, piperacillin, tazobactam, carbapenem, or a fourth-generation cephem can also be used at a high risk of resistant bacteria (Miyashita & Yamauchi, 2018).

The nutritional peculiarity of the elderly is the use of soft and liquid foods due to dental issues, and the complications of pneumonia only reinforce this secularity. However, patients in the rehabilitation process must abandon alcohol and foods that stimulate the production of mucus but replenish their diet with proteins and complex carbohydrates to restore muscle mass and vitamins to strengthen immunity.


Bornet, M.-A., Truchard, E. R., Rochat, E., Pasquier, J., & Monod, S. (2017). Factors associated with quality of life in elderly hospitalised patients undergoing post-acute rehabilitation: a cross-sectional analytical study in Switzerland. BMJ Open, 7(10), 1–8.

Miyashita, N., & Yamauchi, Y. (2018). Bacterial pneumonia in elderly Japanese populations. Japanese Clinical Medicine, 9, 1–4.

Momosaki, R. (2017). Rehabilitative management for aspiration pneumonia in elderly patients. Journal of General and Family Medicine, 18(1), 12-15.

Palleschi, L., Galdi, F., & Pedone, C. (2018). Acute medical illness and disability in the elderly. Geriatric Care, 4(3), 62–64.

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Slota, M. C. (Ed.). (2018). AACN core curriculum for pediatric high acuity, progressive, and critical care nursing (3rd edition). New York, NY: Springer Publishing Company, LLC.

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