Eleanor Lewis
- Age
- 91
- Date of birth
- 17 Oct 1934
- Identifier
- SIM-000284
Why Eleanor is on the list
- Record review
- Review recommended
- Conditions recorded
- Arthritis, Heart failure, Diabetes
- Care planning
- No advance care plan
- Not on the palliative care register in this record source
1 indicator present in the record
Heart failure on the problem list, active, recorded 14 Feb 2026 (SIM-PROBLEM-3). NYHA class is not recorded in this record source.
Shaped after SPICT heart and vascular indicator, adapted: NYHA class is not present in this record source REC_HEART
Recorded 14 Feb 2026
Screening
No screening has been run for this patient.
Record review
The record supports a prompt clinical review for a goals-of-care conversation.
Prompt human review is supported for a sensitive goals-of-care conversation, alongside rather than instead of clinical assessment. The record describes a 91-year-old patient with active heart failure, reduced exercise tolerance, and exertional chest pressure that progressed to occur after shorter walks with sweating. Recurrent leukopenia and intermittent neutropenia also remain clinically relevant.
Show the full review
The snapshot does not document an active advance-care or palliative plan, and residence, functional dependence, current treatment, family support, capacity, and wishes are unknown.
What the record shows
Progressive exertional cardiovascular symptoms
Reduced exercise tolerance and chest pressure progressed to symptoms after shorter walks with sweating; this warrants clinical follow-up and provides a reasonable context for discussing priorities without presuming outlook.
1 source in the record
- Eligible
GP encounters record reduced exercise tolerance with exertional chest pressure relieved by rest, followed by chest pressure after shorter walks accompanied by sweating.
Active heart failure in an older patient
The combination increases the value of anticipatory, preference-led planning, while the record is insufficient to characterize severity or outlook.
1 source in the record
- Eligible14 Feb 2026
The longitudinal GP problem list records heart failure as active; demographics report age 91 at index.
Persistent white-cell abnormality requiring reconciliation
Serial leukopenia and intermittent neutropenia are additional unresolved clinical complexity but do not themselves establish palliative need.
1 source in the record
- Eligible24 Jun 2026
A full blood count reports white-cell count 2.8 and neutrophils 1.8 with repeat assessment advised; later results include white-cell counts 2.5, 2.2, and 3.0.
What they and their family want
- Telephone is recorded as the patient's contact preference.
- The patient's understanding, priorities, preferred place of care, acceptable treatment burden, and readiness for a planning conversation are unknown.
- Decision-making capacity and any communication or accessibility needs are unknown.
- Family, chosen supporters, carers, lasting power of attorney, and consent to involve others are unknown.
- No legal or advance-care-planning records were identified in the available snapshot.
1 source in the record
- Eligible
Multiple GP observations record telephone as the administrative contact preference; the snapshot contains no documented wishes, family preferences, representative, or legal planning record.
Care at present
Unknown; no residence or current care setting is documented in the available snapshot.
Detailed baseline is unknown. The record documents reduced exercise tolerance and chest pressure with walking but does not describe activities of daily living, aids, falls, or dependence.
- GP-owned long-term-condition contacts and longitudinal problem-list review are documented.
- Diagnostics supplied serial routine blood-test results.
- Current medication regimen is unclear because the GP medication list is empty while a hospital pharmacogenomic record references clopidogrel.
- Heart-failure severity, recent examination, investigations, specialist involvement, and treatment plan are not documented.
- Outcome of advice concerning progressive chest pressure is not documented.
- Residence, day-to-day function, frailty, cognition, symptom burden, and informal support are unknown.
1 source in the record
- Eligible
Resources show GP contacts, diagnostics, walking-related chest symptoms, an empty GP medication array, and a clopidogrel-related genomic record; no residence, ADL, frailty, cognition, or carer assessment is present.
Clinical decision support only. A named clinician decides. Generated 12 Sept 2026, committed for the demonstration; wording adjusted to Cairn's language rules where the review used terms Cairn avoids.