Elizabeth Flanagan is an 84 year old woman who lives with her 37 year old son Brendan in their home. They were seen at home in psychiatric counseling. Both the patient and her son were interviewed for the purposes of this evaluation. The patient was previously examined by Marla Cappell, physiotherapist of our medical team reached. Please see his excellent report found on the chart. The patient was originally referred to geriatric medical services after a couple of falls, which resulted in a displaced fracture. The son was a little vague about the fracture history. He knew there had been 2 significant falls. Marla Cappell's note indicates that there was a fall in late July tripping on a loose carpet that left her with a compound fracture of the right greater trochanter, and she had to spend 2 weeks of bed rest followed by 2 weeks of rehabilitation at St. John's. She was scheduled to continue outpatient rehabilitation at St. John's, but was too eager to use Wheel-Trans and was referred to specialized geriatric services for evaluation. She had a second fall on October 5, 2013 while going down the stairs at 2:00 a.m. to check that her son had locked the side door, and was again admitted to North York General Hospital with pain in her right arm and right hip and transferred to St. John's for rehabilitation afterward. Following her most recent stay at St. John's Rehabilitation Center, she was referred to home physical therapy services through CCAC due to her anxiety regarding Wheel-Trans and reaching outpatient services. It is due to anxiety that she was referred to our services and was seen at home today. Your son believes the main issues are around dating. According to him it becomes very repetitive,... middle of paper... alleviated he wasn't very interested in that option. Another option would be a very occasional dose of Ativan 0.5 mg for anxiety episodes as long as it is administered by the child and is not administered more than 2 or 3 times a week. Overall, however, she has expressed a desire not to take additional medications, and given her history as a nurse, it may be difficult to convince her to take medications, even if her ability to make such decisions is impaired. At this point, I do. I have no intention of visiting her again, but I am happy to do so if her son wants her to be re-evaluated or if her situation changes or if the family doctor wants to refer her again, or if the suggestions I have given here have been tried and she has not was successful. Thank you so much for involving me in the care of this pleasant family. Please feel free to contact me if I can be of further assistance.