@indigo oh man yeah. So intensely awful.
Hugs
@indigo also doctors aren't generally great at pinning down prognosis unless death is imminent, according to the literature. O_o. I can attest to that - I initiated end of life care for someone recently and she bounced back! And the reverse happens too, people declining rapidly. O_O
@indigo aspiration pneumonia in general is a sign things are declining. Which episode may be "the one" will be hard to know until it happens i suppose. If that makes sense? It's horrible, uncertainty
@indigo it's really variable. You get mild episodes which respond quickly to treatment, sometimes you get severe ones. Someone who lacks the physical strength to do an effective cough will recover less well than someone with a good cough. As you know aspiration pneumonia is the most common cause of death - many people have multiple episodes and hospitalisations though before it happens. Any severe infection can mean deconditioning too, where you lose muscle mass.
People talk sometimes about things like PEG tubes but it's… One of those things that really if anything worsens quality of life because you never take anything orally again and it doesn't improve prognosis anyway.
Also when people are acutely unwell their swallow is less good than when they're bright, alert and physically at baseline. Often diet gets modified temporarily or permanently - thickened fluids or changes in food consistency
Then there's "at risk" feeding- that's a lengthy conversation. But sometimes people really just want to drink water and thin fluids and enjoy food when they're at the end of their life and accept the risk of aspirations. There are strategies possible to make that safer too.
For some reason, when trying to look up “aspiration pneumonia” I kept typing “aspirational pneumonia” which makes it sound like the next great fad.