Is hyperbaric oxygen therapy safe for elderly patients?

Yes. HBOT is extensively used in older adults for diabetic wounds and radiation injury. Age itself isn't a contraindication. Older patients may need extra attention to ear equalization, vision changes, and cardiovascular status, but these are manageable with proper physician oversight.

Can HBOT help with cognitive decline in seniors?

This is investigational. The Hachmo et al. (2020) study in adults over 64 showed improvements in attention and processing speed after 60 sessions. It hasn't been replicated at scale. Insurance won't cover HBOT for cognitive aging. Discuss with your physician before pursuing it.

Hyperbaric Oxygen Therapy for Older Adults: What Changes with Age

Q: Why might HBOT be harder for older adults?

Ear equalization can be more difficult as Eustachian tube function changes with age. Temporary vision changes (nearsightedness) from HBOT are more common in older patients. Patients with cardiovascular disease need careful cardiac evaluation before starting treatment.

Q: Does Medicare cover HBOT for older patients?

Medicare may cover HBOT for qualifying diabetic lower-extremity wounds (Wagner Grade III or higher) and several radiation injury diagnoses. Coverage rates change annually — verify specific coverage with your facility's billing team.

Age is not a contraindication for HBOT. Older adults make up the majority of patients in wound care and radiation injury programs — the two most common FDA-approved uses. If anything, HBOT was largely developed around conditions that affect older patients.

But age does change a few things about how treatment goes.

Ear Equalization Gets Harder

Younger patients usually equalize their ears easily during pressurization. Older adults sometimes find the Valsalva maneuver less effective. Eustachian tube function can decline with age.

Tell the staff if you’re having difficulty. They can slow down pressurization significantly — there’s no fixed speed requirement. Taking longer to reach treatment pressure isn’t a problem.

For patients who consistently struggle across multiple sessions, myringotomy tubes are an option. A minor ENT procedure places small tubes in the eardrums that equalize pressure passively. Many older HBOT patients find this completely solves the problem.

Vision Changes Are More Common in Older Patients

HBOT can cause temporary nearsightedness, particularly during longer protocols of 40 or more sessions. This effect occurs more often in older adults.

The mechanism is a temporary change in the shape of the eye’s lens under high oxygen conditions. Vision typically returns to baseline after the treatment course ends — usually within a few months.

Don’t schedule an eye exam or update your glasses prescription while you’re in an active HBOT course. If you do, tell your optometrist you’re undergoing HBOT. The prescription taken during treatment won’t be accurate for long.

Cardiovascular Considerations

HBOT causes mild vasoconstriction — blood vessels narrow slightly in response to high oxygen tension. In healthy patients this isn’t a problem. In older adults with significant cardiovascular disease, coronary artery disease, or reduced cardiac reserve, it’s worth a closer look before starting.

Your hyperbaric physician should review your cardiac history thoroughly before clearing you for treatment. This isn’t a reason to avoid HBOT — it’s a reason to have a physician who knows your full medical picture overseeing your care.

Claustrophobia

Some studies suggest claustrophobia complaints are more common among older adults in hyperbaric settings. If you’re concerned about enclosed spaces, mention it before your first session. Many clinics can help with:

A tour of the chamber before your first session
Positioning you so you can see through the window
Shorter practice sessions to build comfort
Discussing medication options with your physician if anxiety is significant

Monoplace chambers (single-patient tubes) are more confining than multiplace chambers. If claustrophobia is a real concern, ask whether a multiplace option is available.

Medicare Coverage

Older adults on Medicare are the primary covered population for HBOT wound care and radiation injury indications. Medicare may cover HBOT for diabetic lower-extremity wounds at Wagner Grade III or higher, and for several radiation injury diagnoses.

See the insurance coverage guide for coverage specifics. Rates change annually — verify with your facility’s billing team.

Cognitive Aging and HBOT Research

The Hachmo et al. (2020) study conducted in healthy adults over age 64 found improvements in attention, processing speed, and hippocampal volume after 60 HBOT sessions. Some clinics promote HBOT for cognitive aging based on this research.

This use is investigational. Insurance won’t cover it. The data is interesting but based on one study and hasn’t been replicated at scale. If your care team raises this as a potential option, understand you’re in early-evidence territory and will pay out-of-pocket.

FAQ

Q: Is HBOT safe for elderly patients? Yes. It’s extensively used in older adults. Age isn’t a contraindication. Some additional monitoring is needed.

Q: Why might HBOT be harder for older adults? Ear equalization gets more difficult with age. Vision changes from HBOT are more common. Cardiac history needs close review.

Q: Does Medicare cover HBOT for older patients? Medicare may cover qualifying wound care and radiation injury indications. Rates change annually — verify with your facility’s billing team.

Q: Can HBOT help with cognitive decline? This is investigational. One study (Hachmo 2020) showed promise in adults over 64. Insurance won’t cover it. Talk to your physician.

Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice. Hyperbaric oxygen therapy must be prescribed and supervised by a licensed physician. Always consult your care team about your specific situation. This site does not establish a doctor-patient relationship.