Question

Case Scenario # 5

An 82-year-old male patient, recently diagnosed with Alzheimer’s disease, has been admitted to the hospital for pneumonia. The patient’s oldest daughter visits and expresses her concern to you that her father will have to move in with her family so she can take care of him. Her mother passed away 5 years ago, and her father has been living on his own since that time; however, his Alzheimer’s disease is progressing and he needs assistance. It is financially and emotionally difficult for the daughter to place him in an assisted living type of facility. She also promised her mother before her death that she would take care of him. The daughter is feeling terribly stressed at the thought of how this will disrupt her family’s home life in addition to her father having to move from his home of 54 years.

Major nursing responsibilities associated with assisting patients to manage stress include assessing a patient’s ability to cope with stressors, identifying personal factors that could interfere with coping, promoting effective coping and stress management, and implementing nursing interventions to modify coping as the situation warrants.

    1.   Clarify how you will proceed with this assessment.

   2.   Identify potential stressors to the people in the situation.

   3.   Identify factors that may affect the daughter’s coping behaviors.

   4.   Explore factors that place this family at risk for dysfunctional coping.

   5.   Describe possible manifestations of altered coping in this scenario.

   6.   Based on the information, plan appropriate nursing interventions.  

Answer 1

1. The stress is physical and mental response to any kind of change of setuation that requires adjustment. Here the older daughter of the patient is in stress as he is unable to provide proper assistant and financial support to her father. So, in this case the nursing assessment will be =

- assess the vital signs of the client.

- mental status examination of the client.

- identify the actual causes of stress in detail.

- take proper history of the client.

- assess the physical movement of the client in exposure with any kind of stress.

2. Stressor is any process or setuation that produce anxiety responses. So it is important for the nursing personal to identify the proper process of stress. There many kinds of stressors in our life.

In the case given inthe content the stressors are =

i. Physiological stressors = this is due to any kind of illness of self or any member. Here the illness of father like Alzheimer's disease and pneumonia causes stress to his older daughter.

ii. Social stressor = the financial problem, death of mother, and anxiety due to her inability to provide assistance to her father, produce stressor to her daughter.

iii. Though = the negative thoughts of the older daughter about provide her father a financial support and assistance cause stress.

3. The factors that may affects the daughter's coping behaviour are =

I. Ability of the daughter to cope with stressors.

ii. Her personal factors that may interfere with the situation in present that causes stress to her.

iii. The promise to her mother that she would take care of his father after her death. But in present setuation she can not do the work as her promise.

4. The factors that may please the family in disfunctional coping are =

- the promise to her mother to help her father after her death and unable to perform her promise can cause self-blame to the the daughter.

- she is not trying to resolve the setuation by finding any alternative solution to cope with the setuation and the negative thinking causes passivity to her.

- the with dewal thinking also arises to her due to anxiety.

These factors may causes the risk for dysfunctional coping to the family.