Coroner's Finding: NIXON Viola Daphne

92y · Female·decompensated congestive cardiac failure secondary to haemophilus influenzae lower respiratory tract infection

A 92-year-old woman with dementia, heart disease, and COPD died from decompensated congestive cardiac failure secondary to haemophilus influenzae lower respiratory tract infection. She was admitted to psychiatric care under an Inpatient Treatment Order due to severe dementia-related behavioural disturbance and medication non-compliance. The coroner found her detention and treatment appropriate. She developed a respiratory infection mid-October, became increasingly unwell, and the clinical team appropriately shifted to comfort care after discussion with her daughter. She died peacefully on the ward. No clinical errors or preventable factors were identified. The case highlights the challenge of managing severe dementia-related behaviour in acute psychiatric settings and the importance of early palliative care discussions when patients are seriously ill.