I am writing to express kind words about Alyssa Distasi, RN, and the excellent care and advocacy she provided for a patient with Down Syndrome and early-onset Alzheimer's Dementia.  Given his Down Syndrome and dementia, the patient has a legal guardian and is not able to speak/advocate on his own behalf. At baseline, the patient lives in a group home, is ambulatory, can speak in short sentences, is able to eat independently, and requires assistance with ADLs (showering, shaving). He was admitted to MGH on with altered mental status, hypoxia, and hypotension. He was treated for pneumonia and possible aspiration, he was scheduled to be discharged. 

His nurse that day, Alyssa Distasi, was concerned that his mental status was still fluctuating and well below his reported baseline. She was also concerned that he was not eating and that he would be discharged without this being addressed. 

Given that the patient cannot speak for himself, Alyssa acted as his voice, and advocated for what she thought was in his best interest, which was to not yet be discharged until a plan was in place. Alyssa felt strongly that the patient had medical issues that had not been worked up and resolved (mental status and no food intake) and brought her concerns to the medical team, who agreed to cancel the discharge. 

Later that night, the patient had a seizure, which he had never had before. He thankfully was still at MGH and was able to quickly be cared for during and after his seizure. He later had additional seizures. Alyssa took great care of the patient that day, and her perceptive observations, understanding of his baseline, and instincts led her to the correct conclusion that he should not be discharged. The result was that the patient stayed at MGH and was able to receive the appropriate care in a timely manner when he had an unexpected new onset of seizures. Alyssa provides excellent care for all her patients, and the patient was fortunate to have her as his nurse that day.