A 61-year-old woman with significant comorbidities including congenital hydrocephalus, stroke, obstructive sleep apnoea, and previous pneumonia with respiratory arrest (2017) died of pneumonia in hospital. She lived in a group home and was wheelchair-dependent requiring substantial care. In her final week, she developed reduced oral intake, drowsiness, apnoeas, and stridor. On admission, she had type 2 respiratory failure and consolidation on chest imaging. Despite antibiotics and steroids, her condition did not improve. A palliative approach was agreed with family. The clinical course and management appear appropriate given her multiple comorbidities and acute deterioration. Early recognition and treatment occurred, though her underlying conditions and previous severe respiratory illness made her vulnerable to severe pneumonia.
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