elderly do not present w/the typical s/s of uti, pneumonia or other infectious processes.
many are not febrile and moreover, most present w/only ms changes.
many have at least, mild cognitive deficits, making them unreliable historians.
many wouldn't even think to report burning on urination.
so in the absence of a temp or other classic signs of infection, pathologies are frequently overlooked in our elderly.
dehydration is an ongoing concern since applicable receptor sites are diminished as we age.
and so, signals that you and i receive, to tell us that we're thirsty, are highly impaired. they just don't receive these needed signals, so fluid intake is dangerously decreased.
uti's can result from poor grooming, e. coli finding its' way to the urethra, and an already compromised immune system that is also pervasive in the elderly population.
pneumonia, same thing.
basilar crackles could be their baseline.
many elderly have crackles as their baseline, usually r/t immobility or ltd mobility.
and in the absence of hacking cough w/fever, pneumonias often are not dx'd until advanced.
that's why you hear about ltc nurses having excellent assessment skills.
it's because of these very reasons: that elderly do not have the classic s/s that we find in the younger population.
change in the elderly, is often extremely subtle.
so if you see your elderly pt. much more lethargic, that's usually a 'classic' sign that something is wrong.
did i make sense with anything?