Psychosocial care plan for dementia

good dementia nursing diagnosis most likely deal with anxiety and altered mental status.

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......

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?

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:

• http://allnurses.com/forums/f205/des...ns-170689.html - desperately need help with careplans (in nursing student assistance forum)
• http://allnurses.com/forums/f50/care...-121128-7.html - careplans help please! (with the r\t and aeb) (in general nursing student discussion forum)