A 28-year-old client with a recent diagnosis of Huntington's disease is preparing for discharge to a long-term care facility. While the nurse is reviewing the transfer documents, the client suddenly tears the papers in half, throws them on the floor, and shouts, "I am not going to some facility to wait to lose my mind! You all just want to get rid of me!" Which of the following is the most therapeutic nursing response?
- Remain seated, maintain a calm posture, and state, "This diagnosis is forcing major changes in your life, and it must be terrifying to think about the future."Answer
- BStep back toward the door to ensure safety and state, "I understand that you are upset, but destroying these documents will only delay your care plan."
- CCalmly pick up the papers and state, "The facility we selected specializes in your condition, and they will make sure you are kept safe and comfortable."
- DState clearly, "We can stop this discussion for now. I will return later when you are ready to talk about this calmly."
Answer
The most therapeutic response is to remain seated, maintain a calm posture, and state that the diagnosis is forcing major changes and must be terrifying.
The correct answer directly addresses the core emotions driving the client's outburst: fear of the disease progression and loss of control. By remaining seated, the nurse demonstrates non-threatening presence (offering self). By verbalizing the client's implied feelings ('terrifying'), the nurse validates their experience, which naturally de-escalates anger and opens the door for meaningful dialogue.
Step-by-Step Solution
Key Concept
Therapeutic Communication in Acute Grief and Crisis