@charisscurry Based on her bronchoscopy, it seems likely that the cause of her pneumonia could be either aspirating food or reflux then swallowing food. This can also introduce bacteria, leading to a later infection.

The usual best practice for recurrent aspiration pneumonia is Speech or Occupational therapy to address the underlying cause. Also, all food and drink consumed should be done while sitting fully upright and concentrating on eating or drinking.

Perhaps if you and she are able to identify when the pneumonia is starting, the doctor would be willing to prescribe antibiotics to be taken at the onset of illness, along with preventive measures.

@charisscurry if the swallow test showed no issues with swallow, but the bronch showed food in lungs, that suggests GERD. Has your Mom been evaluated for GERD? My GERD workup included an endoscopy and a 24 hr PH test. There are a few ways to do the PH test, so consult a gastroenterologist. Even for those of us with negative testing for GERD it is recommended we practices GERD precautions as there is such a strong connection between GERD and lung disease. Some of these are: sleep with elevated torso (wedge, elevated bed), don’t eat at least 3 hours before bed, small meals. For those with active GERD there are often dietary changes that are recommended as well.