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Example case 6 of 40

Check what changed in the medicines

Review the causes and the response

Mrs Nair, 74, is newly confused and inattentive.

Click or tap each illustration to enlarge it. The commentary and text transcript follow below.

Nine-panel portrait clear-line comic. Panel 1: Mrs Nair, 74, is newly confused and inattentive. Panel 2: The doctor checks for urgent illness and assesses delirium. Panel 3: The pharmacist checks recent starts, stops and dose changes. Panel 4: Kidney function has worsened. Other possible causes are assessed. Panel 5: The prescriber reviews benefits and harms, then adjusts her medicines. Panel 6: Next day she remains inattentive despite a quieter night. Panel 7: Her daughter describes her usual function. Panel 8: Staff support eating, drinking, communication and sleep. Panel 9: Attention improves a little. Further assessment is planned.
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Commentary

Review recent medicine changes alongside other possible causes. Assess the response and continue supportive care.

An anonymised composite case that does not describe one identifiable person and is not research evidence.

Read the text transcript

Page 1

Panel 1

Mrs Nair, 74, is newly confused and inattentive.

Daughter: Mum ran her shop on Monday. This began on Tuesday.

Panel 2

The doctor checks for urgent illness and assesses delirium.

Doctor: I will examine her and look for possible causes.

Panel 3

The pharmacist checks recent starts, stops and dose changes.

Pharmacist: A bladder tablet started last week. Any non-prescription medicines?

Panel 4

Kidney function has worsened. Other possible causes are assessed.

Doctor: Medicines may contribute. We will also check her other symptoms.

Panel 5

The prescriber reviews benefits and harms, then adjusts her medicines.

Doctor: I will explain each change and arrange to check its effects.

Panel 6

Next day she remains inattentive despite a quieter night.

Nurse: We need to reassess her and review the response.

Panel 7

Her daughter describes her usual function.

Daughter: She cooks daily and phones me each evening.

Panel 8

Staff support eating, drinking, communication and sleep.

Nurse: Here are your glasses. I will help with lunch.

Panel 9

Attention improves a little. Further assessment is planned.

Doctor: I will review her tomorrow morning, or sooner if needed.

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