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It can be challenging to explain the the reason why she’s crying. First I will introduce myself to Betty and ask her how’s she feeling and ask her if she wants to  go for a walk as she enjoys walking. 

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It can be challenging to explain the the reason why she’s crying. First I will introduce myself to Betty and ask her how’s she feeling and ask her if she wants to  go for a walk as she enjoys walking. 

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- Could still be in shock through the trauma, onset of PTSD
- scared and anxious, young with no family

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Patient might be coming to terms with the whole situation hence not ready to open up.
Trusted friends have let her down
Has patient been given informed choices relating to the treatment plan

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Delirium through UTI adding to confusion
May not be able to express pain or feelings
No NOK or family, her friend may be elderly too
Scared as first time in hospital, scared what could happen now if shes deemed to be unsafe on her own

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Consider that she may have an injury due to her fall

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Refusing care due to trauma, not many nurses/doctors have been in her position to be able to emphasise. Most consultants and doctors are men. Her friend is male and has no family there to reassure and care for her. Is her friend actually her social worker? Has she had a troubled past? Also possibly on a come down from the heroin and having withdrawal symptoms from something she didn't choose to take

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- Fear
- Lack of trust particularly with male staff
- Withdrawal from heroin
- Refusal of all care
- Might be in shock
- New trauma - still processing what has happened
- Being unable to empathise as unlikely to have been in the same or similar situation. Could validate her feelings instead

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Patient will lack trust in anyone after what shes been through
Effects of Heroin/other substance abuse
She may be feeling like the worst has happened, that any treatment/examinations will not help
Lack of support through family or friends
Scared to accept help

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Fear of the unknown might make her emotional.
might be feeling lonely with no next of king
fear of being misunderstood due to memory loss

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- Patient has a UTI and Alzheimer’s, so confusion could be a barrier.
- Crying and being in pain
- Appears frustrated
- signs of sepsis

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Amy might feel alone and she is used to that. Difficult to trust or let anyone in... The only friend she had/has is male and she might view all men as the same as her abusers now.
Amy will be very nervous and scared for anyone to look at or touch her in any way.

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Amy is young with no family
Been through trauma
Scared, anxious, maybe in shock

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Sometimes people with dementia can't acknowledge they're in pain either

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* Saving her life
* Preserving dignity
* ? Dependency/side effects
* Sex of the nurse in charge

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Uti can cause confusion and agitation but also common for dementia to cause anxiety and depression.
Could be worried about the dog, hca may have been uncooperative and caused more agitation as she couldn't get her point across. Feeling sad and lonely?

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- Memory issues
- Disorientated
- Might be fearful of being in hospital
- Missing her dog

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May not remember what happened
Might not be able to communicate her needs
Could be difficult to get a history
Might be scared- unknown environment and people
Uti can lead to increased confusion qnd delirium

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* Diagnosis - her understanding
* Ability to give informed consent
* Relating to the patient in terms of age/gender
* Managing her emotional state

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She is tearful and emotional
Unfamiliar environment
She may be scared
Confusion due to UTI

Agitation

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Betty may be confused due to UTI and Alzheimer's
No NOK
May be worried about her dog (Scottie) and going home
Betty is tearful (find out the reason)