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ellantz Asked July 2013

What are your experiences with pneumonia in elderly?

Tuesday of this week, my 95 year old mother was taken to the ER, from the nursing home, with 102+ fever, and lung X-ray revealed pneumonia - her first bout. She responded well to the antibiotics, and was released today (Friday) back to the nursing home. She is now on an oral antibiotic for 10 days, and oxygen.
We suspect that this is the beginning of the end, so to speak. From some online research, we also suspect that this will recur, and that she will not respond as well next time to the antibiotics. I understand that this can be a relatively peaceful passing.
Would anyone care to share their experiences with pneumonia in the elderly?
Please feel free to be open and direct, as we are very emotionally prepared for the ultimate outcome. Mom has had no quality of life for the last 2 years. Thank you.

freqflyer Jul 2017
Wish people would realize that the amount of morphine giving when one is on Hospice care is the same amount given to a person in the hospital after having major surgery. I remember being on morphine pump 20 years ago.

A person's timetable for passing is going to the be the same whether one uses Hospice or not, it just depends if you want your love ones to pass in comfort using whatever is available, be it morphine or some other pain reducing drug.

jeannegibbs Jul 2017
We were thrilled that mother was dismissed from the hospice program because her recovery took her out of the category of people likely to die soon. I'm sure that the extra care she got from the hospice program helped her recover. Morphine was not suggested for her. Before hospice ended their care they helped us see to it that Mom had a supportive wheel chair and could keep the bed hospice brought in.

NoNonsense, why do you think they talk about morphine? Do you think they get some special reward if they can use a lot of it? Do you think they get a kickback? Do you think they are sadistic people? What would their motive be, if it isn't a genuine belief that the morphine would help the patient cope with pain and be more comfortable? The main caregiver or medical POA gets final say about what drugs are used, and it is OK to not take hospice's suggestions.

Anyone with a loved one on hospice care should realize that morphine is one of the drugs available in the program. And that the caregiver or medical POA can decide whether it is used or not.

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NoNonsense Jul 2017
Unfortunately, I agree with the adverse opinion though it is stated harshly. My experience is all they talked about was morphine. My Mom "failed" hospice and was dismissed from the service because her recovery was "too" good. Unfortunately (from their perspective) they didn't get to use the morphine.

jeannegibbs May 2017
TheirBstIntrst1, both my husband and my mother were on hospice care. I think I'm pretty real. My mother was in a nursing home during the hospice care. She was in a lot of pain but she could not tolerate narcotics. She proved the doctors wrong by recovering well and was dismissed from the program after 3 months.

My husband was in hospice care in our home. I was in charge of the drugs he took. I did not give him morphine, although I would have if he were in physical pain. He died in our bedroom, holding my hand. He died of complication of dementia, but the autopsy report said he would have had a heart attack very soon.

Neither of my experiences were remotely like what you describe.

TheirBstIntrst1 May 2017
Often times I've found the physicians were wrong, they aren't the infallible last word re. life itself. I will however say that I have had a good experience with a private insurance (Kaiser) hospice nurse. She really did care and wasn't in it to just drug up my client like the others did (although her cancer was actually the worst). After much research, coupled with my experience with them, I found out that the hospice that's under Medicaid or Medi-cal or other government ran programs are the main ones who push the whole "comfort them into death" idea, because elderly care costs the government the most $. There are reports and documents online that support this finding. Also, please search Google for "hospice cocktail" and see what you will find. It's no joke. Please do the REAL research, from REAL people who have seen what I've seen... I'm not saying you guys aren't real, but I see a bias that is not very informed of how it has & will again go down.
I'm sorry if I may "scare" others by my input, but if scaring someone may cause them to do the research or to pray for more discernment & direction which actually SAVES A LIFE from a premature death, than so be it.

jeannegibbs May 2017
This thread is four years old.

Shane1124 May 2017
To Theirbestinterest, I understand you are passionate in your adverse opinion regarding hospice but please don't frighten others away from choosing Hospice as an end of life treatment option. A physician must certify that in their professional opinion a person qualifies for Hospice care and one criteria is that person is not likely to live past 6 months. If the person improves, they are discharged from hospice. It's not a death sentence. Nor is it an arbitrary decision or one taken lightly. I am truly sorry your experience with hospice was not good. 
Hard as it is to accept, death is a part of life. All of us will die.
As for this OP, don't give up yet. Elderly people can bounce back quite well from pneumonia. It's good to research options including hospice so you will have the information in case you may need it in the future. For now give her time to recover from this episode and take it from there.
Good luck and I hope she improves.

TheirBstIntrst1 Apr 2017
NO!! HOSPICE MURDERS PEOPLE!! Cant you see this in your own experience MsDaizy? Her circulation was stopping but "she held on" as a "fighter"-- BECAUSE THE DRUGS WERE KILLING HER BODY, before its time!!
Im sorry, but i feel very passionately about this because I'm a caregiver & have had many Loved ones be taken out prematurely by hospices drug inducing hand! The degree of BRAIN WASHING that goes on makes me sick! I could go on, but i wont. I know its falling on deaf ears, as its not what the OP wants to hear. Killing her "comfortably" sounds better.

msdaizy Jul 2013
Yes...You are ready for Hospice. In fact, I think it's essential during this time...so that your mom can be comfortable and it will help you, the family, to be more at ease knowing she is under their care. Hospice was a wonderful asset to us during most of this last stage. It gave us a time to walk out and take a breath. They were there to keep her comfortable, clean and medicated. We were there only to be with her. Good luck and God bless.

ellantz Jul 2013
Thank you, msdaizy - again, more of the type info I am looking for, as in what to expect. I can see that we need to be ready to quickly have hospice.

msdaizy Jul 2013
If this is truly the beginning of the end for your loved one. I can tell you it's a long excruciating ordeal to watch. If she doesn't respond well to the antibiotics she will continue decline. The only thing you can do is keep her comfortable. As hard as it is to watch...as long as your mom is pain free. She will basically sleep...but what's hard is the rattling in her chest. Mom started with her pneumonia the treated her with tylenol and baths. Then as it progressed they just kept her comfortable with morphine and also atropine to keep the mucas down. They would also suction her out. The death rattle sounds really bad and it will get loud and then it will be almost silent. But she will start to struggle and choke a little at times. But usually at this time she might be in a comatose state. Then as the time gets nearer her feet and hands will start turning dark..the veins will be really prominent. When the circulations starts to go..they will turn almost yellow. At this time her feet and hands will be cold. Then it's just a matter of time...How much time? Each one is different. Mom was a fighter and held on for so long...it was so hard to witness. I hope you have family support with you. You will need it.. I'm sorry. I pray things go as smooth as you want. Just be prepared for it. As hard as her years were...there is nothing to prepare you for what you are about to endure. God Bless.

ellantz Jul 2013
Thank you, geewiz - that was the kind of info I was looking for to get a feel for what to expect. From talking to the nursing supervisor at the nursing home today, I don't think she's quite ready for hospice, but will certainly keep that option at the forefront, and monitor carefully over the next few weeks.

geewiz Jul 2013
Wishing you well. BUT I've seen our elderly come back from pneumonia, several times. My guess, it depends upon their overall strength and the condition of their lungs. But . . . it does weaken them. Have you considered hospice? They will still give antibiotics and oxygen. BUT they would have kept her at the nursing home. Each move/change of location makes the dementia patient go downhill. So, it's considered best not to do that. My MIL had pneumonia last November and is back in full swing, she is older than your Mom. And, another senior we knew came back from pneumonia and other infections and made it another 6 months. And they were older than MIL! If you are all prepared, call hospice tomorrow and get them to provide extra care for your Mom.

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