Respiratory Issues with Age

On average, we reach our peak lung capacity between 20-25 years old. During this time, our lungs have a maximum limit of six liters. After the age of 35, our lung capacity decreases and as a result, our breathing rate slows and physical activity becomes more difficult. Even healthy individuals with no history of smoking tend to decrease their forced vital capacity by 0.2 liters per decade. While some loss of functionality is inevitable, there are things you can do to help your residents improve their respiratory health and ensure a higher quality of life.

Be sure to consult with the attending physician and/or other specialists before making any changes to a resident’s individual health care plan.

Respiratory Changes As We Age

As we age, changes in our body cause our bones and muscles to become weaker. Bones in our rib cage become thinner and change shape. The diaphragm is the large muscle in our chest responsible for moving air in and out of the lungs. As it gets weaker, our ability to inhale and exhale to full capacity decreases.

There are also changes at the tissue level within our lungs. Muscles that kept airways open lose their elasticity and can close. The alveoli are the small sacs responsible for exchanging oxygen and carbon dioxide with the bloodstream. With age they tend to lose their shape, decreasing the efficiency of the gas exchange.

Changes in brain chemistry may affect how efficiently our nervous system triggers actions in our lungs and chest muscles. This problem is exasperated by dementia or other mental illnesses. When signals aren’t sent as clearly to our lungs, we lose control and often experience delays in otherwise automatic processes. Systems responsible for triggering coughs become less effective. Foreign particles build up in the lungs and can cause further damage to already deteriorating tissue.

The Consequences of Poor Respiratory Health

Respiratory degradation is so common among seniors that the U.S. Centers for Disease Control and Prevention reports that nearly 15% of all middle-aged U.S. adults suffer from lung disorders such as asthma or chronic obstructive pulmonary disease (COPD).

In fact, lung-related illnesses are the third most common cause of death in this country. Pneumonia is one of the major causes of mortality among seniors over the age of 65. The illness can present with symptoms ranging from mild to severe and can be fatal. More people die every year from pneumonia than from automobile accidents.

Pneumonia can be contagious, but most seniors actually develop the illness independently. Bacteria is present in everyone’s throats and noses. Elderly can have difficulty clearing contaminants from their lungs with reduced body function discussed earlier. The result is the bacteria that causes pneumonia is able to proliferate far more easily in an elderly person. Pneumonia can lead to bacterial infections in the blood and fluid in the lungs.

Once infected, it is also harder for elderly to fight off complications caused by pneumonia due to their weakened immune systems. This is why it is so critical to encourage a healthy respiratory system in your residents to prevent an infection from taking hold.

Another form of pneumonia is aspiration pneumonia, which is also common in elderly seniors. This occurs when the epiglottis (the flap that covers the windpipe during swallowing) does not close properly. Food and other particles can make their way into the lungs, causing inflammation or even lower respiratory tract infection. Because residents often have a reduced ability to cough properly (dystussia, or cough impairment), this contributes to the severity of aspiration pneumonia.

In some cases, switching residents to a soft food diet can sometimes help reduce the risk of aspiration pneumonia. Additionally, ensuring that residents are always seated upright while eating is important to encourage proper swallowing function.

How to Promote Good Respiratory Health

Perhaps the number one way to promote good respiratory health is to help your residents maintain their body’s ability to protect itself. Consuming a proper diet full of protein, and nutrients is key to good overall health. It’s also a good idea to cut back on foods high in simple carbohydrates (processed sugars and white bread products). These foods raise our body’’ insulin levels, causing inflammation.

A decrease in exercise routine with age is common as the body doesn’t function as well or as easily as before. However, in these golden years, it’s more important than ever to incorporate regular cardiovascular exercise into our daily lives to fight back against respiratory degradation. Encouraging  residents who are able to engage in daily cardiovascular exercise is critical to ensuring they maintain a healthy lung capacity and foster a higher quality of life. Even simple or modified routines for those who are not as ambulatory can help keep their bodies active and deterring muscle or other atrophy from setting in.

Avoid Toxins and Environmental Pollutants

Cigarette smoke is the primary cause of lung cancer. If you have residents who smoke, be sure a plan is in place to help them curb their habits and eventually quit. Cigar smoke and chewing tobacco are also dangerous; the chemicals in these products are known carcinogens and cause inflammation and swelling in the lungs, as well as increasing the risk for oral and throat cancers.

Maintaining a clean environment for your residents is vital to preventing many respiratory infections. Air pollution can irritate lungs and leave seniors susceptible to illness. Ensure that your residents have clean, dust-free environments to sleep in. Be conscious of water damage around your property and report any areas that could be at risk for developing mold. Residents and others will benefit from a no-smoking guest policy to avoid exposure to the contaminants in second-hand smoke. Washing or frequent changes of work clothes, as well as hand-washing or using gloves can help prevent the spread of germs.

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