OET transfer letter to an aged care facility: what the receiving nurse needs (with an example)
A transfer letter to a residential aged care facility (nursing home) should tell the receiving nurse who is arriving, when and why, and then give what they need from the first shift: current condition, medication changes, mobility and falls risk, skin and continence care, cognition and communication, diet, and any follow-up already booked. Open with the transfer and the date, group the care needs by topic, and close with the specific actions you want the facility to take.
Why aged care transfers need a different focus
When a patient moves from hospital to a residential aged care facility, the receiving nurse has to look after them from the moment they arrive, often without a doctor on site and without the hospital's notes. Your letter is their handover. The question for every case note is: what will the facility staff need to do, or watch for, on the first day and the first week?
This is a sub-type of the transfer letter; for the general differences between discharge and transfer letters, see discharge and transfer letters.
What to include (and what usually stays out)
| Usually include | Usually leave out or shorten |
|---|---|
| Transfer date and reason (new placement, respite, return to facility) | The day-by-day story of the admission |
| Main diagnosis and current condition | Investigations that were normal and need no follow-up |
| New, stopped or changed medications, and who gives them | Long-standing medications that are unchanged (mention briefly if at all) |
| Mobility aids, transfers and falls risk | Former occupation, hobbies with no effect on care |
| Skin integrity, pressure areas, wounds and dressing plan | Resolved minor conditions |
| Continence and toileting needs | Every set of observations |
| Cognition, communication, hearing or vision | Family history unrelated to current care |
| Diet, swallowing, fluids | |
| Follow-up appointments already booked | |
| Family contact and wishes, if they affect care |
Use the case-notes selection test for anything not in the table.
A paragraph plan
Organise by care need rather than by date. A plan that works for most aged care transfers:
- Purpose: who is being transferred, to where, when, and the main reason.
- Background: a short summary of the admission and the current condition.
- Medications: what has changed and anything the staff must give, monitor or review.
- Daily care: mobility and falls risk, skin and pressure care, continence, diet.
- Cognition and communication, if relevant: how to approach the resident, what helps.
- Request and follow-up: what you ask the facility to do, and appointments already arranged.
Paragraphs 4 and 5 can be combined if the notes are short. For more on choosing between chronological and thematic order, see Organisation & Layout.
Useful phrases
- Opening: "I am writing to inform you of the transfer of Mr Ward, 84, to your facility on 14 May, following treatment for a fractured left wrist and a fall at home."
- Mobility: "He mobilises with a four-wheeled walker and the supervision of one person, and is assessed as at high risk of falls."
- Skin: "A stage 2 pressure injury on his sacrum is being dressed every two days; repositioning every three hours is recommended."
- Cognition: "She has mild dementia and is orientated to person but not to time. She responds best to short, simple instructions."
- Request: "I would be grateful if your staff could monitor his blood pressure daily for the first week, as his antihypertensive dose has been reduced."
For more closing patterns, see closing paragraph examples.
Worked example
These case notes are invented for this guide.
Patient: Mrs Margaret Lyle, 87. Widow. Previously lived alone with daily carer visits. Admitted 2 June: fall at home, fractured right neck of femur; hip hemiarthroplasty 3 June. Progress: mobilising 10 m with a walking frame and assistance of one. Delirium post-op, now resolved; baseline mild dementia. Skin: reddened area on left heel, intact; heel-offloading boot in bed. Medications: new: enoxaparin 40 mg subcutaneous daily until 1 July; paracetamol 1 g four times daily. Stopped: temazepam (falls risk). Continue: amlodipine 5 mg daily. Continence: occasional urge incontinence; prompted toileting every 3 hours. Diet: normal diet; poor appetite; weight 51 kg. Dietitian: high-protein supplements twice daily. Follow-up: orthopaedic clinic 15 July; staple removal day 14 (17 June). Social: daughter (power of attorney) visits weekly; Mrs Lyle enjoys crosswords; former librarian. Writing task: As the ward nurse, write to Ms Grace Tan, Nurse Unit Manager, Willowbank Aged Care, where Mrs Lyle is being transferred for permanent residential care on 12 June.
Sample letter body (about 200 words):
I am writing to inform you of the transfer of Mrs Margaret Lyle, an 87-year-old woman, to your facility on 12 June for permanent residential care, following surgery for a fractured right hip.
Mrs Lyle had a hip hemiarthroplasty on 3 June after a fall at home. She experienced post-operative delirium, which has resolved, and she has mild dementia.
She has been started on enoxaparin 40 mg subcutaneously daily until 1 July and regular paracetamol 1 g four times a day. Temazepam has been stopped because of her falls risk, and amlodipine continues unchanged.
She currently walks 10 metres with a walking frame and the assistance of one person, and remains at risk of falls. There is a reddened but intact area on her left heel, so a heel-offloading boot is used in bed. She has occasional urge incontinence, which is managed with prompted toileting every three hours. Her appetite is poor and she weighs 51 kg; high-protein supplements twice daily have been recommended.
I would be grateful if your staff could remove her staples on 17 June, monitor her heel and weight, and continue her mobility programme. She has an orthopaedic appointment on 15 July. Her daughter, who holds power of attorney, visits weekly.
Notice what was left out: the crosswords and her former job. Neither changes what the facility must do. If the notes had linked them to care (for example, to settle her when distressed), one clause could be justified.
Common mistakes in aged care transfer letters
- Retelling the admission day by day. The facility needs today's picture, not the history.
- Burying medication changes. A new anticoagulant or a stopped sedative belongs in its own sentence. See medications in an OET letter.
- Vague requests. "Please continue care" gives the reader nothing to act on. Name the action and, where the notes give it, the date.
- Unexplained abbreviations. Write "neck of femur", not "NOF"; see abbreviations in OET Writing.
- Disrespectful wording about cognition. Describe needs and what helps, not labels.
Practise and check your letter
Practise transfer letters on the medEmu practice case notes, or paste your own case notes and letter on the check your letter page. The medEmu report marks each of the six OET criteria, lists which case notes you included, missed or could have left out, and marks problems on your own sentences with the fix and the reason. Your first letter is graded free without an account, and you get 5 more when you sign up. Grades are estimates for practice, not official OET results, and medEmu is not affiliated with OET.
Sources
This guide is medEmu's writing advice, not official OET guidance; all patients, facilities and case notes are invented. For OET's own description of the Writing sub-test for Nursing and its letter types, see oet.com.