Q: My mother is going to be 91 this December. Last year she had a nasty experience late in the fall, coming down with a serious case of cold/flu-like illness. She ended up in the hospital with dehydration and spent nearly a month at a nursing facility recovering. She is better now, but I am so worried that she may get sick again. I do not know why she was so sick the last time. Overall she is actually quite healthy. What can I do for her to protect her from another disaster? — Sara

A: I am very relieved to hear that your mom is better. Your concerns are fully justified. It does not take much for an older person to get sick and as a consequence to quickly lose a lot of their functional capacity. We geriatricians call it very low "functional reserve." Imagine yourself in daily life. A healthy adult "operates" on about 75 percent of our total energy. When one gets sick there is still quite a lot of energy to draw from. That is why most middle-aged people get better rather fast after an illness. More "mature" individuals in their 80s and 90s are not as lucky. Even with a relatively healthy body and few chronic problems they function at the top of their energy "allowance."

When a sickness strikes, it takes only a short time for the older individual to stop being functional. Walking, eating, attending to daily chores all become impossible tasks. Both the illness and the recovery tend to take longer and sometimes, quite often actually, the affected person

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never fully regains their abilities. Now, what can we do to help our parents, loved ones and ourselves stay healthy during the flu/cold season?

First, getting flu and pneumonia vaccines is a must. The first one you need yearly, the second every six years. Both have been clearly shown to offer protection against the serious complications that can arise from getting the flu and pneumonia. Many people do not believe in them because: "they never get sick," or "their neighbor had a very bad reaction." Believe me, these shots work. They will not protect us from a simple cold, but they will make the trouble you and your mom both went through (hospital/ nursing home) much less likely.

Second, avoid contact with sick people. If possible, do not have your mom visited by sniffling great-grandchildren, and even when you get sick, try to stay away and have others help her instead. The way we spread colds is usually through our nasal secretions, so pay very close attention to hand washing and other basics of good hygiene (no utensil sharing, etc.).

Third, make sure that your mom is eating well and gets plenty of fluids. Malnutrition is one of the strongest predictors of a cold or flu going really wrong. Some people advocate large doses of Vitamin C or a herbal remedy called echinacea. Truthfully, there is no clear scientific proof that they work, but trying them very early in the course of the cold may be helpful. There has also been a lot of buzz about zinc tablets. Again, they did not fulfill the promise of being really protective, and I would not recommend using them.

Encourage your mom to stay active despite the cold. She cannot stay shut down in her place for four months! Stay updated with doctor checkups. Stay in touch with the doctor if she has a cold, push fluids and do not insist on having antibiotics prescribed unless suggested by a physician. A virus causes the majority of cold and all flu symptoms and taking antibiotics will only make matters worse. As far as your health, avoid crowded spaces and stay away from sick people. I sincerely hope that both of you will be fine this season.

Dr. Beata Skudlarska is a Bridgeport geriatrician. Send questions to Bridgeport Hospital Center for Geriatrics, 95 Armory Road, Stratford CT 06614 or geriatricmd@aol.com.