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Þearl 8ogers ls a 79ŴyearŴold Afrlcan Amerlcan woman who ls admlLLed

Lo Lhe MeLhodlsL Pome nurslng CenLerŦ MrsŦ 8ogers llved
wlLh her husband of 38 years unLll hls deaLh 9 monLhs agoŦ She
had one son who dled ln an auLo accldenL 2 years agoţand she has
one daughLer who llves nearbyŦ AfLer her husband's deaLhţ MrsŦ
8ogers llved wlLh her daughLer unLll her admlsslon Lo Lhe nurslng
cenLerŦMrsŦ8ogers has become lncreaslngly aglLaLed and helplessţ
complalnlng consLanLly of palnŦ Per daughLer sLaLes LhaL MrsŦ
8ogers ls chronlcally consLlpaLedţ has dlfflculLy sleeplngţ and has
sLopped engaglng ln all soclal acLlvlLlesţ lncludlng weekly church
servlcesŦ She crles frequenLlyŦ LxLenslve medlcal LesLlng prlor Lo
her admlsslon Lo Lhe nurslng cenLer revealed MrsŦ 8ogers has
arLhrlLls buL no oLher paLhologlc dlsorderŦ
ASSLSSMLn1
Cn admlsslon Lo Lhe nurslng cenLerţ MrsŦ 8ogers saysţ ºl'm a slck
womanţ and no one wlll llsLen Lo me! l can'L walkţ l'm so weakŦMy
head hurLsţ and l'm always slck aL my sLomachŦ l haven'L had a
bowel movemenL ln a weekţ and l never sleep more Lhan 3 hours
a nlghLŦ" Þhyslcal assessmenL flndlng lnclude swollen knees and
anklesţwlLh llmlLed moblllLy of Lhe lower exLremlLlesŦ
ulACnCSLS
- uysfuncLlonal grlevlng relaLed Lo sLress of husband's deaLh
- Sleep paLLern dlsLurbance relaLed Lo grlevlng
- ConsLlpaLlon relaLed Lo lnacLlvlLy

LxÞLC1Lu Cu1CCMLS
- Lngage ln normal grlef workťWork Lhrough grlef processţ dlscuss
reallLy of lossesţ use nondesLrucLlve coplng mechanlsmsţ
and dlscuss poslLlve and negaLlve aspecLs of Lhe lossŦ
- Lxperlence adequaLe and resLful sleepť fall asleep 20 Lo 30 mlnuLes
afLer reLlrlng and awaken feellng resLed afLer 7 Lo 8 hours
of sleepŦ
- Pave a bowel movemenL wlLh sofL formed sLools aL leasL every
oLher dayŦ
ÞLAnnlnC Anu lMÞLLMLn1A1lCn
- ÞromoLe LrusLť Show empaLhy and carlngţdemonsLraLe respecL
for her culLure and valuesţ offer supporL and reassuranceţ be
honesLţ engage ln acLlve llsLenlngŦ
- AsslsL ln labellng her feellngsť angerţ fearţ
lonellnessţ gullLţ lsolaLlonŦ
- Lxplore prevlous losses and Lhe ways ln whlch Lhe cllenL has
copedŦ
- Lncourage revlew of her relaLlonshlp wlLh her dead husbandŦ
- 8elnforce expresslons of behavlors assoclaLed wlLh normal
grlevlngŦ
- Lncourage parLlclpaLlon ln usual splrlLual pracLlcesŦ
- Lncourage parLlclpaLlon ln a grlef group LhaL meeLs aL Lhe
faclllLyŦ
- ConsulL wlLh Lhe physlcal and recreaLlonal LheraplsL Lo help Lhe
nurslng sLaff provlde afLernoon acLlvlLlesŦ
- Þrovlde measures LhaL asslsL ln bowel evacuaLlonť encourage
exerclse as LoleraLedţ lncludlng walks and rocklng ln a rocklng
chalrŦ Cffer foods LhaL sLlmulaLe bowel movemenLsŦ Cffer prlvacyť
Close Lhe doorţ ensurlng LhaL Lhe emergency call bell ls
wlLhln reachţ and do noL lnLerrupLŦ
- AdmlnlsLer a mlld laxaLlve and/or sLool sofLenerţ lf necessaryţ
buL dlsconLlnue as soon as posslbleŦ
LvALuA1lCn
AfLer 4 weeks aL Lhe nurslng cenLerţMrsŦ8ogers sLaLesţºl don'L feel
any beLLerţbuL l know l have Lo accepL my slLuaLlonŦ"AlLhough MrsŦ
8ogers sLaLes LhaL she doesn'L feel beLLerţshe ls walklng Lhe lengLh
of Lhe hallţ sleeplng beLLerţ and havlng regular bowel movemenLsŦ
MrsŦ 8ogers ls also less wlLhdrawn and has openly dlscussed her
feellngs relaLed Lo her husband's deaLhţ lncludlng her anger aL Lhe
loss of her son and her husband less Lhan 2 years aparLŦ She has aLLended
Lhe grlef group once and has aLLended chapel servlces on
Sunday for Lhe pasL 2 weeksŦPer daughLer vlslLs her each SaLurday
and Lakes her ln a wheelchalr Lo Lhe shopplng mallŦ
CrlLlcal 1hlnklng ln Lhe nurslng Þrocess
1Ŧ WhaL common physlcal manlfesLaLlons of grlef dld MrsŦ
8ogers experlence?
2Ŧ Pow mlghL MrsŦ8ogers's daughLer be more lnvolved ln developlng
and lmplemenLlng her moLher's plan of care?
3Ŧ Suppose MrsŦ 8ogers says LhaL she does noL wanL any helpţ
LhaL she [usL wanLs Lo be lefL alone Lo dleŦPow would you respond?
See LvaluaLlng ?our 8esponse ln Appendlx CŦ

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