Mr. Miles is a widower
who has a daughter named Beth. Beth is 45 years old and works as a call center representative.
No one else lives in their home aside from them so when Beth is on duty she
always summons 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 day
off is Margareth's day off so there's one day every week for Beth to take care
his father for his medicine, food and rest. One Beth's day off, 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.
For more samples of nursing care plan you are free to check it out in our NCP LIST page.
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