A nurse is providing teaching to the partner of a client who has Alzheimer's disease and a new prescription for donepezil. Which of the following pieces of information should the nurse include?

Indicates potential Improvement a. Hygiene b. Food intake c. Rapid change in mood

Indicates potential worsening a. Giving away car b. Condition of skin on right hand

Choice A: Giving away car

This could be a sign of the client’s worsening condition. Giving away possessions can sometimes be a sign of suicidal ideation. It’s important to monitor this behavior and report it to the healthcare provider.

Choice B: Hygiene

The client showered without prompting on the third day, which is an improvement from the first day when they declined to shower. Improved personal hygiene can be a sign of improvement in a client with obsessive-compulsive disorder.

Choice C: Food intake

The client ate 75% of their meals on the third day, which is an improvement from the first day when they refused to eat. Increased food intake can indicate an improvement in the client’s condition2.

Choice D: Condition of skin on right hand

The client’s hands remain reddened with a 1 cm x 1 cm area of peeling skin noted on the center of the right palm. This could indicate a worsening condition, as it may be a result of excessive handwashing, a common compulsion in OCD.

Choice E: Rapid change in mood

The client’s affect rapidly changed throughout the afternoon and early evening; the client is now talkative and appears content. This could indicate an improvement in the client’s condition, as they are engaging more with others and showing more positive emotions.

Choice A reason: Providing a client with a timeline for grieving is not recommended as grief is a highly individual experience and does not follow a set timeline. Each person's journey through grief is unique, and imposing a timeline may invalidate their feelings and hinder the natural process of grieving.

Choice B reason: Encouraging the client to express their feelings is considered a best practice in nursing care for patients with dementia experiencing anticipatory grief. It allows the patient to acknowledge and work through their emotions, which is an important aspect of coping with grief. Open communication can also help the nurse to assess the patient's emotional state and provide appropriate support.

Choice C reason: While showing sympathy can be comforting, it is more beneficial to show empathy. Empathy involves understanding and sharing the feelings of another, which helps in building a stronger connection and providing more personalized care. Sympathy might sometimes be perceived as pity, which can be counterproductive in the therapeutic relationship.

Choice D reason: Sharing personal stories of grief with the client is generally not advised as the focus should remain on the client's experiences. The nurse's role is to facilitate the client's expression of grief, not to shift the focus to their own experiences. Personal stories may also trigger additional stress for the client.