OET Writing practice · Nursing
Dementia with UTI and delirium – return to aged-care facility
An original practice task written by LetterScore AI. Read the case notes in 5 minutes, then write your transfer letter in 40 minutes, about 180–200 words in the body.
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Case notes
NURSING — WRITING TASK (practice) Time allowed: Reading time 5 minutes, Writing time 40 minutes Read the case notes below and complete the writing task which follows. Notes: Today's date: 12/09/2026 Patient: Mrs Lau Wai Fong, DOB 19/04/1938 (88 yrs) Medical Ward 3, Kingsway Hospital, Ashford Admission date: 06/09/2026 Transfer date: 12/09/2026 Social background: - Born in Hong Kong. Cantonese-speaking, limited English - Resident at Rosemount Aged Care since 2024 - Widowed. Son (Kevin, 60) visits weekly, holds enduring power of attorney; granddaughter interprets - Former restaurant owner. Enjoys Cantonese opera music and mahjong - Prefers rice congee for breakfast Medical history: - Moderate Alzheimer's dementia (dx 2021), donepezil 10 mg nocte - Hypertension, amlodipine 5 mg daily - Osteoarthritis both knees - Recurrent UTIs (2 in past year) - Hepatitis B carrier (inactive), monitored annually - Allergy: trimethoprim (rash) Nursing management and progress: 06/09 Transferred from facility: 2 days increased confusion, agitation, hitting out at staff, not eating. T 38.4°C, HR 104, BP 108/64. Dry mucous membranes. Urinalysis: nitrites and leucocytes positive. Dx: UTI with hyperactive delirium - IV ceftriaxone, IV fluids. Urine culture sent 07/09 Pulled out IV cannula twice. 1:1 nursing overnight. Low bed, sensor mat - Haloperidol 0.5 mg × 1 for severe agitation (risk to self) 08/09 Culture: E. coli sensitive to cephalexin → oral cephalexin 500 mg BD (last dose 12/09 evening) - Afebrile. Oral intake improving with son's encouragement and familiar foods 09/09 Delirium improving; calmer when Cantonese music played. Restless at night - Urinary incontinence day and night → pads (before admission: continent with prompting) 10/09 Na 132 mmol/L (mild hyponatraemia); fluids encouraged, monitoring - Falls risk: high. Walks with frame + supervision (before admission: frame, independent) 11/09 Sleeping 5–6 hrs at night. Recognises son. Eating approx. 60% of meals - Skin intact; heels red but blanching → heel protectors 12/09 Na 135 mmol/L. Continent by day with 2-hrly prompting; incontinent at night - Geriatrician: delirium may take several weeks to resolve fully; avoid antipsychotics Medications on transfer: - Cephalexin 500 mg BD, last dose 12/09 evening - Donepezil 10 mg nocte - Amlodipine 5 mg daily - Paracetamol 1 g TDS regular (knee pain; untreated pain may worsen agitation) Transfer plan: - Return to Rosemount Aged Care 12/09 (hospital transport 2 pm) - Monitor for recurrent delirium or infection - Encourage fluids 1.5 L/day; fluid chart for 1 week - 2-hrly toileting by day, pads at night - Supervised mobility with frame; low bed, sensor mat - Heel protectors; daily skin check - GP review within 1 week; repeat U&E in 1 week - Consider reassessment of care level if function does not return to baseline Writing Task: Using the information in the case notes, write a letter to Ms Adaeze Okonkwo, Facility Manager, Rosemount Aged Care, 21 Birch Avenue, Ashford, who will be resuming responsibility for Mrs Lau's care. In your answer: - Expand the relevant notes into complete sentences - Do not use note form - Use letter format The body of the letter should be approximately 180–200 words.
How to approach this transfer letter
- The reader is about to receive the patient. Open with the transfer, the reason for it and when it happens.
- Focus on current condition, care needs, medications and anything still pending, so the receiving team can plan from day one.
- Hospital-stay detail matters only where it changes ongoing care.
Members also get the model answer, the note-selection table and task-specific tips for this task.