Bill’s reality: the accumulation of subtle change

Q. What do you need to know and why?

Nurse: “What do you see?
What do you hear?
What can you smell?
What do you think is going on?”

• Bill has stopped watering his plant.
• It’s 2pm and Bill is still unwashed and in his pyjamas.
• Bill has not shaved and looks unhappy.
• The phone is out of Bill’s reach.
• Bill is wearing food stained pyjamas that have not been washed for days.
• Bill has a damp patch on his pyjamas and is sitting on newspaper suggesting he has been unable to make it to the toilet.
• There are plates of uneaten food and cups of cold tea suggesting Bill has not been eating or drinking for a few days.
• Bill has swollen ankles.
• Bill’s medications are lying about on the floor.