“It’s my husband who’s the patient, not me”

When a carer books "about the patient" but is themselves exhausted, tearful and losing weight, the carer IS the patient — gently redirect to carer strain/burnout (often with depressive features) rather than only adjusting the relative’s medication. Screen mood and risk sensitively (NICE NG222; what does "I can’t do this anymore" mean — exhaustion or suicidal ideation? NICE NG225: respond to what she tells you, not a risk score), examine her and check baseline bloods before attributing her weight loss to stress, and mobilise practical support: a statutory Carer’s Assessment, respite/day-care, carer organisations (Carers UK, Admiral Nurses), and benefits (Carer’s/Attendance Allowance). Address the relative’s presenting problem too (Brian’s night-time confusion — assess delirium triggers and non-drug measures, which also restores her sleep). The examinable hidden agenda is that she booked under his name because she does not feel ENTITLED to be the patient: she believes asking for help is selfish and a failure, and fears that admitting she can’t cope means he will be "taken away". Normalise the guilt/resentment cycle, dismantle the "selfish/failure" belief, and reframe accepting help as what ENABLES her to keep caring — not abandonment. Give her a dedicated follow-up in her own name, with crisis routes if risk emerges.