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Case history
Mrs Gladys Smith, aged 91, has had recurrent cellulitis of the legs, which normally improves with oral antibiotics. This time, however, she has not responded and her renal function is deteriorating. She does not seem confused, but she is refusing hospital admission, and seems unable to care for herself adequately. Dr Steve Brown discusses.
How should I react? I need to explore the reasons for her refusal. Has she had a bad experience of hospital? Does she simply want to die at home? Is she truly able to make an informed decision? What family support is there? I need to build a good relationship with her because I can sense some...
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