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4 Stages of Pneumonia in Seniors

  • Last Updated February 13, 2022

Anyone can get pneumonia with symptoms ranging from mild to severe. Seniors may be more likely to get pneumonia and experience serious complications. Due to these higher risks, senior care providers need to recognize early pneumonia symptoms in seniors.

They also should understand the four stages of pneumonia so they can seek prompt treatment from a qualified healthcare provider.

What is Pneumonia?

Pneumonia is an infection in one or both lungs that is caused by bacteria, viruses, or other less-common types of infections. The infection causes air sacs in the lungs to become inflamed and filled with fluid or pus, leading to:

  • Cough
  • Fever
  • Chills
  • Chest pain
  • Breathing troubles
  • Other symptoms

Pneumonia is classified based on the area of the lungs that it affects. Bronchial pneumonia, which is also called bronchopneumonia, affects areas in both lungs.

Lobar pneumonia affects one or more lobes, or sections, of the lungs and is divided into four stages depending on how it progresses.

Stages of Pneumonia

The four stages of lobar pneumonia include:

  • Stage 1: Congestion
    During the congestion phase, the lungs become very heavy and congested due to infectious fluid that has accumulated in the air sacs. During this stage, your older loved one may experience early pneumonia symptoms such as:

    • Coughing
    • A feeling of heaviness in the chest
    • Loss of appetite
    • Fatigue
    • Rapid breathing

  • Stage 2: Red hepatization
    Red blood cells and immune cells that enter the fluid-filled lungs to combat the infection give the lungs a red appearance. Although the body is beginning to fight the infection during this stage, your loved one may experience worsening symptoms such as:

    • Increasingly productive cough
    • Shortness of breath
    • Muscle aches
    • Headache
    • Extreme fatigue
    • Fever
    • Chills
    • Sweating
    • Blue lips or fingernails due to low levels of oxygen in the blood

    Some older adults may experience confusion or delirium during this stage. If your senior loved one experiences severe symptoms such as difficulty breathing, high fever, or blue lips or fingernails, you should seek emergency treatment or dial 9-1-1.

  • Stage 3: Gray hepatization
    Red blood cells will disintegrate during this stage, giving the lungs a grayish color. However, immune cells remain, and symptoms will likely persist.

  • Stage 4: Resolution
    During the resolution phase, seniors may begin to feel better as immune cells rid their bodies of infection. However, they may develop a productive cough that helps to remove fluid from the lungs.

A Prompt Diagnosis for Proper Treatment

If you suspect your loved one may have pneumonia, you should call a doctor right away. Earlier diagnosis can lead to faster treatment that promotes better outcomes — especially for seniors who are at a higher risk of developing serious complications.

A doctor will conduct a physical exam and may order imaging tests to confirm the diagnosis. Treatment will depend on whether the pneumonia is caused by bacteria, viruses, or other types of infection.

Bacterial pneumonia comes on gradually or suddenly and is typically treated with antibiotics.

Viral pneumonia usually develops over several days and may be accompanied by flu-like symptoms. Antibiotics are not effective against viruses, so viral pneumonia is generally treated with supportive care such as increased fluid intake, over-the-counter medications, and rest.

Older adults who experience severe pneumonia symptoms or have other health problems may need to be hospitalized. While in the hospital, treatment may include intravenous (IV) antibiotics, respiratory therapy, and oxygen therapy. Doctors will also watch for signs of complications.

Pneumonia Recovery

Recovery from pneumonia may take several weeks, and it may take even longer for older adults to get back to normal — especially if they are living with another chronic medical condition. If your older loved one has experienced a bout of pneumonia, he or she may even require temporary or ongoing senior care services to assist with bathing, toileting, grooming, dressing, meal preparation, shopping, and other light household duties.

Hiring a professional caregiver during your loved one’s recovery will ensure personal care needs are being met by a qualified professional, providing you with peace of mind. Your loved one’s caregiver can also keep an eye out for future signs of pneumonia and promptly alert you.

Our Visiting Angels care coordinators are available to discuss your loved one’s needs during a free in-home care consultation.


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