Day 20 Case Notes Analysis



Read the case notes below and complete the writing task which follows.


You are Ms Stevena Lovesky, a nurse who has been assisting Dr Samuel Bison, who is GP of Ms Disney Carpenter. The patient has been under his care for the last seven years.

Patient Details:

  • Ms Disney Carpenter, 78 years,
  • Divorced (three times), lives with a grown-up, “noisy” family of “intellectuals.”
  • Three daughters, two sons, seven grandchildren.
  • Has friends. Talks only over phone.
  • Loves to be on her own.
  • Interests – Gardening, theater, literature – both reading and writing herself – as well as her pets and her faith (quite religious but not a believer).


  • Dx paranoid schizophrenia (May, 2003)
  • Admitted 70 times at Royal Edinburgh Hospital, Sydney.
  • Prolonged periods of poor mental health.
  • Given up work (as a freelance writer for “the Guardian”) in 1999.
  • Receiving daily support from 2005.
  • Potentially fatal overdoses (over ten times, shortly after each three marriages).
  • When well, she has very trusting relationships with all those involved in her support, especially a social worker, but finds it difficult to trust anyone when she is unwell.
  • Says, “not to go to hospital ever again!”

Major support to be provided

  • Assist with practical tasks; offer emotional support; help her to find ways to manage her mental health & general well-being.
  • Support with doing her weekly shopping.
  • Crowded places heighten her paranoia, making her think that people are talking about her.

Behavioral Instability (Real Cases)

  • You arrive at the house expecting her to be ready to go, but instead she is pacing up and down, looking really distressed.
  • When you ask what is wrong, she tells you there’s no point in going shopping.
  • When you ask why not, she tells you she won’t need it, as the voices are reminding her what a bad person she is and that she doesn’t deserve to live any more.
  • You then notice that she has emptied all her medication into a pile on the coffee table.


  • Mostly Aripiprazole (Abilify) or Brexpiprazole (Rexulti) when side effects increase.
  • dizziness, lightheadedness, drowsiness, weakness, lightheadedness, nausea, vomiting, stomach upset.


  • No new plan to be made. Follow the existing plan.
  • Be patient. Be prepared for abusive exchanges of words.
  • GP, Dr Samuel Bison, to be contacted on Phone: +61 2 9879 2600 (One Door Mental Health Gladesville)
  • Psychiatrist (emergency) – Ms Doris Peaks, +61 2 9821 7607 Continue one-on-one individual therapy sessions.
  • Flexibility in treatment plans necessary.

Writing Task

Using the information, write a letter to Ms Lui Holand, Director, ‘At Your Service’ social worker’s agency, to arrange a social worker who can provide services to Ms Carpenter.

In your answer:

  • Expand the relevant notes into complete sentences
  • Do not use note form
  • Use letter format
  • The body of the letter should be approximately 180–200 words.

Now take this Case Notes Analysis and Proceed to Letter Writing

  • Question of

    Who is the patient?

    • An old woman with physical distress
    • An old woman who needs occupational therapy
    • An old woman with mental issues
  • Question of

    Who is the recipient?

    • A GP
    • A social worker
    • Patient’s relative
  • Question of

    What is the purpose?

    • Arrange a social worker
    • Arrange a nurse for medication administration
    • Arrange a physician
  • Question of

    Admission / Discharge status:

    • Admitted and discharged
    • Not admitted (Home care)
    • Admitted

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  1. 26 June,2020

    Ms Lui Holland
    At Your Service

    Dear Ms Holland,

    Re: Ms Disney Carpenter,78 years

    I am writing to request social care services for Ms Carpenter who was diagnosed with paranoid schizophrenia.She requires further assistance in managing her mental health and general well being.

    Ms Carpenter has been under our care for the last 7 years.She has been receiving daily support in completing practical tasks since 2005.During today’s visit,she was found to be distressed and showed disinterest to go out for shopping.She also seemed to be frustrated about her life.In addition,a pile antipsychotic medications was found on her coffee table.

    A divorcee,Ms Carpenter lives with her children and grandchildren.She prefers to be alone and talks only over the phone.She is interested in gardening, literature and pet’s care.She has a history of potential drug overdose.Due to her repeated hospitalizations in the past,she is reluctant to visit hospitals.Please note, crowded places triggers her paranoid behaviour as she thinks all the people are talking about her.

    It would be appreciated if you could arrange a social worker for Ms Carpenter to provide her with adequate emotional support.

    Please be aware that she may use abusive language.In case of any emergency,you can contact her GP Dr Samuel Bison Phone: +61 2 9879 2600 (One Door Mental Health Gladesville) or Psychiatrist Ms Doris Peaks Phone: +61 2 9821 7607.

    Contact me for further queries.

    Yours sincerely,

    Ms Stevena Lovesky

Written by Biju John

Love for English begins with understanding its unknown rules. Biju John lives on the internet, teaching OET, IELTS and PTE. More than a million students have thanked him from their heart.

Day 19 Case Notes Analysis

Day 20 – Today’s Grammar