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It's About Life

A third indicator is propensity for developing infections. It is well known that there is a progressive decline in the power of the immune system with aging. Before the introduction of antibiotics in the 1940’s, many elderly people died from pneumonia.  Pneumonia was called “the old man’s friend” as it promised a swift death.  We may think of pneumonia as being curable, but many elderly people are at risk to contract pneumonia and at risk to die from pneumonia. If a person is older than 75, they have a six times greater chance of getting pneumonia than if they were 60 years old. This is because the lung has lost its elasticity. In addition, changes in the brain and nervous system affect their ability to cough up secretions, which is essential to overcoming pneumonia. Some elderly people have difficulty with swallowing and may cough while eating, inhaling liquid into their lungs. This is called aspiration, and can cause them to get pneumonia repeatedly.   Some elderly people also develop infections of the urinary tract, which can be treated, but which further weaken the body.

Identifying early that your loved one is declining has many advantages. You can tell your health care provider how you want those final months to be, so he or she can support you in your plan. Services can be put in place at home or in a facility so that if a crisis arises, it can be managed without going to a hospital. If you are able to get hospice care in place, oxygen and medications for comfort will be on hand should a medical crisis arise. Nurses will do routine in-home assessments and advise you as to what you can expect. You and your family will be better prepared.

If you suspect your elderly loved one is declining, you can ask for a “hospice consult.” and a nurse will come to your home and advise you and your healthcare provider about eligibility. In-home support and availability of comfort  measures is the key to successful care at the end of life.

Betsy Murphy has worked in hospice care for 23 years. Trained as a Family Nurse Practitioner and certified as a Hospice and Palliative Care Nurse, she has recently published the booklet, “Guide to Caregiving in the Final Months of Life” to assist families facing end of life care of a loved one.

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