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by Lisa905 Lisa905 (New) New Student

Specializes in Nursing Student, Math, APA papers, Care Plan. Has 2 years experience.

My main question is this project/concept map is on Disease, mine is Alzheimer's Disease. However, in my scenario, the patient seems to be the daughter because that is who the community health nurse is speaking to. I have to use the ND book for a diagnosis and expand on defining characteristics, outcomes and interventions then how, why, when expansion on the interventions. I can do this easily but my issue is I can come up with 2 different best possible nursing diagnoses because there are two patients. Only one is the right answer. I feel its the daughter but the project is on a disease and all the other student scenarios don't have two patients. ANYONE ever had this situation? I want to go with caregiver role strain, but in the book when you get to that there is an abundance of caregiver, receiver, both and so many defining characteristics possible that I could use. And I am also having trouble picking a r/t factor as in our class practice assignment the r/t factor was not out of the book it was from the scenario "Acute Confusion r/t polypharmacy AEB the five defining characteristics (which is not in ND book for that diagnosis .... ANY ADVICE would be helpful - Heres the scenario

Caren Walker is a 55-year-old woman who has been caring for her mother, Ellen Smith. Her mother was diagnosed with Alzheimer’s disease five years ago, and her condition is gradually deteriorating. Caren has to do much personal care for her mother. Ellen has more bad days than good days. Most of the time she is mistrusting of Caren and many times, Ellen does not recognize Caren. Any stimuli such as loud noises, people talking, the radio playing, tend to bother Ellen. Over the past months, bad days have consisted of Ellen forgetting what she says and therefore tends to repeat her statements five to 10 times in arrow. She has also been physically abusive to Caren by screaming at her, slapping her across the face, and spitting at her. During her good days, Ellen is kind and has episodes when she remembers Caren as a teenager. As the community health nurse, Caren expresses to you that she has been having difficulty sleeping at night as she is worried about her mother’s condition. She stated, “I am feeling depressed most days, and especially when I come over to care for my mother.” She is worried that physically, she may not be able to continue to care for her mother. She has a brother who lives in Alberta and wants to ask him to come to Ontario and help out more with the care of their mother. However, there has been conflict between the two of them regarding decisions around their mother’s will. Caren tells you that she is finding herself to be more isolated from the outside world and does not seem to have time to talk to her friends anymore as caring for her mother occupies most of her free time. Caren is worried that her present situation with her mother is affecting her high blood pressure.

Rosalie Blythe, BSN, RN

Specializes in Endoscopy/Gastroenterology, General Surgery. Has 3 years experience.

Oh man, not again those concept map assignment from nursing school.

On 3/19/2020 at 10:39 AM, Lisa905 said:

My main question is this project/concept map is on Disease, mine is Alzheimer's Disease. However, in my scenario, the patient seems to be the daughter because that is who the community health nurse is speaking to.

Nope, the patient is still Ms Caren Walker in this case. Her daughter Ellen is her caretaker. I understand what you mean though, but since your project is focusing on patient with Alzheimer's disease and given with your case scenario, I think you are heading to the right path; caregiver role strain. It seems like the daughter is having difficulty taking care of her mother, who is going into the late stage of the disease. I guess you can focus on education, social works and maybe connecting resources like asking her to consider to place her mother in an assisted living nursing home. Something likes that

I’d say the patient is the daughter Caren. It’s confusing because it starts off with Caren Walker, 55 yo woman who has been caring for her mother Ellen.

What it describes us how hard it is on the daughter Caren. Due to her mother’s Alzheimer’s, she’s having a really hard time.

Like Rosalie Blythe said, your on the right path with caregiver role strain. The case study seems to be describing that to a T! Also, like Rosalie Blythe said, it’s clear the daughter is having a hard time taking care of her mother, who is in the late stages of the disease. It’s taking a toll on the daughters health - not being able to sleep, worsening her high blood pressure. Not to mention just the stress of it all and how she has to withstand being treated by her mother during her “bad” times. So, I’d focus on educating the daughter on resources - (1) maybe bringing someone in to help with her mother (which will allow her to keep caring for her mother but give her breaks now and then). Maybe discuss the best time for the help to come in - at night so she can rest easily or during the day when she feels she gets stressed the most. (2) maybe putting the mother in an assisted living nursing home, maybe one that specializes in Alzheimer’s patients. (3) maybe education on different things to do with Alzheimer’s patients to keep them as calm as possible or calm them down during outbursts. Things like that! Hope that helps!