Staph and MRSA in Older Adults: A Family Guide

Why age raises the risk

Staph is a common bacterium. About 30% of people carry Staphylococcus aureus in their nose, usually with no harm.¹ MRSA is a type of staph that doesn’t respond to some common antibiotics. Older adults are more likely than younger people to get sick from these germs.²

Several things tend to stack up with age:

• Long-term health conditions such as diabetes, cancer and vascular disease.¹
• Hospital stays and surgery, which bring wounds and more contact with germs.¹
• Medical devices like IV lines and urinary catheters, which give bacteria a path into the body.^1,2
• Living in a long-term care facility.²
• A weaker immune system.^1,2

Why infections can look different

In a younger person, an infection usually shows up with fever, pain and redness. In older adults, the signs can be much quieter. Geriatric nursing experts note that serious infections in older people may cause no fever at all.³

Instead, you may notice changes like these:³

• New confusion, or confusion that gets worse
• A fall, or new trouble walking or standing
• Eating or drinking less than usual
• Unusual tiredness or weakness
• Trouble with everyday tasks they could handle last week
• A long-term condition that suddenly gets worse

None of these means staph on its own. But if your parent or grandparent “just isn’t themselves,” it’s worth asking a doctor whether an infection could be the cause.

What to watch on the skin

Most staph infections start in the skin. They can look like a pimple, a boil or another skin problem.¹ MRSA skin infections often begin as swollen, painful bumps that look like pimples or spider bites. The area may feel warm and hold thick fluid.²

When you help with bathing or dressing, take a quick look at:

• Cuts, scrapes and skin tears, until they heal
• Surgical incisions
• The skin around IV lines, catheters and other devices
• Pressure points like heels, hips and the lower back
• Any bump that is red, swollen, warm or draining

This matters most for someone with memory loss or trouble speaking, who may not be able to tell you that something hurts. A quick, regular look lets you catch a change early.

During and after a hospital stay

Hospitals are where some of the most serious staph infections happen, including bloodstream infections, pneumonia, and infections of the heart valves and bones.¹ Families can help lower the risk:

• Ask about devices every day. The CDC suggests asking each day whether a catheter or IV line is still needed, so it can come out as soon as it’s safe.⁵
• Speak up about hand cleaning. It’s okay to ask a doctor or nurse to clean their hands before they touch your loved one.⁶
• Report changes fast. Tell the care team right away about redness, swelling, warmth or drainage at a wound or device site.⁵
• Clean your own hands when you arrive and when you leave. The CDC says the chance of catching MRSA while visiting a patient who has it is very low.⁵

Before discharge, ask the team three things: which signs should make you call, who to call after hours, and exactly how to care for any wound or device at home. Write the answers down.

If your loved one lives in a facility, see our guide to questions to ask a nursing home.

When to see a doctor

Because the signs can be subtle, trust your sense that something has changed. Call the doctor if your loved one has:

• A red, swollen, warm or painful bump, or one that drains pus²
• Redness spreading around a wound, incision or device site⁵
• A fever, even a mild one, along with a wound or skin problem²
• New confusion, a fall, or a sudden drop in eating or drinking³

Call 911 or go to the emergency room for signs of sepsis, the body’s extreme reaction to an infection. These include confusion or disorientation, clammy or sweaty skin, extreme pain, fever or shivering or feeling very cold, a fast heartbeat or weak pulse, and trouble breathing.⁴ Sepsis is a medical emergency.⁴

Don’t squeeze or drain a bump, and don’t try to treat a suspected infection with home remedies. A doctor can test it and choose the right treatment.

How families can help every day

• Help your loved one wash their hands often, with soap and water for at least 20 seconds, or with a sanitizer that is at least 60% alcohol.²
• Keep cuts and scrapes clean and covered until they heal.²
• Don’t share towels, razors or other items that touch skin.¹
• Keep a simple list of their conditions, medicines, devices and any past MRSA infection to share with each new provider.
• If antibiotics are prescribed, help make sure they’re taken exactly as directed.

If your loved one has MRSA and lives with you, our guide to caring for someone with MRSA at home walks through laundry, cleaning and bandage care step by step.