[Karin Wells]

I always try to include as much "body language" of the sitter as I can. Hands are so expressive, especially as we age. Including hands in a portrait also gives you more latitude in your composition. Also, I can't imagine that rendering hands would ever detract from a face.

If the poor woman gets tired easily, why not bring your camera and capture her "in an instant." With a camera, you'll be better able to see and grab that "wee grin" and the twinkle in her eye. These things are verrrry subtle and tend to evaporate when we ask someone ill to "sit still" for a sketch - no matter how quickly we draw.

I suggest that because of her condition, you practice with the camera, set up your lighting, chair, props, etc. long before she enters the scene. When she does appear, place her exactly as you want her, be cheerful and shoot quickly.

I am suggesting that you use a camera for photo reference in addition to your sketches. I am NOT saying that you should copy a photo.