Bournemouth looked as though they would be frustrated by a resolute Tottenham defence, but Ake powered in a header from Ryan Fraser's corner to land another blow to Pochettino's men.
Spurs would have guaranteed Champions League football next season had they won on the south coast but red cards for Son Heung-min and Juan Foyth killed their chances of that as they fell to Nathan Ake's late goal.
The game is a must-win for Spurs who need to secure Champions League qualification and give them the boost they need ahead of next week's Champions League clash with Ajax.
Lerma certainly did not do himself any favours with his theatrics, but he has handed his side a huge advantage in ensuring that his side could play the full duration of the second half without the threat of the visitors' most risky attacker.
For all intents and purposes, though the game was decided through the Spurs' indiscipline.
They had their chances in the first half at the Vitality Stadium, but found debutant goalkeeperMark Travers in inspired form. The match starts at 19:30 on 4 May 2019.
Travers was almost beaten by a shot unleashed by Lucas Moura from the half-way line as he was caught off his line in the opening exchanges, before his started to show his class with a series of saves to deny Tottenham.
Tottenham pushed hard for the opener and Travers pushed away Dele Alli's powerful shot well, as Bournemouth rarely threatened on the break. "Huge potential, we think this is an ideal game for him to show what he is capable of".
It was a moment of madness and his red card was deserved.
Referee Craig Pawson had earlier turned down a pair of Bournemouth penalty appeals and generously opted against showing Eric Dier a second yellow card, but Son was dismissed as he shoved Jefferson Lerma to the floor. The day became worse for Spurs when Ake scored the victor in the 91st minute.
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