Melissa, 45yrs old, is single, and lives alone. She is a part-time School Teacher at the local village Primary School.
You work part-time as an Occupational Therapist at a hospital 20 miles away from where you live.. Melissa is a registered patient at a local surgery, although she hardly ever visits, and she is also a direct neighbour of yours . You know Melissa quite well and socialise with her frequently - over the garden fence mainly , also at the community church group on a weekly basis.. You have noticed lately that Melissa gets a little muddled on occasions, but overall you have always been impressed by Melissa's friendly presence and attentiveness to her garden , as well as her very smart appearance .
You have noticed that you have not seen Melissa for a few days in her garden, or at the last two community meetings, which is unusual. There are visible weeds showing in Melissa's garden, the curtains are closed, and there are a few bottles of milk piled up on the front doorstep, both of which you know Melissa would normally never tolerate.
You wonder if Melissa is ill . You decide to knock on her door to see if she needs any help with anything .
When Melissa opens the door you see that she looks very thin, dishevelled and unkempt. Melissa has a problem recognising you, and appears a little disorientated. There are numerous papers and mail piled up in the hall way. Melissa states that she is not ill and refuses to let you into the house for a chat, saying she wants to be left alone. You ask Melissa if she would like you to contact her daughter - who lives 100 miles away - or make an appointment to see her Doctor. Following this suggestion Melissa becomes hostile and says very clearly that she doesn't want you to ring anyone or see a Doctor: she just wants to be left alone and slams the door abruptly.
You leave the house feeling worried for Melissa's welfare since her behaviour was very out of character. You are concerned also because you know she doesn't receive any visits from family normally as they live hundreds of miles away. You also worry that she may be suffering from a mental health problem, or a physical problem.
What should you do?