A group of nurses implement a pilot study to evaluate a proposed evidence-based change to providing client care. Evaluation indicates successful outcomes and the nurses want to integrate the change throughout the facility. Which actions should be taken? Select all that apply.

Rationale:

• Depression or withdrawn behaviour: This behavior is often seen in neglected elders who lack meaningful interaction, care, or stimulation. Emotional neglect and isolation can lead to signs of withdrawal and sadness.
• Oversedation : Overmedicating a client to control behavior or suppress activity is considered physical abuse. It reflects intentional harm or misuse of medications, especially when used to subdue.
• Untreated pressure injuries: Failure to address and treat pressure ulcers indicates neglect, especially when the wounds are visible and advanced. It shows a lack of basic caregiving and health maintenance.
• Bruises in various stages of healing: Multiple bruises at different stages suggest repeated physical trauma over time. This is a strong red flag for physical abuse rather than accidental injury.
• Poor personal hygiene: Long, dirty nails and unclean conditions point to inadequate caregiving. Basic hygiene neglect often reflects poor or absent daily care practices.
• Leaving an older adult in a public space: Leaving an elder alone in public with no supervision or support meets the definition of abandonment. It places the individual in a vulnerable and unsafe situation.

Rationale:

A. It is okay not to love or like your mother when you are caring for her: Caregiving can cause complex emotional responses, including frustration, resentment, or detachment. Acknowledging these feelings as valid reduces guilt and supports emotional well-being.

B. Avoid discussion of negative situations that may occur in the future: Avoiding difficult conversations prevents proactive planning and increases long-term stress. Suppressing such discussions may result in crisis decision-making.

C. Involve your mother in the decision making process: Including the care recipient in decisions supports autonomy and reduces resistance to care. This also reduces the burden on caregivers by promoting shared responsibility and improving cooperation.

D. Saying "no" to things involving the care of your mother is a selfish action: This statement promotes guilt and discourages boundary-setting. Caregivers need to say “no” when tasks exceed their capacity. Establishing limits is necessary to avoid emotional and physical exhaustion.

E. Helping your mother should be easier than raising a child: Comparing caregiving roles is dismissive and unhelpful. Each caregiving situation presents different challenges, and this mindset invalidates the stress caregivers experience.

F. Take time for yourself and the other relationships that you care about: Encouraging caregivers to nurture their personal lives is key to stress reduction. Taking breaks and maintaining relationships prevents caregiver burnout and preserves emotional resilience.

G. Moving your mother into a care facility will show her that you do not love her: This belief promotes guilt and stigmatizes the use of long-term care services. Sometimes institutional care is the safest. Love is not diminished by choosing professional help.

H. You made a promise to your mother that you need to keep: Rigidly adhering to past promises can harm both caregiver and recipient. As care needs change, so must plans. Encouraging flexibility helps caregivers respond to the current situation, not outdated expectations.