Following a severe hemorrhagic stroke 5 weeks prior, an older adult client is experiencing a protracted decline in health that the care team expects to end in death. After teaching the family about hospice care, the nurse determines that additional teaching is needed when the family identifies which intervention as being included?

A. Whomever the client appointed will make medical decisions.

This choice reflects the principle of autonomy and respects the client's wishes as expressed in their living will. If the client has appointed a healthcare proxy or surrogate decision-maker in their living will, that individual would be authorized to make medical decisions, including providing consent for surgery, on behalf of the client. This option emphasizes the importance of honoring the client's preferences and autonomy in healthcare decision-making.

B. The client will always give consent to any procedure.

This choice is not accurate, particularly in situations where the client lacks decision-making capacity due to conditions such as Alzheimer's disease. If the client is unable to provide informed consent, the responsibility for decision-making may shift to a designated healthcare proxy or surrogate decision-maker as outlined in the client's living will. While the client's preferences and values should be considered, their ability to provide consent may be compromised by their medical condition.

C. The family will provide consent.

While family members may be involved in discussions about the client's care and may provide input, the ultimate responsibility for providing consent for medical procedures typically rests with the individual designated as the healthcare proxy or surrogate decision-maker in the client's living will. If the living will specifies a healthcare proxy, their role supersedes that of the family in decision-making regarding medical treatment.

D. A court-appointed conservator will be consulted.

In some cases where there is no living will or designated healthcare proxy, and the family is unable to reach a consensus on medical decisions, a court-appointed conservator may become involved to make decisions on behalf of the client. However, the involvement of a conservator is typically a last resort and may not be necessary if there is a living will specifying a healthcare proxy or surrogate decision-maker. The involvement of a conservator would be determined through legal proceedings and may not be the primary course of action in situations where the client's wishes are clearly outlined in a living will.

A. Investigate the reasons why the client is not bathing or doing laundry:

Before providing any interventions or suggestions, the nurse should first understand the underlying reasons for the client's neglect of personal hygiene. There could be various factors contributing to this behavior, such as physical limitations, cognitive decline, depression, grief from the recent loss of a spouse, lack of motivation, or environmental barriers. By investigating the root causes, the nurse can tailor interventions and support strategies to address the specific needs and challenges of the client.

B. Offer time-saving bathing tips and advice on easy methods for washing clothes:

While providing tips and advice may be helpful, it's essential to first understand why the client is neglecting personal hygiene to ensure that the suggestions are appropriate and feasible. Without addressing the underlying reasons, offering advice alone may not effectively address the issue.

C. Incorporate the help of the client's family to assist with bathing:

Involving the client's family can be a valuable support strategy, but it should come after understanding the client's individual circumstances and preferences. Additionally, not all clients may have readily available family members to assist with personal care tasks.

D. Explain to the client about the health benefits of keeping clean:

While education about the importance of personal hygiene is essential, it may not be the most immediate or effective intervention if there are underlying barriers preventing the client from maintaining cleanliness. Understanding the client's specific situation should precede any educational efforts to ensure relevance and effectiveness.