After the male client receives a diagnosis of amyotrophic lateral sclerosis (ALS), he expresses sadness and states he does not know what to do next. Which is the most effective response by the nurse to facilitate communication?

Question

1. Ask the client what he finds comforting in his life.
2. Reassure the client his family will take care of him.
3. Refer the client to a church for spiritual counseling.
4. Tell the client hospice care is available immediately.

Answer 1

1
1. ALS is a progressive, degenerative neurological disease with no cure and, because of the grim diagnosis, the client expresses confusion and lacks a clear direction. To reduce anxiety enhance coping skills, and facilitate communication, the nurse provides a calm atmosphere by redirecting the client to identify comforting things. The nurse uses the comfort measures hoping they will reduce tension so the client can process information and make decisions.
2. The nurse may provide false hope for the client by stating that his family will assume his care without checking with the family first.
3. Spiritual counseling may not be indicated for this client if the client does not wish to participate.
4. Discussing hospice is premature until end-stage disease and because the client is not thinking clearly. The client can benefit from a calming atmosphere and time to process the new information. Besides, informing the client about hospice implies the end of life is eminent.