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