My mom is 91. She has CHF. In 2013, stroke with sequelae of vascular dementia, some aphasia. Broken hip in Aug 2013, walks with a walker. In nh since sept 2013. Fell in June; while in hospital, heart rate could not be maintained, so we asked her if she'd agree to a pacemaker and she said yes. Since then, she's had an almost constant pneumonia/pleural effusion. Several rounds of antibiotics did not clear the pneumonia. She fell on thursday at the nh; in the er, her o2 sat dropped and they wanted to intubate. She has a dnr and dni.She was put on a bi-pap. They tapped her chest and got a litre and a half of fluid which came back okay from culture, still waiting path report. Had sepsis with a white count of 19000. Better ttodat 13,500. She has a compression fracture of her spine (one doc says old, one doc says new). In addition to her bp and heart meds she's on antidepressants and anti anxiety meds. And now morphine qid for pain plus lidocaine pain. Her legs are contracted because she hasn't been walking much at nh due to shortness of breath (due to pleural effusion). When do you say enough and stop transporting to hospital? Sorry if I'm rambling, I haven't had a lot of sleep! A couple of weeks ago my brother and I asked th he hospice question of the nh folks at our care meeting...they seemed shocked.