My Dad is 99 years old, with late stage Alzheimer’s. His progression has been very slow and gradual over at least 10-12 years. He has dysphagia, had the swallow test, has had speech therapy to work the swallowing muscles, and is on a mechanical soft diet. He recently had pneumonia (2 months ago) and was treated with antibiotic and albuterol by nebulizer. He lives in an ALF in Kansas; I’m in Oregon. I visited him in late February and was concerned to hear his loose, rattly cough. He’s never been a smoker and had never had this before the pneumonia. He continues to get the albuterol by nebulizer twice daily, I guess to keep the fluid loose so he can cough it up. I took him to his doctor who listened to his lungs, ordered another chest x-ray (and yes, it showed considerable fluid in his lower right lung), and gave him a different antibiotic in case he had a secondary infection. He also referred him to a pulmonologist. I’m wondering if I should travel there for his appointment with the pulmonologist in late April. What are the likely findings and next steps? I don’t want to pursue anything invasive or disruptive at his age. certainly not anything requiring anesthesia or hospitalization. Is this the beginning of the end? He doesn’t seem at all like a dying man. He is otherwise quite healthy. He walks with a walker, although he is very weak and wobbly. He enjoys eating, although he often forgets he has just eaten. He says he feels fine, and he has no fever or other outward signs of infection. He is alert, good-natured, and cracks jokes with the staff. He easily recognizes his family members. But this cough. Is this just going to be the state of things for the time being, until something gets worse and we deal with that? Even if it’s possible to clear the fluid out of his lungs, if he is aspirating food or liquid, won’t it just come back? Should I go to Kansas?