Loneliness Interventions?

  1. 0
    Hello! Second semester nursing student here, in need of assistance!

    I have to do a psychosociocultural NPR. I looked through google/forums/my nursing textbooks/my nursing diagnosis handbook, but I believe I've hit a wall.

    My diagnosis is Loneliness r/t loss of social contacts. My professor approved the diagnosis and my interventions (I had 8), but she wants more than 10 interventions (and my norm is 14; I'm very upset with myself that I'm having trouble with this!! This is supposed to be the easy part!! Arrrgh...).

    Data Collection:
    -97 yrs old, Female
    -awake/alert; orientated x2, not to year ("2001")
    -PMH: depression, Alzheimer’s, dementia
    -is retired
    -husband passed away recently; together for 70 years
    -only one daughter, with son-in-law
    -was shouting for help (call bell was not used)
    -said she felt "alone"
    -said she was "scared" that her son-in-law wasn't coming to pick her up
    -stated “please stay and talk to me”
    -when I said I would be right back: “you’re not going to be gone for hours too, are you?”
    -said she was "angry" that she was put into a hospital where she didn’t know anyone
    -told me that her son-in-law visited her often at the nursing home
    -as I was leaving: “thank you for talking with me”

    Goal: Pt will report decreased feelings of loneliness

    Interventions:
    1.) Assess level of consciousness
    2.) Assess mental status/orientation
    3.) Assess developmental level according to E. Erikson
    4.) Assess support system
    5.) Offer self
    6.) Establish trust
    7.) Provide therapeutic communication (use of appropriate touch, reflecting, paraphrasing, summarizing)
    8.) Encourage pt to talk about feelings of loneliness
    9.) Educate pt on support groups
    10.) Educate pt on community resources

    >I'm considering "Identify activities to help keep pt busy during times of loneliness" but for some reason my professor underlined "help" and "busy"; not sure if it was because she couldn't read my chicken scratch, or if there was an issue with the intervention itself.
    >I'm also considering tying in her depression, or even her Alzheimer's, and making an intervention of administering an anti-depressant, but I don't see an anti-depressant OR any medication dealing with her Alzheimer's in her list of medications. Though there is a chance it's one of the two I can't read... can anyone identify what looks like "Cedexa 20 mg po daily" and "Dumelvs 1 unit dose q6h prn"?

    Throw some ideas at me, pretty please? :'[
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  4. 8 Comments so far...

  5. 1
    Encourage patient on senior activities, get them some information on them. That way they can meet some friends and interact with others. Different from a support group. Like "fun" activities.
    FairyPopsicle likes this.
  6. 1
    "Cedexa" is Celexa, an anti-depressant. I got nothin' on the other med.
    FairyPopsicle likes this.
  7. 1
    Oh, just another thought; your professor may have underlined that part because helping keep her busy is not necessarily addressing the problem of loneliness. You can be busy and still feel lonely.

    I always found it best to be specific with care plans: instead of saying "help the patient stay busy," you need to assess the patient's likes/dislikes/feelings and then provide an intervention like "provide art supplies for patient to express her emotions" if she tells you that painting helps her express herself. (That's a lame example; I just made it up for reference).

    Interventions specific to the patient are what makes a care plan useful; they shouldn't be interchangeable for different patients. Hope this helps a little
    FairyPopsicle likes this.
  8. 0
    @ Mi Vida Loca: Ah, senior activities! Thanks!

    Hmmm... I found a Recreation Department in her area. It seems more like a community resource, though.
    But yeah, I'm going to put this in! :]

    @ Always_Learning: Oh, wow, thanks! Exactly what I needed!
  9. 0
    Quote from Always_Learning
    I always found it best to be specific with care plans: instead of saying "help the patient stay busy," you need to assess the patient's likes/dislikes/feelings and then provide an intervention like "provide art supplies for patient to express her emotions" if she tells you that painting helps her express herself. (That's a lame example; I just made it up for reference).

    Interventions specific to the patient are what makes a care plan useful; they shouldn't be interchangeable for different patients. Hope this helps a little
    Oh! Patient specific! That's right!
    Thanks for the reminder! I can't believe I forgot that. That opens up a whole road of possibilities. I guess my anxiety isn't letting me think straight.

    I can put in "Assess for the patient's likes/dislikes regarding activities" (.. there has to be a better way to word that...) but I won't be able to follow through with the intervention because we get a new patient every week, which means I don't know what she would've liked... :[ But I think that if I put into the care plan about what I WOULD do if I could ask the patient, it might be fine, right?
  10. 0
    I just read an intervention about "providing the patient with a roommate that shares similar interests."

    Is that possible? To move your patient into a room with a person who is more talkative?
  11. 0
    i was looking through threads and found this one.

    my experience has mostly been in assisted living and snf, and every facility i worked at would allow roommates in the appropriate room. some were single rooms, but we were predominantly double rooms.

    we put 2 ladies together who liked to knit, they both did have dementia, but they had a blast together. they made a huge blanket together, it was fun to watch.
  12. 0
    I absolutely think that would be a fine intervention, because you are writing a care plan based on what you would do if you were the nurse caring for that patient.

    Also, it may definitely be possible to re-arrange rooms if she finds someone who has interests in common or she gets along with (depending on available rooms, Medicare guidelines for what rooms they pay for, etc. etc.) But it's definitely something that could be brought up at an interdisciplinary team meeting (with social workers, administration, etc.)

    Sounds like you're on the right track.


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