Clinical Case: Coaching and Teaching

12/29/22, 10:46 PM Case Summary

https://www.polypharmacy.scot.nhs.uk/for-healthcare-professionals/case-studies/case-1-frailty-without-overt-multimorbidity/case-summary/ 1/2

Case Summary

Patient Details

69 year old man

Current medical history

Fracture neck of femur 2 years ago

Dementia – mixed Alzheimer’s disease / alcohol abuse

Ex-Smoker

Frequent Falls

Results

BP 120/84 mmHg

eGFR > 60ml/min

FBC and U+E normal

MMSE score 14

Current Medication [stable since admission]

Trazodone 150 mg at night

Thiamine 50 mg three times daily

Bendro�umethiazide 2.5 mg once daily

Tramadol 50 mg four times daily

Cetirizine 10 mg once daily

Amisulpride 100 mg twice daily

Diprobase cream (as required)

Fucibet cream topically twice daily

Current Function

69 year old man who has been a care home resident for 2 years. Long term heavy alcohol use in

the past. Developed dementia exacerbated by alcohol related brain damage. Fell at home

leading to fractured hip. Very confused and distressed post-surgery. When settled, unable to

manage at home post-fracture and transferred to care home. Lacked capacity at time of

admission, however with additional support this has improved.

Assistance of two carers required for transfer to chair. Patient falls frequently as he attempts to

mobilise unaided. Conversation is confused and occasional verbal aggression, patient also has

poor short term memory. Prompting is required to ensure that he eats and drinks. Spends most of

12/29/22, 10:46 PM Case Summary

https://www.polypharmacy.scot.nhs.uk/for-healthcare-professionals/case-studies/case-1-frailty-without-overt-multimorbidity/case-summary/ 2/2

the day sleeping in his chair. Sleeps well at night. Over the last 12 months has developed ankle

swelling and shortness of breath.

Most Recent Consultations

Communication is sometimes di�cult due to cognitive impairment. He has had three consultations

in the last 6 months. One was for a chest infection for which he was prescribed an antibiotic. A

second consultation for review following a fall, only minor bruising was noted on examination. The

most recent consultation was regarding concern over leg oedema. There is minimal contact with

the family.

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