Nursing homes are the ultimate destination for many elderly people in America. According to the CDC, around 1.5 million Americans reside in about 16,000 nursing facilities in the United States. By the year 2020, that number is expected to reach 5.3 million people.
Nursing homes serve an older clientele, often with pre-existing health conditions or compromised immune systems. The close conditions under which they live can make nursing homes a stalking ground for infectious diseases: an estimated 2 million infections occur in US nursing facilities each year. These infections can kill patients and put tremendous pressure on nursing staff. Here are some of the most common culprits.
Urinary Tract Infections
UTI’s are far and away the most common infection found in nursing homes. These infections occur when bacteria get into the urinary tract or bladder, causing everything from inflammation to sepsis. A common source? Catheters: after 30 days with a catheter, about 100% of residents will show bacteria in their urine. Up to half of all nursing home residents are likely to have symptomatic urinary tract infections, and those with indwelling catheters have a higher death rate than those without.
Pneumonia—an infection that inflames the air sacs in the lungs—is a widespread problem, commonly diagnosed by chills, muscle pain, fever and difficulty breathing. Elder care residents in the U.S. make up as much as 18% of all people hospitalized for pneumonia, and the disease is the leading cause of death among nursing home residents. Part of the issue is that older adults don’t always develop clear symptoms, and the diagnosis has to be made through bloodwork and chest x-rays.
As we get older, our skin gets more fragile, drier, and takes longer to heal from wounds. Dry, itchy skin can be an entry point for bacteria. Once there, bacterial infections cause red, inflamed and hot swellings that can produce pus and spread rapidly. These can include potentially deadly conditions like cellulitis, and necrotizing fasciitis, as well as chronic infections around wounds. These infections can enter the blood, where they are particularly lethal.
Gastroenteritis, an inflammation or infection of the gut caused by viruses or bacteria, causes the majority of cases in nursing homes. Elderly adults don’t produce enough gastric acid in their stomach, which makes their organs more welcoming to bacteria. Usually, these infections burn themselves out without any need for treatment. But they can be dangerous for nursing home residents, who tend to have a greater risk of dehydration. Some studies suggest that nursing home residents are four times more likely to die from gastroenteritis than peers living independently.
Airborne viruses are the cause of many illnesses in nursing homes since air is often exchanged through an entire building containing many residents through the heating, ventilation and air conditioning (HVAC) system. Two of the most common airborne infections are influenza and COVID-19. It is of vital importance that nursing homes and elder care facilities routinely test and monitor their HVAC systems to reduce the risk of airborne transmission.