Betty is a 67-year-old widow who lives alone in a two bedroomed council bungalow.  She was born in a wealthy family and spent most of her life in Greece before getting married and relocating to England.  She started smoking at the age of sixteen and still smokes about 20 cigarettes per day. She understands the impact of smoking on her health and is willing to quit but finds it difficult. She started having marital and financial problems with her late husband.  Her only daughter Sonia passed away two years ago due to breast cancer and her son Albert lives in Scotland with his family. She has a care assistant who come twice day to assist in the morning and evening.

Over the past 5 years Betty started having an ongoing productive cough which she assumed a smoker’s cough.  After encouragement from her late daughter she eventually consulted the General Practitioner (GP) and was diagnosed with emphysema which was at a severe stage.  She was prescribed the bronchodilators Salmeterol inhaler and Ipratropium bromide and Paracetamol one gram for pain relief. Betty was admitted to the Acute Respiratory Unit from the A&E following community acquired pneumonia (CAP), shortness of breath secondary to emphysema, bronchitis She has no known drug allergies. Due to exacerbations she has been in A&E six times in the last three months due to medication non adherence. Betty has lost weight due to poor nutrition and has a category one pressure damage on her right hip which was noticed on admission.  She is on Trazodone for anxiety.

Betty finished her Doxycycline course for pneumonia two days ago and clinically fit for discharge but she is not confident due to the history of falls she had over the last months.

Long term condition- Emphysema