Are you over 70? If so, would you please answer this end of life question?

My mom passed in November. She was in the late stages of dementia but I tried my best to still resolve anything that I thought would add to her confusion or give her physical discomfort. I could not help the dementia decline but I could make sure she did not have discomfort from UTI’s, added confusion from thyroid problems, potassium levels and other health issues. I did not have the complications of pneumonia but would have certainly considered antibiotics if I thought it would make her breathing less labored.

I think it is a balance of trying to give them the best quality of life that you can while knowing that dementia is fatal. When her body began to shut down, then we let nature take it’s course, with a goal to keep her comfortable, with as little discomfort and as pain free as possible. Those last days were precious for both of us.

To "if you are over 70" I think you should add "and if you know how it feels to have severe pneumonia" would you want to be given antibiotics.

The gentleman you have in mind had the same opportunities as everyone since about 1970-ish has had to state his wishes in advance. Nobody else has the right to withhold treatment, especially not treatment as straightforward as this.

Even hospice gives antibiotics, CX because they are about comfort care and comfort is what, to my mind, this gentleman should have. He shouldn't have treatment toward cure of incurable diseases such as advanced cancer, and etc, but when he has a painful bladder infection he should receive treatment as long as he cannot make his own decision to say "No"; pneumonia, once knows as "the old person's friend" falls somewhere between; many pneumonias are not bacterial and antibiotics will do little for them. They are viral or mechanical due to swallow problems, due to immobility.
I am 80. I have already written in my advanced directive what I will NOT take, and what I will. What I won't take is a lot including dialysis even temporarily, feedings through tube, PEG or IV (TPN or total parenteral nutrition), CPR or vents, IV fluids. I would take all comfort medications including any to decrease secretions from pneumonia, antibiotics for bladder infections, any and all pain and anti anxiety medications.
As people with diabilities cannot make decisions for themselves,, the system has to. I doubt any would recommend CPR for this gentleman. But I think all doctors would treat a bladder infections. Just my guess.
None of these decisions are easy ones to be certain. Sepsis is in some ways a quick way to go, for my brother it was two weeks total, but sepsis can be painful and is to be avoided when possible. When it isn't possible, and something has become systemic it is time, imho, to bring in the "good" meds.

But then, none of us really know how that person feels.

My LO, who passed away a few weeks ago, was calm and composed and peaceful.

She could still respond when I kissed her and told her I loved her.

I hope that she didn’t feel as though her condition was horrible.

I was very happy to be able to tell her how I felt every time I saw her. She would sometimes say “I love you”, or “I love you too” when I would leave her.

‘’If we are assuming that a nonverbal, immobile person is “suffering” with no indications of distress or discomfort, is it unfair that we would think they might be feeling loved and cherished too?

Right before Christmas, my 100-yr old Aunt with mod/advanced dementia fell in her home and broke her hip right under the ball. The surgeon called (from FL and I'm in MN) to explain that there is no way for this break to heal properly without a partial hip replacement. I said no to the surgery because I was pretty certain that even if she survived the surgery, she would not cooperate with PT and therefore never regain her mobility anyway. As it is, she doesn't keep her IV in.

She was transferred to a rehab facility where unbelievably she is only needing Tylenol for her pain. Every day she has attempted to get out of bed (part of her ongoing "going home" Sundowning). She is amazingly healthy otherwise. Dementia screws up how our bodies process and interprets pain. My goal, as her DPoA and niece, is to keep her calm and pain-free. So I am just taking it one day at a time.

Should an elder with dementia be given antibiotics? It all depends on their individual circumstances at the moment and the hoped-for outcomes of treatment. In my Aunt's case treatment (surgery) would not improve her future situation or return her to her pre-fall condition/abilities... so why put her through it?

Pneumonia is easily treatable and doesn't need to be life-threatening.

Now, having major surgery, treating cancer, or dealing with life-threatening issues when other life-threatening issues are also in play is something else entirely.

I absolutely would have wanted antibiotics for such a treatable condition. I certainly don't want to die by suffocation, which is what death by pneumonia would be.

I'm not over 70, but I fail to see how that's relevant to the discussion.

I'm 66, in a wheelchair, on dialysis, insulin dependent diabetic and wear depends. On dialysis you rarely pee and because I have nerve damage in my lower back I never know when. But it's not a big deal. Lots of people think my life is bad. But I don't. At some point that may change, and I'll stop dialysis and die. In the meantime, I take antibiotics if I need to.

If I were as I am now - physically fit, cognitively sound, and able to do everything I want and need to do - I'd want everything done for me that could be done. That includes antibiotics. If I were as he is and unable to live a decent life, I'd want antibiotics withheld so I could die. It's up to each of us to inform our responsible loved ones what we'd want.

CM,
I don’t know how pneumonia feels. Can you describe it?
Thanks!

Not enough information on that case to make a decision. You did say he "recovered". Life in a wheelchair with a diaper is not the worst thing that can happen to a person.