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My mom's NH always seems to call when I'm driving! She has CHF, vascular dementia from a stroke a year ago and had a pacemaker put in two weeks ago because her heart rate dropped to 37 and wouldn't be budged by medication. I was not so sure about doing the pacemaker, but my brother and I (he's POA, we both on all the HIPAA stuff) asked her if she wanted it and she said yes. The NH did a chest Xray and determined that she had a pleural effusion (which she's had before) and possibly pnemonia. They gave her antibiotics and lasics for the accompanying edema and PE; took another chest film today; the effusion is better, but now they can see more clearly that she still has pneumonia. So my quesiton is, why does she get pneumonia? Is there something that we/they should/could be doing to prevent this? Is this just the inevitable course of events with the diagnoses that my mom has? They've put her back on antibiotics, more diuretics, etc.

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Well, just to update ( I was searching CHF and Pneumonia and come upon my last question!); NH just called my brother and Mom has pneumonia again. They will try a different antibiotic this time. I am very much feeling as though this is the way things are going to go from here on in. She's 91, has had a stroke, can still get to the bathroom on her own with the walker. Her speech is impaired, but she can mostly still get her point across. Last summer, when she was rehabbing from the stroke, she was paranoid, delusional and somewhat combative; that phase is over, thank God, or at least for now. She is calm and mostly oriented, very poor short term memory, but knows who we all are. I was, quite frankly, ready to let her go three weeks ago when they told us she needed a pacemaker; I can't bear the thought of her dementia getting to the point where she's incontinent/angry/not recognizing family members. My mother is and always has been a gentle, non-complaining, make the best of it, somewhat dependent and sometimes hysterical soul who deserves and end that is quiet and without drama. I don't think I'm being selfish. I'm venting and I thank you all on this site for listening.
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Barb, sorry I missed yours and other posts. I see that she's already had a pneumonia shot. One of the questions you could ask is what type of pneumonia will that prevent? We were cautioned that it does not prevent certain types of pneumonia.

Again rereading your post, I see that the pacer surgery was just a few weeks ago. How soon afterward did she get pneumonia?

The last pacer replacement my father had was followed by CHF, which one of the medical staff was probably due to overinfusion during surgery. For your mother, the pacer insertion might have been the start, compromising her respiratory system and making her more susceptible.
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My mom is up and around with PT, not independent with walker yet the way she was two weeks ago, but getting there.

Washing hands is hopeless with her; when she was in IL, we were on her all the time about this, still having problems in NH. they make her use hand sanitizer. She's doing the incentive spirometer frequently, they tell me. So I think theye're doing the best they can.
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ba8alou, this is what little I know about pneumonia, which my father has had several times. And these are good basic articles, the Mayo Clinic article being easy to read and understand.

http://www.lung.org/lung-disease/pneumonia/?

http://www.mayoclinic.org/diseases-conditions/pneumonia/basics/definition/con-20020032

As stated, pneumonia can be bacterial, viral or fungal. So the first questions are what kind of pneumonia does your mother have and how is it treated?

Why does she get it? The Mayo Clinic Causes list is a good one, brief but descriptive:

http://www.mayoclinic.org/diseases-conditions/pneumonia/basics/causes/con-20020032.

Your mother may have the health-acquired pneumonia, being in an NH.

Other than washing hands, covering the mouth when coughing, not sharing personal items, keeping someone who does have pneumonia away from others, I'm not sure what else the nursing home can do. Perhaps others have better suggestions, if their family has acquired it while in a facility.

The first times he had pneumonia were when he was overworking himself, in his 80s...up on ladders or scaffolidng cleaning the gutters in 80 - 90 degree weather, working from sunrise to late at night doing construction projects. He was laying on the cement floor working, exposed to musty items. He wasn't eating or drinkly properly.

After that we learned how to monitor him to catch it before it became life threatening, in combination with other diseases.

What we do now is minimize outdoor time in the winter, tie a warm scarf over Dad's nose and mouth just from the time he goes from the house to the car, drink plenty of fluids (not always easy with an elder), keep plenty of chicken soup on hand, and try to catch it early.

Prepare to gag, but this is one of the first clues: greenish sputum. Not real green as in grass green but more like palish green, barely green. When that's present, off we go to the ER. The first clue though is a raspy voice with congested sounds when he speaks. Those are high alert signals.


My father also has had CHF repeatedly, often in tandem with pneumonia.

My suspicion is that not only are co-morbidities a factor, but also the older and sometimes compromised respiratory system is more vulnerable, elders aren't as active, don't breath as deeply and don't have as strong lungs as younger folks.

It sounds to me as if the NH is really on top of the situation. The only other thing I would think could be done is hospitalize her, but it sounds as though the treatment she's getting is appropriate.

Prevention: My father has gotten the pneumonia shot. He's gotten bronchitis, but at least he didn't have to be hospitalized for it as he would have had he contracted pneumonia.
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Oops forget: Is she getting breathing treatments and that little machine they blow into to make the ball go up the tube (sorry, it's been awhile).
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Is your Mom up and around; walking the halls daily? Does she at least sit up in a chair a few times a day, perhaps to have meals? Staying in bed and not being mobile is not good for the lungs. Best wishes.
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Thank you so much for your reply! Yes, she's had pneumonia several times before and has a flu shot every year and pneumonia vaccine. They give her probiotics whenever they give her an antibiotic to keep her gut in balance. She eats a balanced diet. Just wanting to make sure that I'm not missing anything. Again, many thanks. Barbara
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Has your mom ever had Pneumonia before? Once they have had before, they are more susceptible for it to return along with other health issues. Her immune system is most likely week and of course, everything is going on in her lungs. Ask her Dr about Flu and Pneumonia shots when she is well, she may or may not be able to get them depending on allergies or other health conditions. Is she on any type of vitamins/ probitotc? Ask her Dr if he thinks it will help. Hows her diet? They wont be able to do surgery as you know until she is cleared from any type of infections. I wish I could answer you if its inevitable, Im not sure. But sometimes no matter how hard to try to prevent something it may or may not work.

I will pray for you and your mom, that your mom gets well quickly so she can have her surgery. Your in my thoughts
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