My Father got pneumonia 4 times last year and once already, this year. Is he nearing death?

MGK makes a good suggestion about aspiration pneumonia. If there's a speech pathologist at the facility, speak with her/him and ask if a videoscopic swallowing test would be appropriate; it would determine if your father is aspirating.

Also, there are some things he can do to improve his lung capacity. Our pulmonologist alerted us to a pulmonary/respiratory therapy program paid for by Medicare, with no limits as there are with PT. He can also use a nebulizer (available by script) as well as an incentive spirometer.

Someone might have to help him each time he uses the spirometer, but the nebulizer can be handled by a staff person.

I have found this source very valuable. It's written by a doctor. See page 21 regarding pneumonia and dementia patients. Apparently, once that starts, it's not likely to stop. Treatment is limited long term success. The family has to consider what the long term goals are.

avoidablecare/wp-content/uploads/2012/04/Sharpe-Handbook-A-Caregivers-Guide-to-Advance-Dementia.pdf

Has he had a pneumonia shot? If not, raise the issue with one of his doctors. My father had pneumonia periodically, although not as often as yours did, but we got a pneumonia shot for him a few years ago. It's diminished the incidence of reoccurrence, but it also addresses only certain kinds of pneumonia. So it's still possible that he could get it, but of a different kind.

I think the other issue is to explore with the treating pulmonary physician why he's getting pneumonia repeatedly. Is he bedbound, not getting much exercise or activity? Does he have COPD, emphysema?

I have a cousin having he same problem. It turns out, his food was entering into his lungs causing the pneumonia. He had a feeding tube put in and so far he has not gotten pneumonia again.