Exam standard · Referral · Nursing
Low mood and weight loss after losing his wife
This case practises: Purpose up front · Leaving out what the reader doesn't need · Keeping the meaning of the notes exact
Writing task
Today's date: 3 December 2026. You are the registered nurse on Ward 9 (Medicine for Older People), Eastgate Hospital. Write a letter to Mr Kwame Asante, Community Mental Health Nurse, Eastgate Older Adults Mental Health Team, Eastgate Health Hub, 2 Bridge Street, Eastgate, referring Mr Benson for follow-up at home after his discharge today. Write in full sentences, not note form, using letter format. Aim for a body of about 180–200 words.
Case notes
In the test you get 5 minutes to read, then 40 minutes to write.
Patient details - Mr Harold Benson, DOB 22/05/1947 (79 y.o.) - 15 Mill Lane, Eastgate (2-storey house) - Admitted 22/11/2026, Ward 9; discharge 03/12/2026 Social background - Wife died 4 months ago (August 2026) after long illness; he was her carer - Lives alone; son lives in Canada, phones weekly - Retired civil engineer; enjoyed woodworking - stopped since wife's death - Used to attend Thursday lunch club - stopped attending - Grandson graduated from university in Toronto in June - Has a cat; neighbour feeding it during admission - Watches rugby on TV at weekends Medical history - Hypertension - ramipril 5 mg OD - Mild hearing loss - hearing aids - Cataract surgery L eye 2020 - Flu vaccine given 10/2026 Admission - 22/11: found on kitchen floor by neighbour; had fallen the evening before - CT head: no injury; bruised L hip, no fracture - Weight 64 kg (72 kg in August) - eating 1 meal/day, "no appetite" - Says he feels "there is no point any more"; denies any plan or intent to harm himself - Geriatric Depression Scale 11/15 - 26/11: psychiatric liaison review - moderate depression, low risk - 28/11: started sertraline 50 mg OD Progress - Mood a little brighter; eating 2 meals/day - Sodium 136 mmol/L on 01/12 - OT home visit 30/11: grab rails fitted; personal alarm arranged - Mobilising independently with a stick Discharge plan - CMHN home visit within 1 week: monitor mood, risk and response to sertraline - GP: repeat sodium in 2 weeks (sertraline) - Dietitian referral sent; meals delivered 5 days/week from 04/12 - Bereavement counselling leaflet given; pt willing to consider - Encourage return to lunch club
Write your letter
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Model answer Try writing your own letter first
Mr Kwame Asante Community Mental Health Nurse Eastgate Older Adults Mental Health Team Eastgate Health Hub 2 Bridge Street Eastgate 3 December 2026 Dear Mr Asante, Re: Mr Harold Benson, DOB 22/05/1947 I am writing to refer Mr Benson, a 79-year-old widower with moderate depression, for a home visit within a week of his discharge today to monitor his mood, risk and response to sertraline. Mr Benson was admitted on 22 November after a fall at home. His wife died four months ago, and since then he has lived alone, stopped attending his lunch club and lost 8 kg, from 72 to 64 kg. He told us there is "no point any more", but he denies any plan or intent to harm himself. His Geriatric Depression Scale score was 11/15, and the psychiatric liaison team assessed his risk as low. He started sertraline 50 mg daily on 28 November. His mood is now a little brighter, and he is eating two meals a day. His GP will repeat his sodium level in two weeks because of the sertraline. A dietitian referral has been made, and meals will be delivered five days a week. He has a personal alarm and is willing to consider bereavement counselling. Please also encourage him to return to his lunch club. Yours sincerely, Registered Nurse Ward 9, Medicine for Older People Eastgate Hospital
What the reader needs
- Moderate depression after his wife's death four months ago (GDS 11/15)
- Wife died four months ago; he lives alone
- Says there is no point any more but denies any plan or intent to self-harm; assessed as low risk
- Sertraline 50 mg daily started on 28 November
- Weight loss from 72 to 64 kg; eating poorly
- Admitted after a fall on 22 November
- Request home visit within a week to monitor mood, risk and response to sertraline
Details to leave out
- Grandson's graduation
- Former job
- Cataract surgery
- CT head and hip bruising details
- Hypertension and ramipril
- Two-storey house
- Cat and rugby
- Flu vaccine
One good way to write this letter, not the only one. Written by Kurippu; awaiting nurse review.