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My mom has vascular dementia and Alzheimer's. Tuesday October 5, she started experiencing wheezing, coughing, shortness of breath and swelling in her legs. We took her to urgent care on Friday because it got progressively worse. They diagnosed her as having pneumonia in both lungs and said if she didn't get better to take her to her PCP the following week. She did not get better and we took her to her PCP. He said she had congestive heart failure, took some blood tests, and sent her home. The next day he called and said he needed to go to the ER because one of her blood tests showed that she was in severe heart failure. We took her in and she was admitted. Due to Covid, visitation is limited. After leaving, a nurse called and asked if she could take ativan because she was agitated. I told her that my mom had a bad reaction to Ativan in 2011, but that was a long time ago. I regret not telling her to absolutely not give her Ativan. I left the hospital at about 9 pm. When leaving my mom fully recognized me, was in good spirits, was joking with the nurses, and was completely herself. I returned the next morning around 7am. Upon entering my mom's room, I immediately saw that she was breathing very fast, short breaths. I shook her and she would not wake up. I tried to open her eyes and her pupils were dilated. I called for a nurse. They did a rapid response rushing me from and the room and administered Flumazenil. They said they gave her .5mg at midnight and another .5 at 4am. She now does not know me. She only partially opens her eyes. She mumbles incoherently and screams out. She doesn't know when she needs to go to the bathroom even though she did before. She is just a totally different person. They claim that the Ativan could not have done this to her. But, the only thing that happened between that night and the next morning was the Ativan overdose. It has been 4 days and my mom still has not returned to normal. I am very concerned. Could this be brain damage or could the Ativan effects still be lingering because of everything else going on with her body? I have made an appointment with her neurologist. But, the closest appointment he had was Oct. 25th. She is also going to see her PCP on Oct 11th. I am just so worried that this is her now and that I could have prevented this by being adamant that they not give her the Ativan. Any thoughts? Thank you.

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You did give them the information that she has had a bad reaction to Ativan in the past. It does not matter how long ago. With that information they should not have given her that particular medication.
I am also surprised that the hospital would release her with the symptoms she had, swelling of the legs, shortness of breath with a diagnosis of pneumonia in both lungs with the instruction to take her to her PCP the next WEEK! (heaven only knows how long it might have taken if the doctor had not had an opening. It might have been 2 or 3 weeks before she might have been seen)
I am also surprised that with a diagnosis of CHF that with the monitors that I am sure were on her that they were unaware of the breathing difficulty she was having.
I suggest rather than waiting for the Neurologist that one see her while she is in the hospital so that any tests that need to be done can be done ASAP.
If you want her to see the one she has had call the office and ask if the doctor can see her while she is in the hospital.
If not it might be worth getting another to see her.
She may have had a stroke
By no means it this your fault so do not stress over the fact that you did not tell them that they should not administer the Ativan, that was a medical decision.
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perturbed07 Oct 2021
Thank you for replying Grandma. She is being discharged today and is currently in transport on her way home. They did a CT scan and said that it did not indicate that she had a stroke. I will try to find another neurologist. I am in agreement that she needs to see one soon.
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I'm not a doctor, but the fact that your mom has "severe heart failure" on top of pneumonia, is more than likely the cause of her dramatic change in her breathing and mental capacities. It sounds like her brain is not getting enough oxygen to sustain her as she once was.
My husband who also had vascular dementia, developed aspiration pneumonia and almost died from it, and ended up completely bedridden and on 24/7 oxygen for the last 22 months of his life.
I gave him(per hospice orders)Ativan every 4 hours when he was in his 6 week dying process, and I couldn't tell if it was actually working or not, as he was still quite agitated.
If your mom in fact has vascular dementia, then you are aware that it is the most aggressive of all the dementias, with a life expectancy of only 5 years, so sadly someone with it does decline rather rapidly.
My husband was diagnosed with it in July 2018, and he died Sept. 2020.
At this point I would just get hospice involved, and make sure that your mom is kept as comfortable and pain free as possible. She's not going to get better, only worse, so make sure that you spend as much time as possible with her.
I wish you and your mom peaceful days ahead. God bless you.
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Brain issues can result from the Ativan as well as the breathing issues. She should never have Ativan or anything in the benzos family ever again. Hopefully once the medication is out of her system she should return to being back to baseline before she was given that medication.

It pisses me off that they said her breathing issues were not exacerbated from the Ativan when that is a known rare but serious side effect of the medication. Thankfully you were there to alert them to your mothers condition otherwise they would have kept giving her the Ativan and killed her. Imagine how many of these "accidents" happened to people during lockdowns when people couldn't advocate or see their loved ones in the hospital.
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Hopeforhelp22 Oct 2021
I think sp19690 had given great advice.

And - perturbed07 - I am so sorry to hear about your mom's health and that you're going thru all this. It's absolutely not your fault at all - you had provided the information to the hospital re: Ativan- they had taken over from there and made decisions on how to proceed. Once your mom is settled in and hopefully she'll return to herself, I suggest raising a major issue with the hospital - what they did was negligent and really egregious...I'd suggest going right to the top - making sure you speak to the doctor who was overseeing your mother as well as the nurses...and get answers - they're responsible and the fact that they released her in this state is even more irresponsible - they should be held accountable.
Sending prayers for your mom.
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Grandma1954 raises good issues.  I too wondered and actually gasped when I read that she was released from the hospital with bilateral pneumonia, and a recommendation to follow up with a PCP.  What???   That's totally in contrast with the good care my father received, something I think was standard treatment for CHF.   

When he had pneumonia, whether in one lung, or bilaterally, he was ALWAYS admitted, except once in Texas when he declined admission b/c Mom would have been left alone in their trailer.   (I wasn't impressed with the care the Texas doctors were providing, which is part of the reason I flew down and brought them home.)

Covid notwithstanding, I'm shocked that a hospital did not admit someone with your mother's presentations.

And in fact, I think that might be a breach of standard care for pneumonia patients.

Don't chide yourself about the Ativan situation.    It was your responsibility to relate the information that she had had it before, but it was a doctor's decision to administer it, notwithstanding those facts.  

I  would also support the recommendation that she see a neurologist, ASAP, and preferably in the hospital, but I see that she's already been dismissed.

Did the discharge planner arrange for home care for her?  I certainly hope so.
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