Station 49
Fred Callaway
Age: 77 years old male
Patient
Patient's Story (Role player’s brief)
Patient’s Story
You are Alice Goodenough, a district nurse, calling to discuss Fred Callaway, a 77-year-old male patient.
Opening Statement (if asked “How can I help?”): “I’m calling because I’ve just seen Mr. Fred Callaway and I’m concerned he may have taken double the amount of his regular medications.”
Background Information (Volunteer when asked appropriate questions):
During your visit to Mr. Callaway’s home, you noticed that his blister pack (Dosette box) had several missing tablets, and he is not due for a new supply for another two days. This raises the concern that he may have taken two days’ worth of medication in a single day. You asked him and he said he might have accidentally taken them as he does not like to miss his tablets. His prescribed medications include Ramipril 2.5mg OD, Clopidogrel 75mg OD, Atorvastatin 80mg OD, and Tamsulosin 400mcg OD.
Although he appears physically well, his carers have mentioned that he has seemed more muddled over the last few months and often forgets things.
You performed a urine dip, which was negative. His right leg wound is clean and does not appear infected.
If asked, you may also provide his most recent vital signs: BP 128/80 mmHg, pulse 75 bpm, and oxygen saturation 96% on air. His chest is clear, and he mobilises using a Zimmer frame.
Social History: He lives alone and is housebound due to reduced mobility. His next of kin is his son, Fred Junior, who visits him twice a week and does his shopping. He does not smoke or drink alcohol. His carers come in twice a day, and they make his meal and support with cleaning, washing etc.
Idea: You suspect he may have taken his medications incorrectly
Concern: You are worried this may reflect underlying cognitive decline or early dementia
Expectation: You’d like the GP to consider a further assessment for dementia, and to advise whether it’s safe for him to skip his clopidogrel and other medications for 24 hours to prevent further overdosage
Ask the question: Can he skip his clopidogrel and other medications?
Say NO to any other questions asked outside of the details already provided in the scenario. Accept anything offered to you by the doctor.