She needs way better pain management, OP. Pain is the great enemy, not death. When pain is not managed, death is seen as preferable. My MIL has advanced Parkinson's, and has terrible bouts of painful muscular contractions - some that broke her vertebrae. When she's in pain, her meds are so strong they make her hallucinate, which my husband is not comfortable with (she's otherwise entirely lucid), but in my opinion hallucinating is preferable to muscular contractions so severe as to break bones!!! My MIL has often regretted getting a pacemaker a decade ago - she says she would have been better off dying of cardiac insufficiency...

... aging is not fun, OP. Please do whatever you can to alleviate her pain. Not vaccinating is an ethical concern for the other residents, however. I would get her vaccinated.

No reason to be in pain with arthritis at this stage in life. That could be mitigated at least.

I have POA and Medical Directive. Thanks.

I’m sorry, OP.

OP, who has medical power of attorney. If it's you, then you can specify that she is only to receive palliative care. If you don't have it, you are at the mercy of AL doing whatever possible to keep her alive and keep the bed filled. It's a terrible thing.

As to the shot, given the health of everyone at the facility they may require the shots to keep the other safe, if not her.

It's a hard time of life, OP. Hugs.

Also OP, you may want to see if there are any Directives more important, more overarching, than the yes/no decision re: these 2 shots.

"Palliative Care" only, for example, if that is a Directive (I do not know)

If she doesn't want it say no. If she doesn't care say yes.

This is a great way to offer her an out. You are amazing for considering it knowing that others would think you selfish when it is actually the opposite. Decline everything but pain medication.

I would get it for the safety of others. And because it's not a fun way to go. But I hear ya on the readiness thing.

Mom is 91, demented, incontinent, in pain with arthritis. Has expressed before and occasionally now when she’s able to express herself, that she is ready to go to the great beyond. Her AL home is offering flu and Covid boosters. I’m inclined to decline. The place very small, 8 beds with little outside engagement. I am figuring it’s unlikely she’d catch either, but if she did, and it causes her death, that may be okay. Thoughts? It’s just so sad. Need an objective POV.