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THE CASE SCENARIO Mrs Caroline Smith • 64-year-old woman who lives alone in a small terraced house. • Caroline has three grown-up children who all live nearby. She has little contact with her two sons, George and Mark, however, she sees her daughter, Ann, weekly. • Recently Ann has been doing the shopping for Caroline as she has not felt well enough. • Caroline worked as a receptionist for a local delivery company but has decided to retire early as she feels too exhausted to go in to work. • Caroline is divorced from Stan who also lives near by. They don’t see much of each other but Ann also visits her dad weekly and the boys meet their dad in the pub regularly. Presenting Complaint • Caroline presented to her GP with persistent breathlessness on exertion and a persistent cough. • Initially she was treated with antibiotics when the symptoms persisted and following a Chest Xray that was fairly inconclusive, she was prescribed Salbutamol and beclomethasone inhalers. • However over a period of three to four months her symptoms worsened. She returned to see the GP for the 4th time. Past Medical and Drug History • Hypertension • History of gastric ulcers • Drug history • Omeprazole • Diltiazem • Amilodipine • Beclomethasone • Salbutamol • Smoker x 10 per day • Social drinker • Allergies – Nil known allergies Assessment • On examination the GP found Caroline had bilateral inspiratory crackles when listening to the chest and clubbing of her fingers. • She has referred Caroline to a Respiratory Consultant at her local hospital. Assessment (Roper, Logan and Tierney’s activities of daily living) Caroline has been diagnosed with idiopathic pulmonary Fibrosis (1) Discuss and analyse the way in which BREATHLESSNESS symptom experienced by that patient may be ASSESSED using a person centred approach relevant to the context of the scenario.

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