The writer struggles with limited vocabulary and has difficulty conveying meaning–noting just the broadest of meanings.

Joan is a 78-year-old female who is scheduled with you today because she needs refills for her blood pressure medication. When you look at her record, you notice that she has not been in for 14 months. You notice that there are a number of missed appointments on record, but that she has been calling in for refills for her meds. During the last call, the office nurse told her she would need to come in for a visit to obtain the refills. Her record indicates that her medications at her last visit included Lisinopril/hctz 10/12.5 and simvastatin 20mg daily.