The task
Assume that today's date is 14 November 2026. You visited Mr Begum at home yesterday.
You are an occupational therapist with the Community Occupational Therapy Service. Using the information in the case notes, write a letter to Dr Charmaine Gurung, Mr Begum's general practitioner, updating her on the outcome of your home visit, asking her to review Mr Begum for possible postural hypotension, and asking her to consider respite and support for his wife. Address the letter to Dr Charmaine Gurung, General Practitioner, Wattle Street Medical Practice, 120 Wattle Street. 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.
Length: the body of the letter should be about 180–200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Update letter.
Case notes
Patient details
- Name: Mr Kamau Begum
- DOB: 03/06/1954 (72 yrs)
- Address: 8 Banksia Street
- Referred by GP for home safety assessment after falls; home visit 13/11/26
Social background
- Lives with wife (70) - main carer; single-storey house
- Retired carpenter; still enjoys woodwork in garage
- Daughter lives overseas; phones weekly
- Wife says son 'only visits when he wants money'
- Pet cat often sleeps in hallway
Medical history
- Parkinson's disease dx 2019; neurologist review 6/12ly, last 08/26
- Meds: levodopa/carbidopa QID; tamsulosin daily (BPH); amlodipine daily (HTN)
- Benign prostatic hyperplasia - nocturia 2-3×/night
- Osteoarthritis R knee
- Appendicectomy 1978
- Allergies: nil known
Home visit findings
- 3 falls in 6/52 - 2 × getting out of bed at night, 1 × rising from armchair
- Reports light-headedness & 'vision going grey' on standing, esp. mornings & after meals; settles on sitting
- Nil LOC; bruising L hip after last fall (07/11) - not reviewed by GP since
- 07/11: wife unable to lift pt off floor → ambulance called; not taken to hospital
- Mobilises indoors with 4-wheeled walker; freezing at doorways
- Low armchair & low bed; loose rugs in hallway
- Independent with eating; wife assists with showering & dressing
- Pt complained ambulance took 'over an hour' and crew were 'rude'
Carer
- Wife exhausted - broken sleep from helping pt at night; tearful during visit: 'I can't keep going like this'
- Wife has own R hip pain; awaiting orthopaedic appt
- Nil formal support services or respite in place
OT intervention
- Installed: bed lever, chair raisers, raised toilet seat + frame, shower chair, bathroom grab rails; loose rugs removed
- Urinal bottle provided for night use
- Educated pt & wife: staged standing (sit on edge of bed before standing); strategies for freezing at doorways
- Personal alarm pendant - application submitted
Plan
- OT review 4/52 - check equipment use & any further falls
- Request GP: review for postural hypotension (lying/standing BP) & medication review
- Request GP: consider respite care & referral for carer support / home support assessment
- Physio falls & balance program - referral sent 13/11
Who is reading, and what do they need?
Dr Gurung referred Mr Begum for a home safety assessment after falls, so she knows the reason for the visit but not its outcome. She must act on two requests: a blood pressure and medication review, and carer support. She needs concise findings and actions, not an inventory of equipment.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 3 falls in 6/52: 2 getting out of bed at night, 1 rising from armchair | The pattern of falls links directly to the postural hypotension request and to the changes made at home. |
| Light-headedness and 'vision going grey' on standing, esp. mornings and after meals; settles on sitting | These are the symptoms that justify the request for lying and standing BP, so the GP can see why it is needed. |
| Bruising L hip after 07/11 fall; not reviewed by GP since | This is an unreviewed injury the GP can act on, so it belongs with the requests. |
| 07/11 wife unable to lift him; ambulance called; not taken to hospital | It shows the limit of the wife's capacity to cope alone, which supports the support request. Keep it to the event itself. |
| Levodopa/carbidopa QID, tamsulosin daily, amlodipine daily | The medication review request makes the current list relevant. State the medicines without suggesting any of them is the cause, as the notes do not. |
| Wife exhausted, broken sleep, tearful: 'I can't keep going like this' | This is the main evidence behind the respite request and shows the strain is current. |
| Wife has own R hip pain, awaiting orthopaedic appt; no formal support or respite | It adds to the carer's vulnerability and shows no services exist, which is what the GP is asked to address. |
| Equipment installed, rugs removed, staged-standing teaching, alarm application, physio referral 13/11, OT review 4/52 | The GP needs to know what is already done and planned so she does not duplicate it. Summarise rather than list every item. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Patient complained ambulance took 'over an hour' and crew were 'rude' | A complaint about another service is not for the GP to act on here; only the fact that an ambulance attended matters. |
| Wife says son 'only visits when he wants money' | Family conflict is hearsay with no bearing on the requests. The overseas daughter's weekly calls are likewise unnecessary. |
| Pet cat often sleeps in hallway | Trap: it sounds like a trip hazard, but the notes show no action on it and the GP cannot act on it. Rugs are the recorded hazard. |
| Retired carpenter who enjoys woodwork; appendicectomy 1978; allergies nil | Hobby and old surgery do not support either request. Allergies and knee osteoarthritis add nothing to this purpose. |
| Low armchair and bed, freezing at doorways, grab rails, shower chair, raised toilet seat | Compress into a general statement of home modifications and education; itemising each piece of equipment is too much detail for the GP. |
A paragraph plan for this case
Open with the purpose and the 13 November visit, then give the falls, symptoms on standing, hip bruise and the 07 November ambulance event. Follow with what the OT did and the planned follow-up, then close with the two requests, linking carer exhaustion and her own hip pain to the support request.
Where candidates slip on this task
- Keep the two requests distinct: BP review with medication review for Mr Begum, and respite plus carer support or home support assessment for his wife. Do not blend them into one general request.
- Do not say any medicine causes the light-headedness or falls. The notes give symptoms and a medication list only, so the letter should ask for review, not state a cause.
- With only 180-200 words, do not list every item of equipment or the complaint about the ambulance. Make sure the unreviewed hip bruise and the 13/11 physio referral are not lost.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
More Occupational Therapy letter tasks
- Rheumatoid arthritis flare limiting work tasks update letter
- Home safety follow-up after wrist fracture referral letter
- Transfer of care for a child with developmental coordination disorder referral letter
Your profession's guide: OET Occupational Therapy. Layout and structure: OET letter format.
Questions about this task
Should I tell the GP that his medicines are behind the light-headedness?
No. The notes record symptoms on standing and the medicine list, but no cause. Present the symptoms and the medicines as the reason for the requested review, and leave the conclusion to the GP.
Do I mention the ambulance delay and the crew being rude?
No. It is a complaint about another service and does not help the GP act. Only the fact that the wife could not lift him and an ambulance attended, without hospital transfer, is relevant.
Sources
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