How to Reduce the Risk of Tuberculosis in Senior Care Facilities

Tuberculosis (TB) is a serious bacterial infection that poses a significant threat to health, especially in environments like senior care communities where its highly contagious nature is a concern. Although TB can affect people of any age, the vulnerability of seniors makes it particularly important to address in these settings. Fortunately, senior care communities can take several proactive measures to reduce the risk of TB and safeguard the health of their residents.

Why Senior Care Residents Are at Increased Risk of TB

Dr. Daniel Linares, MD, is a Board-Certified family physician and Co-Founder of Viapromeds

There are several factors that heighten residents’ risk of contracting TB. Dr. Daniel Linares, MD, is a Board-Certified family physician and co-founder of Viapromeds, a telehealth platform tailored to Latinos’ specific healthcare needs. He explains that weakened immune systems, underlying chronic conditions, and old age can leave residents more vulnerable to TB. “Many residents may have been exposed to TB earlier in life when the disease was more prevalent, but their infections can become active as their immune function declines,” he says.

Additionally, the close living quarters inherent in senior care communities can increase the chance of the disease’s spread, and staff members and visitors may unknowingly bring TB into the community.

Given that TB is highly contagious, staff are also at increased risk of exposure when working closely with residents. TB exposure in staff can lead to health concerns as well as absences from work.

Common TB symptoms include a persistent cough that lasts three weeks or more. Individuals may cough up blood or mucous and may have chest pain and difficulty breathing. Additional symptoms can include unexplained weight loss, fatigue, loss of appetite, night sweats, and fever. “In elderly individuals, these symptoms may be less pronounced, and they might instead show general weakness or confusion,” says Linares. Additionally, TB can affect other organs, leading to symptoms like back pain or abdominal pain.

Challenges in Identifying and Treating TB in Senior Care Communities

There are also several challenges to identifying and treating TB in senior care settings. “For starters, TB symptoms can vary from fatigue, weight loss, and chronic cough, and these can easily be mistaken for normal signs of aging or other common conditions in elderly residents, leading to delayed diagnosis,” explains Linares. Additionally, residents often have underlying health issues, which makes it difficult to distinguish TB from other diseases. For example, in older adults with pre-existing lung conditions, chest X-rays may be harder to interpret.

Linares explains that managing long-term antibiotic therapy to treat TB can be difficult, since antibiotics can interact with the other medications residents are taking. “Lastly, infection control in shared living environments requires significant resources, training, and vigilance, which may strain already limited staffing and budget capacities in these communities,” he says.

How to Identify and Prevent TB Spread

Linares recommends that senior care communities implement regular TB testing. Common tests like the Tuberculin Skin Test (TST) and the Interferon-Gamma Release Assay (IGRA) blood test can both detect latent TB infections, which can help the community prevent the disease from becoming active.

If a resident tests positive for TB, it’s crucial to immediately isolate the resident to prevent the spread. “This should be done in a well-ventilated room or, ideally, a negative pressure room,” says Linares. “The individual should undergo a comprehensive medical evaluation, and public health authorities must be notified to conduct contact tracing and provide guidance.”

Exposed individuals should be tested for TB, and treatment for the infected resident should be based on the type of TB they have and its severity. “Close monitoring and adherence to prescribed medication regimens are critical to ensuring recovery and preventing complications or resistance,” notes Linares.

To prevent TB spread, senior care communities should implement regular screenings for residents and staff. Linares encourages communities to adopt annual TB tests for high-risk individuals, and to ensure that new residents and staff are screened prior to joining the community. Ventilation systems need to be optimized to reduce airborne transmission, and residents with respiratory symptoms should be promptly evaluated. Training staff also plays an important role. Staff should know how to recognize early signs of TB and enforce infection control protocols.

Preventing TB to Ensure Resident Safety

“TB remains a serious public health concern, especially in senior care facilities where residents are more vulnerable,” says Linares. Senior care communities need to take a proactive approach to infection control, and adopting early detection practices can help reduce the risk. “I encourage facilities to regularly review their protocols and stay updated on the latest public health guidelines to ensure they’re providing the best care possible for their residents,” Linares explains. “Collaboration with local health departments and specialists is also critical in managing and preventing TB outbreaks.”

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.