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Our Mom always said no to the flu shot. Don't know why but She never did for years. She even had that horrible Hong Kong flu and was out for days. She still talks and walks and knows me. Who am I to decide? Darn D.P.O.A. I have signed a do not resuscitate order already. Why prolong this awful dementia? Thoughts? So conflicted.

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It was decided we would not give my mother a pneumonia shot last year (flu shots are/were mandatory at the ALF where she lived), and she came down with pneumonia. Tsk tsk, WHY did you NOT give her a pneumonia shot, everyone wondered, at the age of 92-1/2? So they hurried up and gave her one. She recuperated from pneumonia and had to be moved into Memory Care for increasing dementia & mobility issues/being wheelchair bound after her stint in rehab after hospitalization. Now she probably won't get pneumonia again, or the flu, and her life will wind up being extended even LONGER as a result, and that's the bottom line of all this 'medicine' being used to help our folks live to be 100. Oh, by the way, her money will be running out soon and I'll have to apply for Medicaid to get her placed into a Skilled Nursing Facility which she will probably hate even MORE than she hates Memory Care, but hey, she'll be alive and that seems to be everyone's goal. Life at ANY cost, even when there's no quality of it left to live. Dementia really sucks.
Use your own good judgment. For me, I will be taking NO life saving techniques if/when I am diagnosed with dementia. Who the heck wants to live like that?? Not me.
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Reply to lealonnie1
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Isthisrealyreal Aug 12, 2019
Nor me. I think I would take a nice long walk into the great unknown and be reported on a silver alert. We get quite a few of those for people with dementia and I often wonder if they don't feel like I do about losing my mind and wearing diapers at 85.

Lealonnie, I am sorry for your mom. I lost a sister at 52 to pneumonia.
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Pneumonia used to be called 'the old man's friend' when it was not so easy to treat. It led to a quick death, which seemed like the best thing. Flu is probably on the same spectrum now. That's pretty much how you feel: 'Why prolong this awful dementia?'. Could you ask her, not just guess what she would say? If you decide against the flu shot, it will at least help you to know that she did actually turn it down herself.
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Reply to MargaretMcKen
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There are many others at risk - residents, employees, visitors and that is taken into account. Vaccinations are a group/public health issue. My spouse has standing DNR/no intubation/no dialysis orders that will be upheld since these choices are just about him. Flu/pneumonia shots are required.

One time all visitors were banned for a week because several patient/residents had the flu. Signs are posted facility-wide, year round to not bring children who are experiencing colds, flues, or other symptoms. When my husband first entered the facility and they noticed I visited a lot, a nurse asked me if I was up to date on my vaccines. I told her I went to Walgreens because it had a 2 for 1 offer - for each vaccine purchased/administered one vaccine is donated to a member of the community who can not afford the shot.
I understand not wanting to keep Mom alive with dementia and of course she would not want it either. It is heart wrenching to watch family members go through the mental/physical decline.
Your mom can not think things through the way she used to. You, as the DPOA are also working with a team of providers who also have to stay healthy. Of course you need to stay healthy so you can endure this whole sorry situation for everyone in your family. I hope Mom gets vaccinated.
I see nothing wrong with everyone getting vaccinated because it's not just all about you, me, my husband, your mom, or staff and visitors.
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Reply to Houseplant102
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She never wanted it, and that's her decision. However, I would ask her why and make sure she has accurate info. If she says something like "I don't care if I get the flu", that's fine, if she lived in a vacuum, but she doesn't, not any more. Ask her if she would want to get her friends and other patients sick and possibly hospitalized, as well as the staff, and the staffs children. That's a real possibility, given that she lives in close quarters to other residents now. She might change her mind.

dying of complications from the flu is not pretty, and I'm not sure if you would want her on a mechanical ventilator or not, it's such a hard decision. DNR does not mean no care....these days, flu shot is standard care.
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Reply to SofiaAmirpoor
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No, because your mother always refused it and it is correct to continue her established habits as far as possible.

But yes, because she is now living among other vulnerable people in a community and is therefore a potential vector for infection if she is not immunised.

So in one way you can't win ethically! - but then again, neither can you be wrong. It depends whether you want to be a model DPOA or a model citizen, and you have good arguments on both sides.

Sigh. Sorry, I'm not really helping, am I... :/
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Reply to Countrymouse
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LexiPexi I can't speak for the opinion that is against vaccination in principle, but in the context of advanced dementia it almost boils down to a grim selection of possible/preferred causes of death. Or, at least, to a revision of the risk-benefit analysis: does protecting a person against the risk of contracting 'flu and/or developing pneumonia materially benefit that person? If the person is saved from death by these infections, what end does await him? What are you potentially condemning him to instead?

My mother was always "good" about getting her flu shots, and I continued her practice (didn't disagree with it, either). Then, when she was offered the pneumococcal pneumonia vaccine, of course I snapped it up on her behalf. Hurrah! I thought; no dying from that kind of pneumonia for MY mother!

On sober reflection over more years, given the chance I think I'd think again about the pneumonia vaccine. As it happened it was never an issue, but I can't imagine that pneumonia would have been worse than what she did have to go through. I'm not sure it was a good use of resources or a rational decision.

It's as though we're barrelling down the road past "exit" signs, and avoiding them strenuously, only without looking ahead at what possibilities we might be left with.

Obviously, it isn't as though we get a clear-cut choice anyway - vaccination won't protect elderly immune systems 100%, not vaccinating doesn't mean you will get the disease, let alone that it will be fatal or cause lasting damage. But when we make such choices as we do have we are tinkering with the odds, and I just feel I could have thought through ours a bit more logically.
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Jannner Aug 13, 2019
I have a chronic immune illness and don’t get live virus shots because for me it’s questionable if they do more harm than good but the pneumonia one almost did me in. Obviously everyone is different but yeah, you might get a “ detour” you’d rather not take , to play on your illustration 😁
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I would say yes. At my mother's former AL the flu hit most of the residents en masse and the whole facility had to be quarantined and professionals brought in to clean and sterilize. Some residents were sent to the hospital with more severe symptoms. No visitors were allowed in for a period of time. All meals had to be served in residents rooms for a period of time. It was pretty major.
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worriedinCali Aug 12, 2019
But did they get hit with a strain of flu that was covered by that years strain? Because the flu shot only covers certain so it’s entirely possible that having a flu shot wouldn’t have made a difference in your situation. And how many of the affected residents had been given a flu shot?
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Tough call.
If the majority of people that come into the facility have had a Flu shot then she would be sort of protected by what is called "Herd Immunity". But if many people do not have a flu shot then her risk of getting the flu increases.
And she is in an environment that is loaded with bacteria of all types. So flu is just a minor player along with Norovirus and Shingles not to mention staph and MRSA.
As an older person her immune system is compromised to begin with and living in a community she is exposed to more.
I guess the answer would be how healthy is she at this point? and could she survive a nasty bout of flu?
I feel like I am on a see saw with this answer but you know her best and if you feel that she would decline the flu shot then decline it.
I had my Husband get the flu shot when he was going to Adult Day Care and I continued when I kept him at home because I did not want to have to deal with a person with dementia that was having all the nasty results of the flu.

other bit of advice...always make the best decision you can and don't regret that decision with 20/20 hindsight.
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Reply to Grandma1954
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My mother never had a flu shot. Always claimed she was allergic to eggs. (Excuse me, but you ate potato salad and French toast for years - still eating them.) Mom has always mistaken side effects for allergies. I've told her numerous times that a true allergy, be it to food or medicine, involves a histamine reaction - itching, hives, swelling, rash, etc., not stomach upset or a funny taste in her mouth. When her memory care facility tried to coax her to have one, she flatly refused. My sister backed her up telling me I shouldn't insist on Mom having it because of her "allergy." Mom has had the flu more than once and has been deathly sick with it. I figured she stood a better chance of getting it in the care facility than anywhere else. I had recently switched Mom's medical care to my family doctor when hers retired and decided to let her talk some sense into Mom. My doc is a strong believer in flu vaccines. Doc convinced her to have it, telling her there was a vaccine she could receive that did not use eggs and Mom would be much better off being protected from the flu as it was predicted to be a particularly bad season for it.

Guess who was pleased and proud to tell everyone who would listen that she had her flu shot and didn't get sick at all last winter!
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Reply to lablover64
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my2cents Aug 15, 2019
Good for you! Sometimes they need to hear it from a dr because info they got from friends wasn't on the up and up.
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As an RN, I personally hate to get my flu shot. I feel like I have flu for 3 days afterwards. However, I know that my patients - children, seniors and the immune compromised don't need to get flu from me. Your mom have similar feelings.

That being said, she is at increased risk of getting flu AND passing it to others. My vote is to get her vaccinations. While at it, make sure her shingles and pneumonia vaccines are up to date for similar reasons.
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