Marjorie Williams
78, Female

History of presenting complaint

According to Mr Williams, his wife has been increasingly more confused over the last week.  She has been forgetting what she is doing, putting clothes into the fridge, speaking about dead relatives as if they were still alive and forgetting how to use a kettle. She seems undisturbed by the events. Marjorie Williams is unable to give any history herself.  Mr Williams has also been aware that his wife has been incontinent of urine, which is new. She has had no falls or recent head injury and has not been complaining of pain. Mr Williams continues to give his wife her regular medications, (he has been doing this for the last few years as she always forgets) but he has struggled to get her to eat or drink anything for the last 2-3 days. Over the last few days he has also needed to help wash and dress Marjorie as she is struggling with this. They normally walk 2 miles together daily, but Marjorie has not felt up to this for the last week.

Past medical history

• Hypertension diagnosed 10 years ago
• Hypercholesteroleamia diagnosed at the same time as the hypertension

Mr Williams suspects his wife has a bit of dementia as she has been getting increasingly forgetful for the past few years.  This has never been formally diagnosed as she gets very angry whenever he suggests they talk to the GP about it. She has never been confused like this before.

Drug history

• Ramipril 5mg od
• simvastatin 40mg,
• Occasional paracetamol for headaches
• NKDA (no known drug allergies)

Family history

• Mother died of breast cancer aged 60.  Her father died aged 80 in a care home with dementia.

Social history

• Marjorie is an Ex smoker having stopped 50 yrs ago.
• She drinks roughly 10 units of alcohol a week (sherry).

She’s a retired head school teacher and she lives with her husband, he is a retired chef and he does the shopping /cooking. He has been needing to take care of the finances over the last few years as Marjorie is finding this increasingly difficult. They live independently in a bungalow and although they have no children and no other family close by, they have good friends and Mr Williams feels he is coping well.  He thanks God for his own good health!