Nursing home residents are at particular risk for infectious diseases because of host risk factors, as well as risks inherent to grouped living quarters.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3083824/
Infection risks in the elderly
Host (i.e. resident) risk factors include age-associated changes in their immune system, which increases their susceptibility to systemic infection from pathogens. In addition to this, multiple comorbid diseases associated with ageing (e.g. diabetes mellitus, chronic obstructive pulmonary disease) can increase the risk of infection. Not to mention that degenerative disease requiring the insertion of prosthetic devices (e.g. joint prosthesis, implantable cardiac devices) and other indwelling devices, such as urinary catheters and feeding tubes, place nursing home residents at increased risk of common community-acquired infections.
Now that we know why our elderly residents are at a higher risk of infection, let’s look at some of the most common ones.
Both upper and lower respiratory infections are very common in our elderly residents. The most common respiratory infection likely to impact an aged care facility is influenza, or the flu.
The flu is caused by the influenza virus. There are many different strains of influenza and they change every year. Flu is not the same as a common cold. It is a serious disease as it can lead to bronchitis, pneumonia, heart and other organ damage, and death. The symptoms of flu include runny nose, cough or sore throat, fever and chills, headache and body aches. Symptoms usually start about 1 to 3 days after being contaminated and can last for a week or more. Some people can be mildly affected, while others can become seriously ill.
The flu spreads via droplet or contact. That is, when an infected person coughs or sneezes and another person breathes it in. Flu can also spread through direct contact with fluid from an infected person’s coughs or sneezes, and by touching a contaminated surface with flu virus on it, then touching your mouth, eyes or nose. So, to reduce the risk of spreading the flu, stay home if you are unwell, cover your coughs and sneezes, and perform effective hand hygiene often. You can find more information about influenza here.
Urinary tract infections
Another common infection in aged care is urinary tract infections (UTIs). UTIs are caused by bacteria. Escherichia coli (E. coli) is the most common cause, but other organisms such as Enterococci and Staphylococci are common in older adults who live in a nursing home or other full-time care facility. The classic symptoms of a UTI are burning pain and frequent urination, as well as abnormal urine odour and fever, although UTIs may not cause these classic symptoms in older adults. Instead, older adults, especially those with dementia, may experience behavioural symptoms such as confusion and agitation. Other symptoms may include incontinence, lethargy, falls, decreased mobility and decreased appetite. A urine culture will determine what type of bacteria is causing the infection, and therefore what is the appropriate antibiotic to treat it.
To lessen the risk of UTIs in residents, encourage them to drink plenty of fluids. It’s also important to keep the genital area clean by wiping front to back after going to the toilet, and to encourage effective personal hygiene, including effective hand hygiene.
Gastroenteritis, the dreaded gastro, is unfortunately a common infection in aged care facilities. Gastro is a short-term illness that can be caused by viruses, bacteria, parasites, bacterial toxins in contaminated food or chemicals (lead poisoning can trigger gastro). The symptoms can include abdominal cramps, diarrhoea, nausea and vomiting, body aches and lethargy, and in some cases blood and pus in the stool. It is important to establish the cause of the gastro, as different types of gastro respond to different treatments. Treatments may include plenty of fluids, electrolyte replacement, an appropriate antibiotic if bacteria is the cause, and anti-parasitic medication if parasites are the cause. But as they say, prevention is better than the cure, so prevent the spread of gastro by practicing effective hand hygiene frequently with soap and water. It’s also crucial that people affected by gastro stay at home until 48 hours after symptoms have ceased. For cleaning, the toilet and bathroom should be cleaned regularly (especially the toilet and toilet seat, taps and door handles and other frequently touched items and surfaces).
These common infections in aged care, as well as many others, are fortunately preventable through good infection control practice. Ensuring that good hand hygiene is performed by staff, visitors and residents alike is the first step. Infection prevention strategies should also include ensuring staff and visitors who are unwell do not come into the facility. It is also crucial that outbreak plans are up-to-date and well-rehearsed. This way, if there is an outbreak, everyone will know exactly what to do as soon as it happens.
If your facility is struggling with infections, or if you’d like an expert eye to check your infection control processes, contact Bug Control for an obligation-free chat. With over 25 years of experience, we can help you with all things infection prevention and control in aged care.