A nurse is assisting with teaching a newly licensed nurse about hospice care. Which of the following information should the nurse include?

Rationale:

A. While this may seem convenient, longer cords can create tripping hazards, particularly for older adults or those with mobility limitations. In assisted-living environments, reducing environmental risks is critical; adding a long cord increases the chance of falls, which can result in serious injury. Safe fall-prevention strategies emphasize keeping walkways clear of obstacles and avoiding unnecessary extensions of objects that could interfere with mobility.

B. Armrests on chairs provide leverage and stability when residents sit down or stand up. Chairs without armrests can make it difficult for individuals with reduced strength, balance issues, or joint problems to safely transfer, increasing the risk of falls. Proper seating should include stable chairs with armrests at an appropriate height to support independent movement.

C. Bathrooms are high-risk areas for falls due to wet surfaces and slippery floors. Handrails or grab bars provide stable points of support for entering, exiting, and moving within the bathroom. Their use helps residents maintain balance and confidence, reducing the risk of slips and falls. This is a primary recommendation in fall-prevention programs for older adults in assisted-living or home settings.

D. Throw rugs are inherently unstable and prone to slipping, and placing them over cords creates a compounded hazard. This can cause residents to trip and fall, potentially resulting in fractures or head injuries. Fall-prevention teaching emphasizes removing loose rugs and securing cords safely along walls or with cord covers rather than covering them with unsecured rugs.

Rationale:

A. This statement reflects depressive symptoms, which are consistent with the depression phase of grief. The client is acknowledging the reality of their illness but expressing feelings of hopelessness, fatigue, and emotional heaviness. While it is part of the grief process, it does not indicate denial, as the client is not rejecting the truth of their terminal condition.

B. Denial is the initial reaction to a terminal diagnosis in Kubler-Ross’s grief model. It is characterized by refusing to accept the reality of death or the severity of illness. In this statement, the client questions the accuracy of the prognosis and rationalizes that the doctor is exaggerating, which allows the client to avoid confronting the emotional reality of impending death. Denial serves as a temporary coping mechanism that can help reduce overwhelming anxiety and give the client time to gradually process their diagnosis.

C. This reflects anger, the second phase of grief. The client is redirecting feelings of frustration, helplessness, or fear toward others, often blaming family, healthcare providers, or even themselves. While anger can coexist with denial, the primary emotion here is resentment rather than refusal to accept reality.

D. This statement demonstrates acceptance, the final stage of grief. The client acknowledges the reality of death and expresses a sense of peace or resignation, showing psychological adaptation to the terminal prognosis.