Psychosocial care plan for dementia

by werlp
  38,843 Views   4 Comments

  1. I have a careplan due tomorrow. It has to have a psycosocial nursing diagnosis. I am at a total loss. I can't really do it on fear or anxiety, because the patient is "happily delirious". Any ideas would be appreciated.
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  2. 4 Comments

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  3. by Leahr
    Nov 27, '07
    good dementia nursing diagnosis most likely deal with anxiety and altered mental status.
  4. by fluffwad
    Nov 27, '07
    potential or actual alteration in psychosocial function / status related to [whatever is making her delirious] resulting in impaired social interaction / mood changes / impaired emotional control


    you might also want to care plan delirium / resulting in impaired ability to make decisions/ perform activities of daily living/ recognize or express needs / impaired safety awareness

    Just because she's not unhappy now, doesn't mean she won't stay that way......
  5. by birdgardner
    Nov 27, '07
    I'm wondering something along those lines myself. I'm making a care plan for a 93 y.o. demented patient who stopped taking her meds, stopped eating, drinks very little, and rips out anything you stick in her - IV twice and Foley 3 times. Everyone figures she just wants to go - family signed a DNR, no feeding tube.

    So NANDA 1 is Self-care deficit: feeding. Interventions are mouth and neck assessment, request for bedside swallowing evaluation, attempted feeding, experimentation with textures, tastes, finger food, sippy cup, nutrition supplements, hourly offer of water, etc.

    and NANDA 2 is something to care for her as she dies as she most likely will. There's Impaired Comfort but so far she's only Risk for Impaired Comfort which is not a NANDA - coping, grieving, spiritual distress, denial just don't apply with her cognitive level, same as your patient. She should have eye, oral and skin care, comfortable positioning, a hand to hold which she likes, maybe music, IM or patch meds PRN for pain, air hunger, anxiety - and it should be planned for in advance whether she's in hospital, hospice or back home.

    If your patient's mental status isn't likely to change soon, what about a Family Coping NANDA, or Impaired Social Interaction?
    Last edit by birdgardner on Nov 27, '07 : Reason: read a little more carefully.
  6. by Daytonite
    Nov 28, '07
    all nursing diagnoses are based upon the patient's symptoms and all you've given us is that the patient is "happily delirious". i don't know of any nursing diagnoses that include that as a defining characteristic except for, perhaps, disturbed sensory perception which includes disorientation, and changes in the usual responses to stimuli and behavior patterns as defining characteristics. here is a link to a webpage on this diagnosis: [color=#3366ff]disturbed sensory perception specify: visual, auditory, kinesthetic, gustatory, tactile, olfactory.all diagnosing is based upon the objective observations and subjective perceptions you discovered during your assessment of the patient. a diagnosis is then your decision of the problem that they have. however, you must have symptoms to support the diagnosis and you have not given any other symptoms so that i can help you out with this.

    there is lots of information on care planning on these two threads in the student forums:

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