- Assess patient's cognitive abilities and changes in behavior to provide baseline data for comparison with ongoing assessment findings.
Encourage family members to watch you perform mental status assessments to give them a more accurate view of patient's abilities.
Evaluate patient's ability in regard to self-care as well as to function alone and drive a car. Safety is a primary concern.- Assess patient for depression to determine need for treatment.
- Weigh patient, document your findings, and include instructions for regular weighing as part of care plan to monitor patient's nutritional status.
- Ask family members about their ability to provide care for patient to assess their need for assistance. Project an attentive, nonjudgmental attitude when listening to them to help ensure that you receive accurate information.
Take steps to provide a stable physical environment and consistent daily routine for patient. Stability and consistency enhance functioning.- Teach family members or caregiver strategies to help patient cope:
- Place an identification bracelet on patient to promote safety.
- Touch patient to convey acceptance.
- Avoid unfamiliar situations when possible to help ensure a consistent environment.
- Provide structured rest periods to prevent fatigue and reduce stress.
- Avoid asking questions patient can't answer—for example, questions that test the patient's orientation to time, place, person, or situation—to avoid causing frustration.
- Provide finger foods if patient won't sit and eat to ensure adequate nutrition.
- Select activities based on patient's interests and abilities, and praise patient for participating in activities to enhance the sense of self-worth.
- Use television and radio carefully to avoid sensory overload, which may exacerbate confusion.
- Limit choices patient has to make to provide structure and avoid confusion.
- Label familiar photos with names of individuals pictured to provide a sense of security.
- Use symbols, rather than written signs, to identify patient's room, bathroom, and other facilities to help patient identify surroundings.
- Place patient's name in large block letters on clothing and other belongings to help patient recognize personal belongings and prevent them from becoming lost.
- If possible, make a home visit to assess safety of patient's living environment.
Assist family members in contacting appropriate community services. If necessary, act as an advocate for patient within health care system to help secure services needed for ongoing care.- Provide family members with information concerning long-term health care facilities. If necessary, assist family members in moving patient to a nursing home or other long-term care setting. A patient with chronic confusion may require ongoing skilled nursing care.
- If patient is to be moved to a long-term care facility, explain the reason for the decision in as simple and gentle terms as possible to facilitate comprehension. Allow patient to express feelings regarding the move to facilitate grieving over loss of independence. Provide psychological support to patient and family members to alleviate stress they may experience during relocation.
- Communicate all aspects of the discharge plan to staff members at patient's new residence, including measures to ensure a stable environment and consistent routine; need to monitor patient's ongoing ability to perform ADLs; measures to ensure adequate nutrition; and interventions to provide emotional support to patient and family members. Documenting a discharge plan and communicating it to caregivers helps ensure continuity of care. Interventions should ensure patient's dignity and rights.
Suggested NIC Interventions
Anxiety Reduction; Area Restriction; Calming Technique; Cognitive Stimulation; Dementia Management; Emotional Support; Energy Management; Family Involvement Promotion; Medication Management; Reality Orientation; Sleep Enhancement |