Many families move a loved one into a nursing home with the hope that they’ll be safe, well cared for, and closely monitored. But during visits, you might notice troubling signs—a persistent cough, shallow breathing, or unusual fatigue—all of which can indicate serious respiratory issues.
Respiratory infections are among long-term care’s most common and dangerous health risks. The Centers for Disease Control and Prevention (CDC) reports that just over 93 out of every 100,000 adults over age 65 die from the flu or pneumonia each year, with the risk rising sharply for those over 85.
Nursing home respiratory illness can develop due to age and vulnerability, but in some cases, neglect and unsafe conditions may be to blame.
Understanding the types of respiratory infections that affect residents, how they spread, and what to do when you suspect something is wrong enables you to respond quickly and prevent further harm.
Common Respiratory Infections in Nursing Homes
Many respiratory illnesses spread quickly in group living environments, especially when residents are elderly or have weakened immune systems. One study published in BMC Geriatrics found that during an outbreak, up to 85% of nursing home residents may be affected—most often by infections like pneumonia or influenza.
Viral respiratory outbreaks in assisted living typically see these conditions:
| Infection | What It Is | How It Spreads |
| Pneumonia | Lung infection that makes it hard to breathe and often brings fever, weakness, or chest pain. It can become life-threatening for older adults. | Nursing home-acquired pneumonia is often linked to bacteria or viruses, but can also develop when food, fluid, or saliva accidentally enters the lungs (dysphagia aspiration). |
| Influenza (Flu) | Brings on sudden fever, body aches, cough, and exhaustion. In a group setting like a nursing home, it can spread quickly. | It spreads through droplets in the air, such as from coughing, sneezing, or touching shared items after someone has been sick. |
| Bronchitis | Inflammation in the airways that causes heavy coughing, chest discomfort, and fatigue. May be short-term or ongoing. | Usually follows a viral illness like a cold, especially when the lungs are irritated or weakened. |
| COVID-19 | A wide range of symptoms, from sore throat and fatigue to severe respiratory distress. Older adults face a much higher risk of complications. | Triggered by the coronavirus, which spreads through close contact or shared air in poorly ventilated spaces. |
| Respiratory Syncytial Virus (RSV) | Often starts like a cold—with congestion and cough—but can lead to more serious lung infections in seniors. | Passed from person to person through coughs, sneezes, or touching surfaces where the virus lives. |
| Tuberculosis (TB) | Slow-moving infection that may cause weight loss, fatigue, coughing (sometimes with blood), and night sweats. | Caused by airborne bacteria released when someone with active TB speaks, coughs, or sneezes nearby. |
These infections differ in severity and impact. Influenza and RSV outbreaks, in particular, can lead to high hospitalization rates. One review found that RSV results in up to 1,104 admissions per 100,000 person-years, with a mortality rate of up to 23%.
During peak flu season, the CDC recorded 93.14 hospitalizations per 100,000 residents for influenza, higher than the rates for both COVID-19 and RSV.
Causes of Nursing Home Respiratory Infections
Although age and chronic conditions increase a resident’s risk, many respiratory infections in nursing homes trace back to facility-related failures. When care is inadequate, even a minor infection can become life-threatening.
Facility-related causes include:
- Improper hygiene practices. Failing to wash hands or change gloves between residents can transfer viruses and bacteria to shared surfaces or other patients. Cross-contamination increases the risk of respiratory infections spreading in the facility.
- Inadequate feeding support. Aspiration pneumonia in elderly care can occur when residents with swallowing difficulties aren’t closely supervised during meals. Without proper support, food or liquid may enter the lungs, leading to choking or serious infection.
- Poor ventilation. Inadequate airflow allows airborne viruses like COVID-19 or influenza to linger in the air, raising the chance of illness spreading between residents and staff.
- Delayed or missed medical care. Early signs of infection—like coughing, fatigue, or fever—can go unnoticed without regular health checks. When treatment, such as antiviral medication, is delayed, mild symptoms can turn into severe illness.
- Overcrowding and understaffing. High resident-to-staff ratios make it harder to follow recommended protocols for infection control in nursing homes, such as vaccination, isolating sick residents, and disinfecting shared equipment. Crowded facilities or rushed care create more opportunities for respiratory illnesses to spread unchecked.
These failures aren’t always apparent, but they can have devastating consequences. When signs of respiratory infection are caused by nursing home neglect, families need to know what to look for and how to respond.
Symptoms To Watch For
Respiratory infections in elderly residents can look different than those in younger people. Understanding these warning signs can help families recognize when something isn’t right.
Signs of pneumonia in nursing home residents often include:
- Persistent cough with mucus
- Shortness of breath
- Fever or chills
- Chest pain when breathing or coughing
- Weakness or fatigue
- Confusion or disorientation
Symptoms linked to other respiratory infections, such as bronchitis, RSV, or the flu, may include:
- Wheezing or noisy breathing
- Sore throat or hoarseness
- Runny nose or nasal congestion
- Dry cough
- Muscle aches or body pain
- Loss of appetite
- Rapid breathing or elevated heart rate
If these signs develop and staff don’t respond promptly—or if you suspect the facility’s conditions caused or worsened the infection—it may be time to take further action.
What To Do if You Suspect Neglect
When you see signs of a respiratory infection and suspect the facility hasn’t responded appropriately, you have the right to speak up and seek answers. The following steps can help you protect your loved one and begin building a record of what happened:
- Document the situation. Keep a written log of your loved one’s symptoms, when they began, how staff responded, and any communication you had with the facility.
- Ask direct questions. Ask the nursing staff or supervisor what symptoms they’ve observed, whether a doctor has assessed your loved one, and what treatment has been provided.
- File a complaint. Contact the California Department of Health to report suspected neglect or infection control violations. A long-term care ombudsman can also assist with investigating the facility and advocating for your loved one’s care.
If your loved one was hospitalized, suffered serious harm, or passed away due to a respiratory infection, speak with an experienced nursing home neglect lawyer. They can explain your family’s legal options and pursue justice on your family’s behalf.
Know Your Rights After a Nursing Home Respiratory Infection
Most serious respiratory infections in nursing homes are preventable with proper hygiene, supervision, and medical care. If your loved one was harmed due to respiratory issues in a nursing home, don’t stay silent.
At Gharibian Law, we represent families who have experienced nursing home neglect, including cases involving pneumonia, aspiration, and preventable respiratory infections. Our team understands how nursing homes operate and how neglect can hide behind vague explanations or delayed diagnoses.
We’ll review your case at no cost and help you decide the next steps. Contact us today for a free consultation.
FAQs
Pneumonia, influenza, and RSV are the most frequently reported respiratory infections. These illnesses spread quickly in shared living spaces, especially when hygiene practices and airflow aren’t well managed.
Pneumonia can develop from exposure to bacteria or viruses or inhaling food or fluids into the lungs. In nursing homes, it often spreads more easily when residents receive inadequate feeding support or when staffing is too limited to monitor early symptoms.
Aspiration happens when food, liquids, or saliva accidentally enters the lungs instead of the stomach. This can lead to inflammation or infection in older adults with swallowing difficulties, commonly known as aspiration pneumonia.
Prevention of respiratory infections in elderly care. Poor ventilation allows airborne viruses like the flu, COVID-19, and tuberculosis to build up indoors, especially in shared rooms or overcrowded facilities.
Reach out to a qualified elder abuse lawyer if you believe delayed care or unsafe conditions led to a severe infection. Legal support can help you understand your options and hold the facility accountable.