A client with advanced multiple sclerosis (MS) has been a resident in a nursing home for the past 2 years. One day, the client tells the nurse, "I want to get out of here and try living in my own home." What is the best response by the nurse? A)"Do you have family or friends who could take care of you?" B)"I'll make a referral to the local home care agency in your area." C)"It will be very difficult to manage your care at home." D)"Tell me how you think your life would be different if you moved from here."

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After 2 years of residence, this client has expressed a desire to leave the nursing home and return home. This client with advanced MS will need maximal assistance with basic activities of daily living (bathing, grooming, toileting, transfers, locomotion), meal preparation, laundry, shopping, and other housekeeping chores. Discharging this client to care at home will require much planning and present numerous challenges related to safety, finances, support and informal caregiver system, durable medical equipment, and layout of the home. Therefore, before any discussion or planning can take place, the nurse needs to determine why the client wants to go home at this point in time. The nurse should also ask the client if something happened in the nursing home. However, asking "why" or "yes/no" questions is non-therapeutic and will not facilitate a meaningful nurse-client interaction. By using the therapeutic communication technique of exploring, the nurse can encourage the client to discuss thoughts, feelings, and reasons for wanting to leave the current residence. (Option A) This is important information to obtain when planning the discharge of a client who needs care at home; however, it is not the priority assessment. (Option B) This would be an appropriate nursing action after the nurse has discussed and assessed the reasons why the client wants to return home. (Option C) This is an appropriate response as it presents the reality of the client's situation, but it is not the priority response. Educational objective: Exploring is a therapeutic communication technique that will facilitate further assessment of a particular subject or experience. It is a technique that is especially helpful when a client makes a statement or presents a topic that alerts the nurse that there could be additional information beyond the surface of the initial communication.

A Client with Advanced Multiple Sclerosis (MS) Has Been a Resident