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AF.09. Anila Sarath - Mrs Caderina Piper


Ms Bhavna Sandrine

Charge Nurse

Palmer Home Care Facility


03 January 2018

Dear Ms Sandrine

Re: Mrs Caderina Piper, aged 90

I am referring Mrs Piper, who was diagnosed with post traumatic stress disorder, for follow-up care and appropriate management following her discharge today.

Ms Piper is a widow. She has only a nephew, who talks her about once a month. Even though, she has had pernicious anaemia, osteoarthritis and urinary incontinence,she is fully functional and independent.

In October 2016, Ms Piper's home was robbed.Therefore, she was distressed, delusional, and confused. After 2 months, she was slowly improved and was shifter to a senior living building. In March 2017,Mrs Piper was acutely ill with psychotic symptoms and severe paranoia along with hallucinations. Hospitalisation was provided for 14 days without antipsychotic medication. One week after the discharge, the symptoms were rapidly recurred when she was at senior apartment. Hence, medication such as haluperidol 0.25-1.0mg per day along with cognitive behavioural therapy and exposure therapy have been provided.

Encouragement was provided for the identification of coping mechanisms and its consequences. Adequate time was given for her to discuss and explore the feelings. Appropriate support system were developed for further therapies and accepted her emotions. Medications were administered as per the requirements.

Up on discharge, kindly call the emergency number if she tries to hurt by herself or others. Please call the doctor if she can not sleep or sleeping too much.

If you require any additional information, please do not hesitate to contact me.

Yours sincerely,

Charge Nurse

Beacham Ambulatory Care Centre


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