Information
- Assessment:
- Feelings of shame (personal, private, self-judgment of failure) due to loss of bowel and bladder control, speech function.
- Body image boundaries disrupted; contact with environment is hindered by inability to ambulate or manipulate environment physically; may result in personality deterioration due to diminished number of sensory experiences. Loses orientation to body sphere; feels confused, trapped in own body.
- Nursing care plan/implementation:
- Reduce frustration and infantilism due to communication problems by:
- Rewarding all speech efforts.
- Listening and observing for all nonverbal cues.
- Restating verbalizations to see if correct meaning is understood.
- Speaking slowly, using two- to three-word sentences.
- Assist reintegration of body parts and function; help regain awareness of paralyzed side by:
- Tactile stimulation.
- Verbal reminders of existence of affected parts.
- Direct visual contact via mirrors and grooming.
- Use of safety features (e.g., Posey belt).
- Health teaching: control of bowel and bladder function; how to prevent problems of immobility.
- Evaluation/outcome criteria: dignity is maintained while relearning to control elimination.