>She has been using Google AdWords for several years, but lately even this has not been enough to get her any >business, even though her ad is usually on Page 1.

This is an interesting statement. Has her adword traffic deterioated?

Does she get traffic to her site that is not generating business? If so, perhaps her site is not appealing to her target audience.

Or is she not getting traffic in which case perhaps her keywords are incorrect or her ad is not appealing.