The candidate card
Setting
Dementia community clinic
Candidate
In this original independent practice role-play, you are a community dementia nurse. Mrs Wendy Prempeh, aged 56, supports her 80-year-old mother, who was diagnosed with Alzheimer's disease three years ago and lives with her. Her mother is with a support worker in the waiting area and has agreed that her daughter can discuss difficulties with washing. Mrs Prempeh reports increasing distress during morning showers over the past month and believes her mother is deliberately making care difficult; no personal-care assessment has yet been completed.
Task (interlocutor: relative)
- Explore one recent washing episode and what usually works, including her mother's preferences, abilities and any discomfort or sudden change.
- Explore how the difficulty affects Mrs Prempeh and why she feels her mother's response is deliberate.
- Explain possible reasons for distress using the episode, responding sensitively to Mrs Prempeh's concerns.
- Discuss one or two changes matched to her mother's preferences and abilities, including asking permission and pausing if she becomes distressed.
- Agree which change to try first and a clinic review to assess the washing difficulties, and check Mrs Prempeh's understanding.
In the test you get 3 minutes to read the card and plan, then about 5 minutes to talk. This card is original, written for this site; the interlocutor's card is not shown.
Prepare this card, then say it out loud.
Plan your opening and the tasks below. Keep these notes when you move to the AI role-play.
In this original independent practice role-play, you are a community dementia nurse. Mrs Wendy Prempeh, aged 56, supports her 80-year-old mother, who was diagnosed with Alzheimer's disease three years ago and lives with her. Her mother is with a support worker in the waiting area and has agreed that her daughter can discuss difficulties with washing. Mrs Prempeh reports increasing distress during morning showers over the past month and believes her mother is deliberately making care difficult; no personal-care assessment has yet been completed.
Getting your plan ready…
Preparation is free without an account. AI conversation and marking need sign-in; your first role-play is free. Notes are saved on this device when available. This checklist is your plan, not a score.
How to approach this card
- Begin with the daughter's experience before challenging her interpretation. A likely concern is feeling blamed for difficult washing episodes; ask what feels hardest and what makes the behaviour seem deliberate. Acknowledging the difficulty does not mean agreeing about her mother's intentions.
- Use one recent episode to guide focused questions about discomfort, familiar washing preferences, retained abilities and what has helped. Briefly check whether there has been a sudden health or behavioural change. Keep the exploration relevant to choosing a manageable alternative rather than attempting a full personal-care assessment.
- Present fear, confusion, discomfort and loss of privacy as possibilities to explore, not established explanations. Refer to distress during washing and avoid implying the daughter caused it. Dementia Australia supports attention to privacy and personal preferences: https://www.dementia.org.au/living-dementia/staying-healthy/hygiene. Checked on 5 November 2026.
- First ask how and when her mother previously preferred to wash, and which steps she can still manage herself. Use what Mrs Prempeh tells you to select one or two changes together, checking whether the proposed approach and timing are practical for her daughter. Build in permission, privacy and a pause if distress rises, then invite the daughter's response before agreeing which change to try first. Any reported pain or illness requires appropriate clinical assessment, and persistent washing difficulties warrant individual assessment and support.
- Keep the closing plan brief: agree the first change and a clinic review to assess the washing difficulties, including possible pain or other unmet needs. Check how Mrs Prempeh would try the change and what she understands about follow-up. Address any reported pain or illness through appropriate clinical assessment. If sudden new confusion is raised, advise immediate emergency medical help without waiting for an appointment; this is supported by NHS guidance at https://www.nhs.uk/symptoms/confusion/, checked on 5 November 2026. The gradual washing-related distress described here does not, by itself, establish an emergency, so an extended emergency discussion is not a routine task.
Model route: what a strong candidate might say
Example lines in a workable order for about 5 minutes: opening, key questions, the patient's concern, explaining, then the close. Use them to plan, not to memorise: the patient's replies are not scripted here, and your next line should follow what they actually say.
1. Opening
- “Hello Mrs Prempeh, I'm a community dementia nurse. Thank you for coming; I understand your mother is happy for us to talk about washing. How are you doing?”
- “Could you tell me about the mornings with your mother, and what has been hardest?”
2. Key questions
- “Could you walk me through the last shower that was difficult, from start to finish?”
- “What usually helps, and what does your mother like or manage by herself?”
- “Has she seemed uncomfortable, in pain, or suddenly different in any way?”
- “How is this affecting you, and what makes you feel she's doing it on purpose?”
3. Handling the patient's concern
Likely concern: Likely to say her mother is deliberately making care difficult, and may need her feelings heard.
- “It sounds really wearing, and it's understandable to feel that way when mornings are so hard. I'd like to look at what happened to understand what might be behind it.”
- “Distress in dementia can be a way of communicating something rather than a choice. Depending on what you've described, it might be fear, confusion or discomfort, but I'd want to assess her properly.”
4. Explaining
- “Thinking about the morning you described, I'd consider what might feel frightening or confusing for her, such as being undressed, the water or feeling rushed, and whether anything is hurting her.”
- “Because the distress has increased over the past month, I'd like to assess her in clinic rather than guess. Does that fit with what you've noticed, and have I understood the part that troubles you?”
5. Closing
- “Two changes we could try: following her preferences for how she's washed, and asking her permission at each step. If she becomes distressed, we pause and try again later.”
- “Which change would you like to try first? We'll book a clinic review to assess her washing difficulties. Could you tell me in your own words what you'll do?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- You can tell me what feels hardest without worrying about being judged.
- Have I understood the part that troubles you most?
- Let's separate what you noticed from what it might mean.
- Which part of today's discussion would you like me to explain differently?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| personal-care assessment | A review of washing and other personal care to understand what help your mother needs. |
| distress | Feeling very upset or frightened. |
| supporting independence | Helping your mother do the parts she can manage herself. |
How this card is marked
Two assessors mark the recording on nine criteria: intelligibility, fluency, appropriateness of language and resources of grammar and expression (each 0–6), then relationship building, understanding and incorporating the patient's perspective, providing structure, information gathering and information giving (each 0–3). See the AI Speaking practice guide for what each criterion looks for.
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Questions about this role-play
Should I involve her mother even though this discussion is with her daughter?
Acknowledge that her mother has agreed to this discussion about washing. Keep that permission specific rather than assuming agreement to other discussions or care. Offer an opportunity to hear her mother's own preferences if she wishes, without assuming her daughter can speak for every preference.
What if Mrs Prempeh asks whether this means the Alzheimer's disease has progressed?
Explain that the reported change during showers does not, by itself, establish progression. No personal-care assessment has been completed, so avoid drawing that conclusion or offering reassurance that rules it out. Distinguish the reported experience from what still needs to be understood.
How should I respond if she asks whether she has been doing everything wrong?
Avoid giving a blanket verdict on care you have not assessed. Thank her for describing something difficult and explain that reviewing the routine is a shared problem-solving exercise. Focus on a particular interaction rather than labelling her as either a good or bad carer.
What if she insists her mother is doing it deliberately?
Do not argue or label her view as wrong. Separate what she saw from what it might mean, acknowledge how hard it feels, and offer the assessment as a way of finding out what is behind the distress.
How do I fit exploring one episode into five minutes?
Ask only for the most recent difficult shower and follow it in order: what happened, what helped, how her mother seemed to feel. Summarise once, then use that example to explain possible reasons and choose one change.
Sources
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