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

My 97 yo mother with dementia ended up with 3 flu shots this year. First one at pharmacy with us. Second one at her ALF. Third one at the hospital when she was admitted for heart failure. I have medical POA, but no one bothered to ask me if it was okay. It didn't hurt her.

I was 55 years old before I didn't have any health insurance and I was broke and decided that through my temporary job, I could get a flu shot and that it would be "cheap insurance" to do so.  Have been getting them ever since and never come down with the flu, plus I don't get sick like I used to.  At the same time, I talked my mother into getting a flu shot because she was ALWAYS getting sick resulting in pneumonia.  She was freaked out about getting it, but I insisted on it, and she has not been as ill as often as she was, plus she even WANTED to get the pneumonia shot, which she did, and now she wants to get the Prevnar-13.  She is 89 years old.  She has been in a facility for 3 1/2 years now, both AL and MC, and I am her POA and Guardian.  I recently decided to sign the DNR due to the A & B x 2 that she received at the FORMER facility where she was that left her septic as a result.  She is now doing much better, but I left the DNR in place because what she has a diagnosis ( dementia and Alzheimer's) has no cure, so the end result will be the same.  However, I don't have to "hurry it along".  The end result is the same for all of us down the road.

There are controversies towards the flu shot & what they are putting in it. I do not blame your mother one little bit.I will not get one either!! Make sure she takes good care of herself. Sleep enough, eat right, stay hydrated & wash her hands often. Keep door knobs & phones & the like clean. Of course, stay away from anyone sick.

Shane: Yes, true about that in regard to eggs. Though freqflyer is right about the importance of getting the flu shot.

Influenza killed about 80,000 people in the 2017-2018 season. And as many as up to 700,000 need hospitalization.

Please remember you can have the flu and not feel any symptoms until days later.... by then, you had already infected everyone around you who hasn't had the flu shot. I would hate to have been the one who made an elder deathly sick from the flu, or even a grandchild who didn't have his/her flu shot.

One thing I noticed with my parents, who lived to their mid-to-late 90's, they had been getting their flu shot every year for over 40 years. And for several decades did they volunteer work at a regional hospital 3 times a week. Not once did either parent ever had as much as the sniffles all those years.

I also do volunteer work at the same hospital, and I remembered back in the 2017-2018 flu season, the hospital had to set up beds and hospital recliners in the hallways for patients because there weren't enough rooms to handle everyone :(

The influenza shot is not given to anyone with adverse reactions, e.g. has had a allergic reaction to it in the past.

My mom says the same thing. I tell her every year she needs to get a flu shot, her doctor tells her she needs to get a flu shot, but NOPE, she refuses. I too have DPOA, but I have to follow her lifelong wishes and I do not, nor will I, push her to get one anymore. This still gives her what little bit of control she has over herself and her life.

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.

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.

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!

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)

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.

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.

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.

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!

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.

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 )))

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.

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.

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?

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.

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.

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.

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.

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.

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... :/

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.

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.

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.

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.