Alzheimer’s Delirium and Dementia Q 3
80-year-old Mr. Stevens is accompanied to the clinic by his son, who tells the nurse that the client’s constant confusion, incontinence, and tendency to wander are intolerable. The client was diagnosed with chronic cognitive impairment disorder. Which nursing diagnosis is most appropriate for the client’s son?
A. Risk for other-directed violence.
B. Disturbed sleep pattern.
C. Caregiver role strain.
D. Social isolation.
Correct Answer: C. Caregiver role strain
The son’s description exemplifies some of the problems commonly encountered by a primary caregiver who is caring for someone with a cognitive impairment disorder. Assess family’s knowledge of patient’s disease and erratic behaviors and possible violent reactions. Knowledge will enhance the family’s understanding of dementia associated with the disease and development of coping skills and strategies.
Option A: Assess for level of family’s fatigue, reduced social exposure of family, feelings about role reversal in caring for the patient, and increasing demands of the patient. Long-term needs of the patient may affect the physical and psychosocial health of the caregiver, their economic status, and prevent the family from achieving their own goals in life. Provide an opportunity for the family to express concerns and lack of control of the situation to promote venting of feelings and reduce anxiety.
Option B: Assist in defining problems and use of techniques to cope and solve problems. Provides support for problem solving and management of family’s fatigue and chronic stress. Assist the family to identify patient’s reactions and behaviors and reasons for them. This may indicate onset of agitation and allow for interventions to prevent or reduce frustration.
Option D: Instruct family regarding community resources available for AD, their families, as well as utilization of respite care. Provides information and support from those people that understand and empathize with these families. Respite care may help facilitate a caregiver’s sense of well-being. Some families may feel that asking help from others indicates lack of caring for the patient.