My husband in the late stages of copd and was doing fine but since the end of April he has been in and out of ER/hospital with an exacerbation and three bouts of pneumonia, each declining his health. His palliative care doctor thinks it may be time for him to start hospice. He is reluctant because he was on hospice 18 months ago for a few months. We took him off because he was having health problems that needed treatment that hospice wasn't allowed to treat. I am nervous about his ability to breath now. Does anyone have any tricks that have to avoid pneumonia? His sees his doctors regularly through videos, takes his medication as prescribed, exercises when he can. Also, could he be over exercising? How do you know when you are over exerting?