A woman in bed with flu complications looking at a thermometer.

The body aches, cough, fever, chills, and sore throat that come with the flu are miserable enough.

But “older adults are at a much greater risk of serious complications compared to young, healthy people because the immune system in general becomes weaker with age,” says William Schaffner, M.D., a professor of medicine in the division of infectious diseases at the Vanderbilt University School of Medicine in Nashville, Tenn. 

Certain chronic conditions can also make seniors more vulnerable to flu complications. For these reasons, 67 percent of flu-related hospitalizations and 83 percent of flu deaths were among people older than 64 during the 2017 to 2018 flu season. 

Try to Avoid Flu in the First Place

It’s best to try to dodge the flu altogether. So wash your hands thoroughly and often, stay out of physical contact with people who have the flu, and get a flu shot each year. 

The vaccine might not fully protect you, but it reduces your flu risk and may make a case milder if you come down with it.

More on Colds and Flu

Plus, a 2018 study associated the yearly shot with a lower risk of cardiovascular death in people with heart failure.

You might consider a vaccine designed for people 65 and older, such as Fluzone High-Dose or Fluad. Some research suggests they may be more effective for older adults.

And make sure you’re up to date with the pneumococcal vaccines, which are two shots, given at least a year apart, for people 65 and older with normal immunity.  

Take These Steps If You Suspect the Flu

Feeling fluish? See your doctor right away. You may benefit from an antiviral such as oseltamivir (Tamiflu and generic). Given within 48 hours of the flu’s onset, it may lessen the time you’re sick by about 17 hours. This may cut complication risks, Schaffner says. Also ask the doctor how to handle your regular medications.

If you’re using nonprescription meds for symptoms, check labels. Certain cold and flu meds might “contain decongestants like pseudoephedrine, which aren’t good if you have high blood pressure,” says ­Michael Hochman, M.D., M.P.H., director of the Gehr Family Center for Health Systems Science and Inno­va­tion at the Keck School of Medicine of USC in Los Angeles.

Some may have an antihistamine, such as diphenhydramine, which can make you sleepy and raise your risk of a fall.

Instead, consider using a saline nasal rinse to help flush out your nose and sinuses, and for aches and fever, an over-the-counter pain reliever, such as acet­amin­o­phen or ibuprofen.

Try to drink an 8-ounce glass of nonalcoholic liquid every few hours to help keep you hydrated and thin mucus, making it easier for sinuses to drain. Because your body is losing electrolytes when you sweat, Hochman recommends Pedialyte.

Watch Out for These Complications

For most people, flu symptoms should start subsiding within three to seven days, although cough and fatigue may last for up to two weeks. But watch for:

Dehydration. Older adults are more susceptible to dehydration, and fever may increase its likelihood. Untreated, it can cause potentially life-threatening events such as seizures, Hochman says. Call a doctor right away if your urine is dark yellow, you feel dizzy and/or faint, or you have a rapid heartbeat and breathing.

Sinusitis and bronchitis. The flu can leave the lung’s bronchial tubes vulnerable to bacteria, which can lead to the breathing difficulties and coughing jags of bronchitis. Sinuses may become blocked, which can let bacteria breed and cause a painful sinus infection. If you suspect either, or if overall flu symptoms ease but then worsen, see a doctor; you may need medication.

Pneumonia. The flu virus can damage the epithelial cells of the throat and lungs, increasing the risk. Get emergency help if you have trouble breathing, a bluish tinge to your lips and/or nails, and a very high fever (it could soar to 105° F).

Heart attack. People with heart disease are about six times more likely than usual to have a heart attack within a week of a flu diagnosis, according to a 2018 study. If you experience chest pain, intense sweating, or what feels like extreme indigestion for more than a few minutes, call 911.

Editor’s Note: This article also appeared in the February 2020 issue of Consumer Reports On Health