A formerly independent older adult becomes severely withdrawn upon admission to a nursing home. Which action should the nurse take first?
a. Offer a reward to the patient for participation in all events.
b. Encourage the patient to eat meals in the dining room with others.
c. Allow the patient to incorporate personal belongings into the room.
d. Advise the patient of the importance of attending mandatory activities.
ANS: C
The nurse should first allow the patient to actively participate in an independent activity (the patient was formerly independent), such as preparing the room with personal belongings. Erikson's theory proposes that the older adult faces integrity versus despair. Offering a reward does not address the need for continued independence. Encouraging eating in the dining room would be a step after fixing the room since it does not address independence, and the question is asking for the first action. Advising the patient to attend all mandatory activities as the first intervention does not allow for the patient's independence. Some activities may be mandatory, but by first allowing the patient to decorate room, the nurse is fostering independence and is helping the patient feel welcome and more at home, fostering integrity.
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