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Question

Difficulty: EasyFamily Dynamics

A home health nurse is visiting a family where an adult daughter is the primary caregiver for her mother with severe Alzheimer's disease. The daughter appears exhausted, begins to cry, and states, "I cannot do this anymore, but I promised I would never put her in a facility." Which of the following is the most appropriate initial response by the nurse?

  1. It sounds like you are feeling completely overwhelmed. Tell me more about what you are experiencing.Answer
  2. B
    You should consider placing her in a long-term care facility; it is the best thing for your health.
  3. C
    Why do you feel like you have to do this all by yourself without any help?
  4. D
    I will check your mother's vital signs first, and then we can discuss your concerns.

Answer

The most appropriate response is to acknowledge the caregiver's feelings and invite her to share more about her experience.
The correct answer utilizes therapeutic communication techniques by reflecting the caregiver's feelings ('feeling completely overwhelmed') and using an open-ended statement ('Tell me more'). This allows the nurse to establish a supportive relationship, validate the caregiver's distress, and thoroughly assess the extent of the caregiver strain before discussing potential interventions.

Step-by-Step Solution

1
Analyze the caregiver's statement and nonverbal behavior.
The caregiver is exhausted, crying, and expressing conflict between her limits and her prior promise.
Identifying the core issue (caregiver role strain and emotional distress) is necessary to formulate a response.
2
Evaluate the response options based on therapeutic communication principles.
Identify which option addresses the immediate emotional needs without offering premature solutions.
The priority in a psychosocial crisis is to establish trust and assess the situation fully before intervening.
3
Select the option that reflects feelings and uses open-ended exploration.
The correct response validates the caregiver's overwhelm and asks her to tell more.
This approach facilitates communication and helps the nurse assess the severity of the caregiver strain.

Key Concept

Therapeutic Communication in Caregiver Strain
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Topics

Family Dynamics

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