Eileen Wilson, a 52-year-old woman with Down's syndrome and Alzheimer's dementia, died from aspiration pneumonia after 27 days of hospitalisation. She was transferred to hospital in early July 2009 after DHS staff noted acute deterioration with inability to stand and confusion. Chest imaging confirmed aspiration pneumonia; however, she did not respond to antibiotic therapy (cefriaxone and metronidazole) and continued to deteriorate. Planned transfers to nursing home and palliative care were abandoned due to her clinical instability. The coroner found no basis to criticise her care. The case highlights the poor prognosis of aspiration pneumonia in end-stage dementia and the challenge of managing swallowing dysfunction in this population. Early recognition of aspiration risk and implementation of preventive measures may have reduced pneumonia incidence.
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