The nurse is assessing an older client who is having difficulty remembering events from earlier in the day and concentrating on the questions being asked. A family member shares that the client’s home was recently sold and the client has just moved in with them.
Which nursing response best promotes effective communication with the family?
A.
If the dementia is a result of Alzheimer’s disease, it is often reversible even in the late stages.
B.
The client is exhibiting symptoms of dementia and because of age, it may be permanent.
C.
The client’s delirium may be due to depression and is possibly reversible.
D.
Delirium is often a sign of underlying mental illness and institutionalization is often necessary.
The correct answer and Explanation is :
The correct answer is C. The client’s delirium may be due to depression and is possibly reversible.
Explanation
In the scenario described, the older client is exhibiting signs of confusion and difficulty concentrating, which can be indicative of delirium, especially given the recent significant life change of moving in with family after selling their home. Delirium is often triggered by various factors, including emotional distress, changes in environment, infections, medication effects, or underlying health issues. In this case, the stress of relocation and potential depression due to the upheaval may have contributed to the client’s cognitive symptoms.
Option C emphasizes the possibility of delirium being reversible, particularly if it is related to situational factors such as depression. This perspective is crucial because it opens the door to potential interventions. For instance, the healthcare team can explore the client’s emotional state and any underlying depressive symptoms. By addressing these factors, there is a chance to improve the client’s cognitive function and overall well-being.
In contrast, options A and B suggest that dementia is a likely diagnosis and imply permanence, which could lead to a negative outlook on the client’s condition. While it’s important to consider dementia in older adults, assuming it is the cause without further assessment can be premature and discouraging.
Option D incorrectly suggests that delirium is indicative of a more severe mental illness requiring institutionalization, which may not be necessary if the underlying causes are identified and addressed.
Ultimately, recognizing the potential for reversibility in the client’s condition not only encourages a more hopeful outlook but also facilitates collaborative care planning that includes both medical and psychosocial interventions. This approach can enhance communication with the family, allowing them to be more actively involved in the care process.