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Discerning Between Influenza or COVID-19 in Older Adults

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Aging adult sitting.jpgKnowing whether you or an aging loved one is coming down with influenza or COVID-19 can be tricky since symptoms are similar. But, there are key differences amongst the symptoms and their onset. With either illness, older adults aged 65 and over and individuals with underlying health and/or chronic conditions, are at a higher risk of becoming sick.

COVID-19 Symptoms

While many of these symptoms are similar to those of influenza, the primary difference to note is the loss of taste and/or smell. As individuals age, sensory loss is common; therefore, aging adults experiencing any of the following symptoms or any abnormalities noticed, should contact a primary physician and consider being tested for COVID-19.

Symptoms may be noticed 2-14 days after exposure and can range from mild to severe.

According to the Centers for Disease Control (CDC) and the World Health Organization (WHO), people with the symptoms below may have COVID-19.

Seasonal Influenza Symptoms

Most of the time seasonal influenza, an acute respiratory infection, is a sudden onset of not feeling well (malaise), fever, headache and dry cough. Most people recover within a week without complications; however, older adults are at higher risk. According to WHO symptoms can range from mild to severe.


The Concern this Season

What has healthcare providers and family caregivers concerned for this flu season, is that there is no evidence an individual cannot become infected with both viruses at the same time.  Since both can be deadly for seniors and those with underlying health conditions, the need to diligently practice proper handwashing techniques and decrease any unnecessary exposure is paramount.

The risk increases for older adults with chronic conditions such as, diabetes, asthma, COPD, heart disease, post-transplant, immunocompromised with cancer or on a long-term steroid or other immunosuppressant.

For aging adults with chronic conditions, the most serious complication of influenza or COVID-19 is pneumonia, which can become deadly if not treated quickly.

See a healthcare provider for any of these symptoms:

  • Difficulty breathing (respiratory distress of any kind) including difficulty with any amount of exertion. For example, going up a flight of stairs leaves you unable to catch your breath.
  • Persistent chest pain or pressure
  • Fever of 103 degrees or higher
  • Severe weakness or unsteadiness
  • Harsh cough that produces blood
  • Signs of dehydration such as not urinating or decreasing level of alertness

9 Ways to Limit Exposure to Viruses

In addition to these five tips to help seniors prepare for and reduce the risk of illness, following these guidelines can help limit exposure and protect from either virus.

  1. Wear a mask. Mask wearing is critically important in public spaces, but wearing a mask at home when visitors (ask them to wear one too) come over will help decrease any potential exposure.
  2. Avoid crowds and unnecessary travel. Limit visitors and outings to only necessities. Consider online ordering with porch delivery or enlist the help of a CAREGiver to run errands and grocery shop.
  3. Practice proper handwashing. Wash hands often for at least twenty seconds with soap and water. To prevent the spread of either virus, wash hands after blowing your nose, coughing or sneezing; after being in public; before and after caring for someone who is sick.
  4. Practice social distancing. When outings are required, be sure to stay six feet from one another wear a mask for extra protection.
  5. Stay home if ill or not feeling well. The country has been practicing social distancing measures for months, and social isolation and loneliness may be setting in for older adults. Now is not the time to become complacent. If you or another family member or friend feel ill, or have knowingly been exposed to either virus, avoid contact with others. Either virus can be spread up to two days before symptoms present and, in almost all cases, they remain contagious for a minimum of seven days.
  6. Carry your own pen or stylus. When outings are necessary, bring your own pen to complete transactions.
  7. Walk instead of drive. Walk when possible to increase exercise and limit time within the close quarters of vehicles and public transportation.
  8. Avoid buffet style meals. This will limit potential germ transfer from shared utensils.
  9. Add moisture to your air. Viruses tend to linger longer in dry air. A Yale School of Medicine study suggests that increasing water vapor in the air through humidifiers is a potential strategy to reduce flu symptoms and speed recovery. 

Boosting the Immune System

Older adults have weaker immune systems and its possible family caregivers do as well because of stress and lack of sleep, which are common amongst those caring for others. These tips can help older adults and family caregivers improve their immune systems.

  • Increase fluid intake. Hydration plays a vital role in keeping our bodies well.
  • Take dietary supplements. Vitamin C is known for its antioxidant properties and vitamin B12 is an energy producer. Many older adults, 60 or older have vitamin B12 deficiency
  • Eat a balanced diet. Eat whole foods rich in key nutrients like zinc, iron, protein and vitamins C and D. Avoid processed foods like packaged cookies, meats and chips.
  • Get enough sleep. Sleep is an essential element for a strong immune system. Lack of sleep decreases the body’s ability to fight off viruses. Studies show that people sleeping less than six hours per night are four times more likely to catch a cold than those who sleep seven hours a night.
  • Exercise. Exercising boosts the immune system and benefits the body. These helpful fitness articles are designed for older adults.

Get a Seasonal Influenza Vaccine (Flu Shot)

This season it is more important than ever to be vaccinated to decrease the risk of becoming ill and any complications that could arise from either virus. For seniors, influenza and complications from it can quickly develop into severe illness or death. The CDC recommends seniors (individuals over 65) get a flu shot before the end of October, but timing should be discussed with a healthcare provider before being vaccinated.

Why Get the Influenza Vaccine?

  • Reduce risk and severity. Even if the flu vaccine isn’t 100 percent effective, if you or a loved one come down with influenza, the symptoms will be less severe and the risk of developing complications decreases. One of the most severe and common complications is pneumonia, which can be deadly.
  • Medicare or most insurances cover the cost. As long as the provider accepts Medicare, the vaccination is free. Check with your insurance company about coverage for this preventative service. Many drugstores, pharmacies and Veterans Affairs medical facilities also offer low cost flu shots.  

Of all things to be aware of this cold and flu season, it’s of utmost importance to listen to your body and be in touch with aging loved ones to help assess any virus symptoms. Don’t be afraid to call a healthcare provider or schedule a telehealth appointment to discuss any influenza, COVID-19 or other health concerns. Remember it’s best to be proactive with any health concerns and you shouldn’t feel guilty for calling a physician or the nurse line.

For more caregiving during COVID-19 resources, visit For more information about COVID-19 and seasonal influenza, visit Centers for Disease Control (CDC) and the World Health Organization (WHO).

Author: LaNita Knoke

LaNita Knoke is a Registered Nurse with more than 25 years of clinical experience including direct care and clinical business. As a healthcare strategist, she is responsible for the healthcare adjacency strategy for the Home Instead Senior Care global network, which includes a focus on care transitions programs, community resources, and understanding of home care as it relates to the clinical continuum.


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