Is shingles dangerous for older adults?

Understand the challenges and risks of shingles in older adults

Shingles is known as a common condition that can affect older adults, so understanding more about this and the impact it could have can help you avoid the condition, or take the necessary steps if you or a loved one does develop shingles.Here, we are providing an overview of shingles, how it relates to chickenpox, the level of risk for older adults, symptoms to watch out for, how it is diagnosed and treated, how you may be able to prevent it, how to manage it at home, and support for home caregivers. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about shingles, we can help. 

What symptoms can shingles cause? 

Shingles tends to affect only a small area of the body or face, such as near the waistline, and normally on just one side. As the virus travels along specific nerves the rash only appears in the area where the nerves transmit signals. Some of the most common symptoms of shingles in older adults include: 

• A burning or shooting pain  
• Tingling or numbness on skin 
• Itching 
• A rash, or blisters filled with fluid 
• Chills 
• A fever
• A headache 
• An upset stomach 

Many people will only experience these symptoms mildly, and can manage them well on their own. For others, shingles can be intensely painful and easily irritated, making it difficult to continue with daily life as normal. When this happens, home care may be needed. The symptoms of shingles typically don’t last more than 3-5 weeks, but knowing the early warning signs can prompt an intervention from a doctor that could stop the further progression of the illness.

How is shingles diagnosed? 

With shingles, an early diagnosis is incredibly important in order to minimise symptoms and stop them progressing or developing into one of the above mentioned serious conditions. Studies have shown early diagnosis can make a significant difference to the long-term impact of shingles in older adults, as the condition could lead to blindness if it involves the eye, hearing issues if near the ear, worse infections such as pneumonia or encephalitis, and even death. Some medicines for shingles can be effective if administered within 3 days of a shingles rash appearing, so the earlier this can be diagnosed, the better the outcome. If you or a loved one is experiencing any symptoms of shingles (even if they seem mild), it is recommended that you seek medical advice as early as possible by calling 111 if you are in the UK, so they can provide tailored advice based on your exact symptoms and where the rash has occurred. Keep in mind, the first signs of shingles may include a tingling or painful feeling on a particular area of skin (often pain will occur before a rash shows up), a headache or a general feeling of illness, or a rash somewhere on the body, with the most common places being the chest or stomach on only one side of the body. A doctor will typically diagnose shingles after asking questions about the history of pain on the affected side of the body, as well as examining any rash or blisters that appear. In some cases, they may request to take a tissue sample of the rash to be able to conclusively diagnose shingles, if they suspect something else could be causing this. 

How is shingles treated? 

There is no cure for shingles, and it can get better on its own without assistance. However, it is advised older adults at least speak to their doctor if they suspect they have symptoms of shingles, as often treatment is needed to reduce the severity and duration of symptoms. Receiving treatment with medications as early as possible can help ensure a speedy recovery from shingles; 2018 research suggests a quick response to the early signs of shingles is the best way to ensure no further complications. Medications that may be used to treat shingles include antivirals, pain medications like topical patches, numbing creams, corticosteroid injections, anticonvulsants to help calm nerve pain, and antidepressants if symptoms are affecting the person’s mental health. If any of the aforementioned complications develop, such as secondary infections or skin conditions, these can be treated accordingly alongside treatment for shingles. 

Can older adults avoid shingles? 

If you are wondering if any steps can be taken to avoid developing shingles in future, the best way to prevent shingles is to get the available vaccine, known as the Shingrix vaccine here in the UK. This is often recommended for anyone aged 50 and over in order to avoid developing shingles, and this involves two doses of the vaccine administered a few months apart. Even if an older person has already had shingles, unlike chickenpox they can develop this again, so getting the vaccine is very important for this age group. Some research finds the vaccine is thought to be around 68% effective at preventing shingles within the first year after getting it, while further studies suggest it could be more than 90% effective at preventing shingles, as well as postherpetic neuralgia, and could remain 85% effective for at least 4 years after being vaccinated. As well as the vaccine, it can also help to take steps to naturally boost the immune system in order to reduce the chances of developing shingles, and this can be done by reducing stress as much as possible, eating a healthy, nutrient-rich diet, maintaining a healthy weight, exercising regularly, getting enough sleep each night, and avoiding smoking.

How can shingles be managed at home? 

If you are caring for a loved one who has developed shingles, there are steps you can take to make them feel more comfortable at home during a time when they are likely feeling very ill and vulnerable due to being unable to take care of themselves as they could before. Firstly, it is helpful to know that you cannot catch shingles from someone who has it, so you don’t need to worry about this spreading to you. However, if you have never had chickenpox, you can still catch chickenpox from someone with shingles, so if this is the case for you it is wise to arrange alternative care for your loved one to avoid you catching this. Shingles spreads through contact with the fluid-filled blisters that develop on skin. Until these blisters or the rash has dried up, this is still contagious unless covered with a dressing. When caring for someone with shingles, you can help them by:

• Making sure they are dressed in loose clothing around the rash site for comfort 
• Gently cleaning the rash with mild soap and water, and keeping it dry
• Helping them to take a cool bath to relieve pain in the rash
• Using a cool, wet compress on the blisters to relieve itching and pain
• Ensuring they get plenty of rest to boost their immune system 
• Keeping them hydrated

As well as physical support, depending on the severity of the condition and the pain your loved one is experiencing, you may need to provide emotional and psychological support for them as they manage their symptoms. Shingles can be incredibly distressing due to the pain, potentially limited mobility, and the fear of further serious complications. For this reason you should make sure they stay as calm as possible, address any concerns they have, and provide additional support for mental health concerns such as anxiety, depression or stress. Communicate with them regularly and ask them questions every day about how they are feeling. If you think it could help, encourage them to participate in support groups or counselling if they are struggling to talk about their pain or distress. Managing shingles in a loved one can be challenging for family caregivers too, and it can become difficult to maintain effective, compassionate shingles care alongside other responsibilities. Remember you can reach out to your GP to discuss the care work you are doing and find out more about the resources and support available for you, as well as possible respite care if shingles and any further conditions continue long term.If you need help looking after a loved one with shingles, you can reach out to your local Home Instead office to learn more. Our Care Professionals are the best of the best, and highly trained to deliver the services you need. No matter what type of home care you are looking for, we can provide a tailored service that suits you or your loved one. We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.