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Difficulty: MediumEnd of Life Care

The adult child of a client who is actively dying expresses anger and yells at the nursing staff, stating, "You aren't doing enough to save my parent! Someone needs to do something right now!" Which actions should the practical nurse take? (Select all that apply.)

  1. Maintain a calm, non-defensive presence while allowing the adult child to express their emotions.Answer
  2. Use therapeutic silence and remain available after acknowledging the adult child's distress.Answer
  3. C
    Reassure the adult child by stating, "Try not to worry; we are doing everything we can to keep your parent comfortable."
  4. D
    Inform the adult child that this anger indicates a normal progression from the denial stage of grief and will subside shortly.
  5. E
    Approach other family members in the facility waiting area to discuss the adult child's outburst and request their intervention.
  6. Offer the adult child a private, quiet space nearby to talk if they wish to step away from the client's room.Answer

Answer

The nurse should maintain a calm, non-defensive presence, use therapeutic silence, and offer a private space for the adult child to de-escalate and express their emotions safely.
Anticipatory grief often manifests as intense emotions, including anger and helplessness. The most effective nursing interventions involve creating a supportive, non-judgmental environment. Maintaining a calm and non-defensive presence, utilizing therapeutic silence, and offering a private area allow the family member to express their feelings safely while demonstrating empathy and respect for their emotional process.

Step-by-Step Solution

1
Assess the underlying cause of the family member's behavior.
The family member is exhibiting anger, which is a common manifestation of anticipatory grief as the client approaches death.
Recognizing that the anger is directed at the situation, not the staff, helps the nurse respond with empathy.
2
Select appropriate therapeutic communication techniques.
The nurse chooses active listening, offering presence, and therapeutic silence.
These techniques validate the family member's emotional pain without dismissing their feelings.
3
Identify non-therapeutic actions to avoid.
The nurse avoids giving false reassurance, categorizing their grief into rigid stages, or violating privacy.
Non-therapeutic responses can escalate anger, damage trust, and violate professional boundaries.

Key Concept

Psychosocial Support and Therapeutic Communication at End of Life
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Topics

End of Life Care

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