A nurse is making a home visit to a client who is in the late stage of Alzheimer's disease. The client's partner, who is the primary caregiver, wishes to discuss concerns about the client's nutrition and the stress of providing care. Which of the following actions should the nurse take?

Rationale:

A. This response minimizes the client’s current feelings and redirects them without first acknowledging or validating the emotion. While support groups are helpful, immediately suggesting them may make the client feel dismissed or unheard.

B. This response shifts focus to others rather than addressing the client’s personal feelings. At this stage of grief, the client needs validation and emotional support, not comparison with family members.

C. This response demonstrates therapeutic communication by acknowledging and validating the client’s feelings. Labeling the emotion as anger normalizes the reaction, helps the client feel understood, and encourages further expression. It supports the grieving process by recognizing emotions as part of normal bereavement.

D. This response is non-therapeutic because it shifts the focus to the nurse’s personal experience rather than the client’s feelings. It can unintentionally minimize the client’s unique grief and may make the client feel that their emotions are less important.

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.