A nurse is assisting with teaching a newly licensed nurse about end-of-life care. The nurse should include that which of the following services provides support for a client's caregiver?

Rationale:

A. This statement highlights chronic workload stress and low morale. Nonstop work indicates that staff are overwhelmed and likely experiencing fatigue and burnout. Low morale suggests poor job satisfaction and emotional exhaustion, which are key indicators that efforts to reduce stress have not been successful.

B. Frequent absenteeism and the need to work in isolation are signs of staff burnout, fatigue, and lack of support. When stress interventions are effective, staff are more likely to collaborate and feel supported, rather than feeling forced to manage heavy workloads alone.

C. This statement reflects frustration, lack of systemic support, and ongoing workload challenges. Staff feel that their efforts do not lead to improvement, contributing to emotional exhaustion and chronic stress. This indicates that interventions aimed at reducing occupational stress have not yet produced meaningful results.

D. This statement reflects a positive cultural change and stress-reducing intervention on the unit. Staff are recognizing the emotional toll of client deaths and are engaging in self-care and team support, such as taking breaks or pausing to process grief. These behaviors indicate that strategies to reduce occupational stress, improve coping, and foster resilience have been effective.

Rationale:

A. In the terminal phase of Alzheimer’s disease, clients often experience severe physical decline, including loss of mobility and muscle strength. They may become completely bedridden and unable to sit up independently, reflecting the progressive degeneration associated with late-stage Alzheimer’s. This finding is an expected part of the terminal phase and indicates the need for comprehensive supportive care, including repositioning, skin care, and prevention of pressure injuries.

B. While needing cueing to eat is characteristic of moderate to late-stage Alzheimer’s disease, it is not specific to the terminal phase. By the terminal stage, clients often lose the ability to feed themselves entirely and require total assistance with eating or may be receiving alternative nutrition such as enteral feeding.

C. Needing help with finances occurs in the earlier or moderate stages of Alzheimer’s disease when cognitive decline interferes with complex tasks. In the terminal phase, the client’s deficits are far more profound, affecting basic activities of daily living rather than higher-order tasks like managing finances.

D. Speech degradation to a few words generally occurs in the late stages of Alzheimer’s, but in the terminal phase, clients may lose verbal communication entirely. The inability to sit up is a more definitive and observable physical marker of the terminal stage.