Time for the black suit once again. A gentleman in my care who is an Alzheimer's patient was taken to the hospital with difficulty breathing. Some Alzheimer's patients have swallowing problems. If the food and water is not going to the stomach it ends up in the lungs. He was diagnosed with aspirational pneumonia.

After several days in the hospital he was transferred to a nursing home. He entered the nursing home on Thursday night and due to ignorance and neglect he was dead by Saturday morning.

This same weekend his grandson was getting married. All the family was out of town and I was asked to check in on him. I called his son Friday night to report that he was knocked out by the Ativan the nurse had given him. Yes it is great to sedate someone who has trouble swallowing an hour before a meal. I decided since he was not going to eat I would return in the morning for his breakfast.

His intake of fluids was low due to the fact his drinks had to be thickened. He refused to drink or maybe I should say eat any water or juices. Even though he was not drinking or eating much they continued to medicate him.

Saturday morning I stopped in and he was even less responsive than before. I called the son at 9:30 AM to tell him his father was really zonked and I said I was going to ask the nurses to please not give him anymore Ativan. I went to the nurses station and I mentioned that his pulse was only 52 BPM and someone suffering from dehydration usually has a faster pulse. She asked the Aide to check his vitals and I requested swabs to clean his mouth and some thickened liquid to try to get him to drink. I asked when and why was he last given some Ativan. She said he kept calling out and saying he had trouble breathing several times so she medicated him.

At 9:45 AM I called the son back to tell him his father had passed away. He asked if I was kidding. Yes I have an odd sense of humor but joking about death with a family before the wedding is not part of my repertoire. I told him I wanted to call him before the nurse starts calling the names on the chart since they were all together at the wedding. I handed my phone to the nurse and he told her who he wanted contacted and he would tell his mother. I just could not imagine how that would be for her to receive that call on what was to be a happy day.

Now for what I think was the cause of death. He had such little fluid intake and was still being medicate routinely that I think he reached toxic levels from the Ativan. He was becoming jaundiced. I also wonder if his breakfast that the aide claimed he ate just bites was fed to quickly and that is why he was having so much difficulty breathig again. I would guess they fed him in bed with little elevation of his head.

When he complained of difficulty breathing I wish they had helped him into a chair and given him a breathing treatment. That would have been so much more benficial than another Ativan. R.I.P.