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She was on oxygen and was to be weaned off. This never happened! They discovered there was still fluid on her lung and preformed a procedure to remove the fluid. Will she ever be able to stop receiving oxygen? Even with oxygen her pulse ox rate is 92. Is this bad? I can’t get a straight answer from her doctor and she is in a care facility. She is being monitored by home health care who share her readings with me weekly. Thank you

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Usually aspiration pneumonia occurs due to swallowing difficulties in advanced dementia and at some point it may be unavoidable even if she is on a pureed diet. That "straight answer" from the doctor may not be available, they will be treating the infection with antibiotics and oxygen and hoping she can fight it off, but depending on her overall health she may not be able to. I think at this point you need to hope for the best but prepare yourself for the worst.
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Mare,

Aspiration pneumonia occurs when a person cannot swallow correctly.
The food, instead of going into the stomach, is breathed into the lungs. Then the pnemonia occurs.

You mention fluid in the lungs and I am assuming that the doctor knows this isn't fluid from Congestive Heart Failure?

Are you the health care proxy or POA for health care or the person listed on any advanced directive?
Is your mother capable of telling the doctor that he or she can discuss her case with you, or would that power have been conferred upon another family member?
What is your mother's underlying condition?
What has been happening to get your Mom into a debilitated state?

If currently the O2 sat is over 90 that is a good thing. If this is aspiration pneumonia then it will be treated with antibiotics. If this is CHF from a failing heart it will likely be treated with diuretics.

As you can imagine, we--even those of us who are or were in the medical field -- do not know your Mom nor her age, nor her underlying medical condition. Anything we say to you is PURE guesswork. You must insist that the person who does have MPOA (medical power of attorney) be fully informed by your mom's doctor of what is KNOWN about her current condition.

For someone who is suffering from pneumonia, an O2 sat of over 90 is actually fairly good. The important thing now, if this IS aspiration pneumonia, will be not to feed mom in an unsafe manner. No food or fluids until the doc indicates it is OK, a good swallow evaluation by OT to insure it is OK to feed her, and whomever helps with her food must understand all about swallow defiicits. So begin to education yourself by looking up online the following:
Aspiration pneumonia
Swallow deficit
Feeding someone with swallow defiict.

Good luck and hope you'll update us.
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MareMare222 Nov 20, 2023
Dear Alva. Thank you for your support . I thought I would update you on my mother and get your opinion on the current situation. My mom is 84 and her current pulse oxygen is 93 with oxygen . She is being released from home healthcare because they feel that she is stable. The weird thing is that I feel she is not and this is what I’m observing. 1. Every time I come over to visit she is asleep and at times seems incoherent.2. I noticed in the last couple of weeks that she is not eating much so I have tried to bring her favorites but she just picks at this also.3. I am noticing paranoia and she is making weird cries off and on, when I ask what’s wrong she says she is fine.Her vision is getting worse .


She has glaucoma so I feel that it is getting worse. I am afraid to take her to the doctor because of the current oxygen levels and I’m afraid that her oxygen level could become dangerously low during the trip to the doctors. I’m so confused help!
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My late husband developed aspiration pneumonia in Nov. 2018, and almost died. And because of that he developed sepsis and septic shock.
He wasn't on oxygen before all this but had to be on it until his death in 2020.
So your mother may very well have to be on it for the rest of her life too.
I wish you all well.
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So sorry to hear this, MareMare. Hopefully some others who have experience with aspiration pneumonia will chime in as the day gets started again tomorrow.

I will mention we checked my late father’s oxygen saturation at least a couple times each day due to his respiratory issues as a quadriplegic. 92% was in the OK range for him per his medical team.
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If you “can’t get a straight answer from her doctor”, tell this doctor that if he doesn’t provide better details you will get another doctor. You need to know what is going on! You have to plan your own life, as well as understand hers.
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Maremare: due to liability issues and each individual's body/system a Dr. cannot make assertions that specific. Each individual behaves and responds to treatment differently. And because of our crazy legal system no good Dr. will tell you X/Y/Z will happen or not happen, they cannot. Frustrating? Yes, absolutely.
If it helps you my father was in the hospital for 21 days with 10 of those days in ICU intubated due to food aspiration which lead to sepsis, fluid build up around the heart and lungs. He came out without needing O2 supplement; however now he is back in hospital for the same issue (food aspiration) even eating ground food, a step up from pureed and I do not believe he will be that lucky this time around.

As far as acceptable O2 saturation acceptable level for the elderly is 95% anything lower could potentially cause hypoxemia or hypoxia.

Wishing you and your mom the best.
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CMS rules is that the patient qualifies for oxygen if at rest the saturation levels are 88 or less for atbleast 5 minutes. Same with walking sats. Getting it weaned off is difficult if at home or on a care center other than a hospital because care outside of a hospital may not have a staff member qualified to follow a protocol on weaning oxygen off. When she is stable with no fluid issues or continued aspiration, then the doctor might write an order to have a sat study in a qualified facility.
This leads me to ask about swallow ability and decline which makes aspiration a chronic condition. Soon may be a time when her physician may ask you or her to consider palliative care or hospice. If agreed upon hospice then the doctor might just order oxygen discontinued if she feels comfortable without it.
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I’m sorry for what you’re going through. My dad had aspiration pneumonia due to a degenerative brain disease. He eventually contracted MRSA pneumonia in the hospital and he did not recover.

My mom has end stage pulmonary disease and is on oxygen permanently. When her O2 sat is 92 it’s considered acceptable. The problem is when it drops below 90. Everyone’s case is different and I think even good doctors have a hard time giving definitive answers.
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02 sat over 90 is good.
AspiraTION pneumonia is the word you want.
This most often happens when food or fluid is sucked down the airway into the lungs instead of into the stomach.
They will now have OT assess the swallow reflex, and until this is done it is unlikely that feeding by mouth will be allowed.

Hope you will update us. When you do, tell us a bit more about mom, her age, her diagnosis and her prognosis as well as her general health and mentation.
Best to you.
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