Sepsis is serious

Because they are easy candidates for sepsis, those over 60 must take extra care

elderly man having meal alone on the table

Sepsis is a medical emergency in response to a serious infection that spreads in the blood and overwhelms the body. Unless antibiotics and life support are given quickly, the condition can lead to multi-organ failure and death.

Since the elderly have decreased immunity and also often have other conditions like diabetes, hypertension and ischaemic heart disease, they are more prone to sepsis than younger individuals.

What causes sepsis

Micro organisms like bacteria, virus and fungi cause sepsis. Infections like pneumonia, urinary tract infections, cellulitis, gastro-intestinal infections if not treated on time, can spread quickly and lead to sepsis.

Signs of sepsis

  • A heart rate of more than 90 beats/minute [tachycardia]
  • Fever above 100.4 degree Fahrenheit along with chills or trembling, or body temperature below 96.8 degree Fahrenheit [hypothermia]
  • Rapid breathing—more than 20 breaths per minute

Skin rash, confusion, disorientation, weakness, agitation, dizziness or decreased urination are also signs of sepsis in the elderly. If any of the signs or symptoms mentioned above are present, the source of the infection needs to be determined with the help of tests.

Delay in seeking medical help in the elderly for initial infections could prove fatal. Death rate due to sepsis in this age group is about 80 per cent and a risk of developing dementia, neuropathy or cognitive impairment is also high. If you spot a sign, seek immediate medical attention.

When to be cautious

You need to be extra careful, if any of the conditions mentioned below are already present:

  • Poor immunity: Older people are often nutritionally and immunologically compromised, rendering them vulnerable to infections and associated complications. It is common to find individuals from this age group suffer from conditions such as arthritis. Many of them are even on catheters or feeding tubes—foreign objects in the body further increase their risk for sepsis.
  • Malnutrition: With ageing, as the sense of taste and smell diminishes, the elderly don’t enjoy their meals as much. This further leads to anorexia and deficiency of nutrients. They also have inadequate nutrition due to poor appetite, inactivity, depression, dental problems, social isolation, chronic diseases or dementia.
  • Social changes: Institutionalisation [nursing homes/old age homes] is on the rise and this often adds to risk of depression, crowding and neglect. These factors affect the senior person’s nutrition and immunity.

How to prevent it

Sepsis can be prevented if the senior takes the following steps:

  • Getting vaccinated against diseases like flu and pneumonia.
  • Maintaining good nutritional status.
  • Engaging in regular physical activity.
  • Maintaining good hygiene. This is key—mouth, skin, nails, genitals, and surrounding areas need to be kept clean.
  • Maintaining good hydration and electrolyte status.
  • Going for regular follow ups with family physician for existing diseases and taking prescribed medicines regularly in case of health conditions like diabetes and hypertension. Family members may have to keep a check to ensure regular intake of medications.
  • Avoiding exposure to extreme weather changes.
  • Taking adequate measures to prevent mishaps and accidents such as falls or burns.
  • Frequent position changes, in case of bed-ridden seniors to avoid bed sores.

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Chandrashekhar Tulasigeri
Dr Chandrashekhar Tulasigeri, MD[Internal Medicine] is an experienced physician, consultant intesivist and critical care physician at Fortis Hiranandani Hospital, Mumbai.


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