Mr. Miles is a widower who have a daughter named Beth. Beth is 45 years old and works as a call center representative. No one else live in their home aside from them so when Beth is on duty she always summon Margareth. Margareth is an on call nurse for Mr. Miles. She was a professional personal nurse who is responsible for Mr. Miles' medicine, food and rest while Beth is out for work. Every Beth's dayoff is Margareth's dayoff so there's one day every week for Beth to take care his father for his medicine, food and rest. One Beth's dayoff, she was fall asleep and took a nap but when she woke up Mr. Miles, his father, gone missing. She immediately called for help since Mr. Miles was diagnosed with Alzheimer's disease. This is a nursing care plan sample about wandering of Mr. Miles, 70 years old, diagnosed with Alzheimer's disease.
ASSESSMENT:
Subjective:"I want to go home, but I don't know exactly where I am now. I've been walking for almost 2 hours." client said.
Objective:
- Poor eye contact
- Keep looking around
- Looks anxious
- Pale
- Dry mouth
- Dry skin
- Persistent walking
- Weakness
- Fatigue
DIAGNOSIS:
Wandering related to persistent walking for almost 2 hours as manifested by weakness and fatigue.PLANNING:
After 4 hours of nursing intervention, the client will return to home safely and the caretakers will anticipate and prevent wandering behaviors.INTERVENTIONS:
- Assess the contributing factors to Mr. Miles such as his anxiety, confusion, frustration, boredom, agitation and physiological urge like hunger, thirst, urination and constipation. Reduced or eliminate the assessed contributing factors, if possible.- For anxiety intervention, go to ANXIETY Nursing Care Plan.
- Always redirect Mr. Miles when he is lost. Provide him a safe route for walking.
- Provide regular opportunities for Mr. Miles to walk with a caregiver or Margareth which is his personal nurse or a companion in a safe area.
- To provide safety and restrictions, install locks on doors and windows. If you try to provide electronic devices such as buzzers on doors and pressure sensitive alarms, make sure your neighbors, police and other residence are aware of Mr. Miles's wandering behavior. Also encourage them to notify the caregiver or Margareth or Beth when Mr. Miles is wandering. Provide them a picture or image of Mr. Miles in order to familiarize his identity.
- Encourage therapeutic relationship and be available to Mr. Miles for listening and talking. Provide accurate information to the situation and do not give false reassurance to him, helps Mr. Miles what is reality based. Provide to Mr. Miles diversional activities such as watching TV or listening to music, before and after the operation. Gradually increase Mr. Miles's activities and involvement with others as anxiety is decreased. Use cognitive therapy to focus on correct faulty catastrophic interpretations of symptoms.
- Assist Mr. Miles to identify his precipitating factors and new methods of coping with wandering. Assist also in developing his skills like awareness of negative thoughts, saying stop and substituting a positive thought to eliminate his negative self-talk. Mild phobias tend to respond well to behavioral therapy.
EVALUATION:
After 4 hours of nursing intervention, the client returned to home safely and the caretakers will anticipate the prevent client's wandering behavior.
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