QUESTION: I have been getting flu shots for the past three years. A friend told me she had a pneumonia shot. Is this the same thing, or do I need a pneumonia shot, too?

ANSWER: The shot your friend is referring to is a vaccination against pneumococcus bacteria strains, the most common form of bacterial pneumonia that represents close to one-third of all pneumonia. It does not protect against viruses.Since pneumonia can be caused by influenza virus, pneumococcus bacteria or a variety of other infections, you should get the flu and pneumonia vaccine if you are over 65, a smoker and/or suffer from any chronic cardiovascular or respiratory condition.

Pneumonia is one of the most common infections of hospitalized older persons, and a leading cause of death for nursing-home residents. The federal Centers for Disease Control estimate that close to 40,000 Americans die of pneumococcal pneumonia each year. The CDC estimates that 60 to 70 percent of these cases can be prevented by the pneumococcal-pneumonia vaccine.

Dr. Dean Norman, clinical director of the Geriatric Research, Education and Clinical Center at the Department of Veterans Affairs Medical Center of West Los Angeles, says the pneumococcal-pneumonia vaccine only has to be administered once in a lifetime unless you are among a high-risk group of immuno-suppressed individuals. This includes persons with sickle-cell anemia, lymphoma or no spleen. These persons should get vaccinated every five years.

Consult your doctor regarding the pneumonia vaccine. The side effects from the vaccine are generally limited to pain at the injection site and mild fever.

The cost of the pneumococcal-pneumonia shot is covered by Medicare.

- A READER IN SALT LAKE CITY wrote us recently about the Brigham Young University Senior Helpline. This free telephone service provides a wide variety of informative taped messages of interest to older adults and caregivers.

The Helpline offers more than 100 recorded messages on caregiving, health, housing, retirement, financial planning, safety and mental health. The messages are two to five minutes long and carry a disclaimer that they are not a substitute for medical or legal advice.

The BYU Senior Helpline currently receives more than 16,000 calls per month. Users are asked to limit calls to three per day. This service is free throughout the United States, Canada and Puerto Rico.

Those with touch-tone phones may call anytime, 24 hours a day, seven days a week. Those with rotary phones should call between 8 a.m. and 4 p.m. (MST), Monday through Friday, except holidays. Written copies of messages as well as Braille directories are available at no charge.

The BYU Senior Helpline is a non-profit service. It makes a recorded pitch for donations, but callers may skip that message if they wish. To receive a listing of the Helpline messages call 1 (800) 328-7576 or write to BYU Senior Helpline, Brigham Young University, F-274 Harris Fine Arts Center, Provo, Utah 84602.

QUESTION: My 78-year-old father was hit by a motorcyclist and suffered two broken hips and internal injuries. His expressed wishes were that he did not want to be resuscitated. Four weeks into his hospital stay, he went into cardiac arrest and was resuscitated. He lived in the hospital for another five weeks, and only after his death did I learn the doctors had resuscitated him against his wishes.

What is being done to help people who do not want to be resuscitated?

ANSWER: Congress recently enacted the Patient Self-Determination Act. Sponsored by Sens. John Danforth (R-Mo.) and Daniel Patrick Moynihan (D-N.Y.), and Rep. Sander Levin (D-Mich.), it was passed as part of the Omnibus Budget Reconciliation Act of 1990. Passage of this bill represents a significant step forward toward recognition of individuals' rights at the end of life.

The new law affects all health-care facilities, including hospitals, nursing homes and hospices receiving Medicare or Medicaid. It stipulates that individuals must be given written information at the time of admission about their right under the state law to accept or refuse medical treatment and the right to formulate advance directives such as Living Wills and Durable Powers of Attorney for Health Care.

The facilities will be responsible for documenting in each individual's medical record whether he or she has executed such an advance directive. In addition, the facilities are required to undertake public-education programs for staff and the community on issues concerning advance directives. States are required to develop a written description of the state law.

The new law attempts to ensure that more Americans will learn about their treatment rights and be empowered to protect themselves under state law. To most effectively implement these changes, both the health-care community and the public will need to cooperate and to become better informed about the legal, medical and ethical issues. Living wills and advance directives can help people articulate the type of care they want.

Washington Post Writers Group