Flu shot in Memory Care? Yes or No? Thoughts?

That’s a tough one because on one hand you know she would say no if she was fully competent. It would be her right to decline the shot and it would be on her if she picked up one of the flu strains the shot covers. But on the other hand, as POA its not only your job to make decisions as your mom would have but also to act in her best interest and it can be argued that getting her a flu shot is in her best interest.

Seems to be the answer is no. No flu shot. She wouldn’t consent to it if she could. And it only covers certain strains anyway. So I wouldn’t give her a flu shot. FWIW I get a flu shot every year so I’m not anti flu shot/anti vaccine.

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.

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.

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.

I do not support vaccinations for anyone. It makes me cringe to think of a person with dementia being injected with the chemicals in a vaccine. Vaccinations are not harmless and some would say not even helpful. Everyone is entitled to their own opinion. Based on the information I have read for several years, I am anti-vaccines.

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.

My Mom never had one so I chose not to give her one. Flu shots are based on what strain they will think will show up. Last year or the year before a strain popped up that they didn't know about. Now the pneumonia that I had her dr. give after my Uncle died from it.

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.

If she didn't get the flu shot before, why should she have it now? I don't get it and wouldn't want it even if I was no longer of sound mind.

It is correct that the flu shot is made for usually the 3 strains that are expected to hit. It is not an exact science and there are alot of virus's not included in the shot. But if a patient in MC gets the flu it can be very very miserable for them and they may survive but feel horrible. A hard call to make for sure.

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.

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... :/

Mthr always refused flu shots; however, our state has some kind of ranking system for facilities that includes flu shot coverage for the population. I decided that the nasty chemicals which she did not like might actually not have enough time to cause any dread disease which they are rumored to. In fact, if they did cause disease or a reaction, that would cause her dementia to end more quickly and end her suffering.

The second year, I asked the MC administrator. She said that she did not care about the flu shot coverage ranking. (Her husband is a MD and she is a NP). She also cited how ineffective the flu shot is in the elderly.

There's not a right answer! If your NH requires the shot to live there, do it! If not and your mother would not, then don't. No big deal either way at this age.

What do the admit documents say about the flu shot? You may not have an option. State statute may require that those in facility living are required to have one.

Thank you everyone for answering! I had her at home for 7 1/2 years and this is the start of 2nd. year in M.C. so actually living in a facility is a whole different ballgame. M.C. etiquette lol! I think it will be yes shot for me (to protect everyone else there), and no for her because that was always her choice back in the day.

Why are so many people against the flu shot? I'm not looking for an argument, I truly would like the know the medical reasons.

My husband and I have gotten a flu shot for years, and have never had a reaction from the shot - nor have we had the flu. We are out and about throughout the flu season - so we aren't just sitting at home.

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.

Countrymouse: "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."

That's an interesting (and apt!) way of putting it!

My mother got a potent flu vaccine last year for seniors 65+. I got a different version for older people who weren't 65 yet. The point is, there are vaccines that are targeted to the older population.

I remember the NH asking me if my mother had gotten the flu and pneumonia vaccines, but it was for informational purposes only, as they were not required.

It does seem to make sense to try and protect the others at the facility, to include the all-important staff. As understaffed as facilities can get, why do anything that might cause even more of a staff shortage?

This is just my understanding of it. The flu shot for those who are terminally ill, assuming they are not allergic, is for the protection of others, like staff, visiting doctors, nurses, etc. As well as the other residents. I can't imagine having a flu breakout in an MC wing and all the extra care that would require from the facility, which could even call for some residents needing hospitalization. Anyone who gets it, could pass it to other people. Plus, I think that at my LO's MC, they require the residents to get flu shots, unless it's medically exempted.

The flu shot is NOT required for residents at the nursing home my mom is in. My mom still wants it so she gets it. When her dementia is to the point of her not knowing, we will not allow her to get the shot.

Boots
I’ve worked for a LTC Pharmacy for 14yrs now, we provide medications to all LTC type facilities, when the flu hits a certain facility it’s Z-Packs for ALL, Zithromax, Azithromycin, not sure if the staff is required to take it or it’s a choice, very powerful and can have many side affects, we also provide the flu shots, that are sent out in mass, IMO have her get the shot, better safe than sorry.
((( HUGS )))

Flu is a danger to ALL residents. Some perhaps do not wish to hurry their final exit. Flu and pneumonia spread like mad in this sort of facility. If your mother is able to make this decision rationally, and if she never took it for years, you could fulfill her wishes to refuse it if you choose to. You clearly know the risks for her. And she made her decision when of rational mind. Do know that when you allow the spread of this among other elders, you may be dooming more than your Mom.

My job requires all employees get the flu shot, to protect the patients, as well as to ensure that we will hopefully have enough staff to take care of them! If we have medical reason not to get it, they work with other options. I have seen terrible flu issues with pts, and although I know my mom is going to die from something.. the flu is not what I would chose for her at 88! And I would not want to be the one spreading it,, it goes like wild fire in elderly homes and hospitals!

Riverdale, thank you for the reminder of what real flu does feel like, and that it's worth avoiding if at all possible regardless of other concerns!

There was a tale from family doctors' circles going way back - if your waiting room is crammed during a flu outbreak, you can sort the heavy colds from the flu by leaving a £20 note on the floor in front of your desk. The people with colds will bend down and pick it up. The ones with flu... won't.

There are many people of the mindset that they got the flu from the shot, when they actually had already been exposed just prior to getting the shot. Just like being around everyone at work or kids in close proximity at school, someone is going to bring the bug in and everyone will get it. The difference for your mom is flu and pneumonia can be more serious for elderly. Get the shot. She's in fairly good health so why risk things going south when there is a preventative.

Same situation here, but I just refused a flu shot for my mother who is in a private home/5-person memory care home. She had us vaccinated as kids (were all between 54-60 now) and I continue to get flu shots for myself but she has never wanted a flu shot so I said no. Her chance of getting it is slim because of her current circumstances, and she's always had a fetish about washing her own hands and not touching her face, so I'm not worried about it. She barely leaves her room and there aren't a lot of comings and goings. It would have been her preference to refuse, so that's what I did.

I have always been of the mind if you’ve always gotten the flu shot this is not the year to stop
if you never get the flu shot and never get the flu this is not the year to start ( maybe you just have a good immune system)

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!

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.

As POA always remember that as much as possible you are to carry out your mother's wishes just as you would want your own wishes to be carried out. Do both sides of research on flu shots please. Always seems strange to me that senior's homes where pretty well everyone gets the flu shot are still hit by flu over and over. They're just an expensive gamble. I've done enough research to never get one.