13th September marks World Sepsis Day – a useful reminder that infections, when ignored, can become far more serious – especially for older people, and those living with underlying health conditions.
For those that don’t know – Sepsis is a life-threatening condition and reaction to infection that can cause serious damage to a person’s vital organic if it’s not recognised and rapidly treated. The most pernicious thing about Sepsis is that it can begin with relatively ordinary-seeming infections – such as a Urinary Tract Infection (UTI), or chest infection. Statistically, older adults are the most at risk of these conditions becoming the early stages of sepsis.
While there is a greater level of risk, it doesn’t mean that every infection will inevitably become sepsis – most won’t. The important thing, however, is being aware of the symptoms, noticing when a loved one is becoming unwell, and making sure that there is someone around to notice and report it, to ensure they get help as soon as possible.
For an older person living alone, that second part can be particularly important.
Understanding Sepsis - How Fast it Develops
While not every infection can become sepsis, infection can sometimes deteriorate rapidly, which is why it’s important to keep a vigilant eye.
For example, if a loved one contracts a UTI, this can cause symptoms like:
- Urinating more frequently
- Pain or burning sensation when urinating
- Elevated or lower temperature
- Feeling weak or tired
- Changes in behaviour
For those living with neurological conditions like Parkinson’s or dementia, a UTI can also present with increased confusion or agitation.
A chest infection can become even more serious, especially if an elderly person has, or develops breathing difficulties.
The key distinction is that infection and sepsis are not the same thing. But if someone with an infection suddenly seems to be getting worse, it is important to take that deterioration seriously and seek medical advice as soon as possible.
The (Not So Neat) Progression of Sepsis
While we’ve discussed the way that sepsis can manifest from chest infections and UTI, it’s important to go over the way that it can progress. Here, we’ll break down the way that infection can break down into sepsis.
Infection
Every case of sepsis begins with infection. Common sources like UTIs, chest infections like pneumonia, and infections affecting the skin, already formed wounds.
Possible signs of infection include:
- Elevated or low temperature
- Feeling unusually tired or weak
- Pain or discomfort
- Coughing or difficulty breathing with a chest infection
- Pain or burning when urinating
- Needing to urinate more frequently
- Changes in behaviour or new feelings of confusion or frustration
Inflammatory Response (SIRS)
Following on from an infection, the body triggers an immune and inflammatory response. Clinicians typically refer to this inflammatory response as SIRS – Systemic Inflammatory Response Syndrome.
SIRS can involve changes such as:
- Temperature: Above 38 degrees or below 36 degrees
- Heart Rate: Above 90 BPM
- Breathing rate: above 20 breaths per minute
- White blood cell count: unusually high or low
Importantly, SIRS does not mean that someone has sepsis. These signs can manifest as part of the body’s normal response to infection, and can also happen with a large number of conditions. While modern definitions of sepsis don’t use two or more SIRS criteria as a definition of sepsis, they are still important to know as potential signals of sepsis.
More practically speaking, the message for families and carers is simple: any substantial change in a loved one’s condition should not be dismissed out of hand, simply because they are older or have pre-existing medical problems.
Sepsis
Sepsis occurs in the body as a response to infection, becomes dysregulated and causes symptoms including life-threatening organ dysfunction. When infection progresses to sepsis, it becomes a medical emergency, and requires urgent medical assessment and treatment.
Warning signs for sepsis include:
- New confusion, disorientation or difficulty with speaking
- Severe or irregularly fast breathing
- Extreme levels of shivering or muscular pain
- High or low body temperature
- Passing little to no urine
- Pale, blue or greying skin
- Rapid deterioration of health or feeling extremely unwell.
There is no single symptom that immediately confirms sepsis, and someone doesn’t need to have every single warning sign above. For older people, especially those who are frail, or living with alzheimer’s or dementia, may also present differently from younger, healthier adults.
Septic Shock
In the most serious cases of sepsis, it can unfortunately progress to, what is referred to is septic shock; which involves severe problems with circulation and the body’s ability to maintain adequate blood flow to vital organs.
This becomes a critical medical emergency requiring urgent treatment.
Signs of deterioration or septic shock include:
- Severe difficulty breathing
- Increased confusion or difficulty staying awake
- Very little to no urine
- Pale, blue, grey or mottled skin
- Signs of very low blood pressure or poor circulation
Septic shock isn’t a condition that can be monitored or managed through home or live in care. If someone is unwell and exhibiting these kinds of conditions, call 999 or immediately go to A&E.
Why Understanding This Progression Matters
What is important for families to know is this: it is not a case of trying to personally diagnose SIRS, sepsis or septic shock at home.
Instead, it is important to look and be aware of any significant changes from a loved one’s usual condition, especially when they have an infection, or one is suspected.
A person that suddenly starts feeling confused, unusually sleepy or breathing differently, urinating less or deteriorating needs quick medical attention. This becomes really important when someone whose elderly lives alone, because there may be nobody present to notice these changes early.
Regular home care cannot diagnose or prevent sepsis, but a carer who knows someone’s normal routine may be well placed to notice when something has changed and alert the appropriate person.
Why These Early Signs Get Missed
One of the greatest challenges for anyone suspected of having sepsis is that many of its early-stage symptoms can easily overlap with other illnesses.
An elderly person might suddenly feel tired, less interested in conversation or eating, or simply not feel ‘like themselves’. New feelings of confusion can manifest, so it’s important not to dismiss this as a part of age either, as this is a critical symptom of initially developing SIRS / Sepsis.
For someone living with Alzheimer’s or dementia, recognising and communicating a change in how they are feeling can be more of a challenge. Consistent support – including live-in dementia care where necessary – can mean there is someone familiar with them, who understands their usual behaviour and can notice, and raise any changes.
The Importance of Someone Noticing
It’s here that regular care can make a serious difference.
While family members may have contact with their loved ones, that can range from anything from occasional, in-person visits to a phone call a day to hear that everything is ‘fine’. But having a carer who regularly visits them at their home may notice changes in their behaviour in habits; like not eating meals, feeling unusually sleepy, or feeling more confused than normal.
This doesn’t mean that a carer would diagnose them with an infection or sepsis.
Their importance is in understanding that person’s normal routine, and noticing any changes in it.
That observation can then easily be communicated to their family or associated healthcare professionals, allowing concerns to be escalated and addressed, rather than waiting for the situation to deteriorate.
For someone that lives alone, regular home care or live in care can provide an additional, vital layer of everyday observation, alongside practical help with meals, personal care, medication management and companionship.
A Little Extra Watchfulness Can Make a Difference
The important take-away of World Sepsis Day is not about fretting over every cough, rise or drop in temperature or change in routine. It’s about understanding that, if not properly monitored, infections can sometimes become serious – and that early recognition is vital.
For an older person that’s living alone, regular care visits can provide reassurance and another pair of eyes when family members cannot be there every day.
Rainbow Home Care provides regular home care and overnight support in Hertfordshire, helping older people remain comfortable and independent at home while giving families greater peace of mind. Talk to Rainbow Home Care about a care routine that provides the right level of practical support and watchfulness.
