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AIIMS Jodhpur SNO-2023
Community Health Nursing
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A short-term goal for a patient with Alzheimer's disease is:

Appeared in: AIIMS Jodhpur SNO-2023

Explanation

  • Alzheimer's disease is a progressive and irreversible condition, so care goals must be realistic and supportive, not curative.
  • The primary aim of care is to maintain the patient's current level of function and ensure their safety for as long as possible.
  • The principle of the 'least restrictive environment' seeks to balance the critical need for safety with the patient's right to autonomy and independence.
  • This goal focuses on adapting the environment and support systems to the patient's abilities, which is a cornerstone of effective dementia care.
  • Desired outcomes include maintaining functional levels and improving safety awareness and risk management.

Why Other Options Were Wrong

  • Option A: This goal is unrealistic because the neurodegeneration in Alzheimer's disease is permanent and progressive. Lost cognitive function cannot be regained.
  • Option B: While psychosocial health is important, the priority goals in Alzheimer's care are safety and functional maintenance. Severe cognitive decline also makes it difficult to address abstract concepts like self-esteem.
  • Option C: Problem-solving is a complex executive function that is severely impaired in Alzheimer's. The therapeutic approach is to simplify tasks and provide cues, not to expect improvement in this skill.

Related Visual

column chart contrasting Realistic Goals e.g., Maintain safety, Support ADLs, Manage symptoms, Simplify routines with Unrealistic Goals e.g., Cure disease, Regain memory,...
Clinical Relevance
  • Nursing practice connection: Use the key finding related to Goal setting in the care of patients with progressive neurocognitive disorders like Alzheimer's disease to guide bedside assessment, documentation, and the next nursing action.
  • Nurses are central to creating and managing a safe, least restrictive environment. This includes conducting home safety assessments, recommending modifications (e.g., removing throw rugs, installing grab bars), and establishing predictable daily routines to reduce confusion.
  • Patient and family education is a key nursing intervention. Nurses teach caregivers how to adapt communication, simplify tasks, and manage behavioral symptoms, empowering them to support the patient's functioning.
  • What if? If the patient had delirium instead of dementia, the primary short-term goal would shift to identifying and treating the underlying cause (e.g., infection, medication side effect), with the expectation that cognitive function would be regained once the cause is resolved.
How to Approach the Question
  • First, identify the key elements of the question: it asks for a 'short-term goal' for a patient with 'Alzheimer's disease'.
  • Recall the nature of Alzheimer's disease: it is a progressive, irreversible neurocognitive disorder. This is the most critical fact for answering the question.
  • Evaluate each option against this fact. Eliminate any goals that suggest a cure, reversal of symptoms, or regaining of lost complex cognitive abilities. This immediately makes options A ('regained... cognitive function') and C ('improved problem solving') highly unlikely.
  • Compare the remaining options. Option B focuses on a psychosocial outcome (self-esteem), while Option D focuses on functional ability and safety within the environment.
  • Prioritize the goals of care for a patient with dementia. According to Maslow's hierarchy and standard nursing principles, safety and physiological functioning are the highest priorities.
  • Conclude that improving function in a safe, minimally restrictive environment is the most appropriate, realistic, and high-priority short-term goal.
Concept Tested & Keywords
  • Concept Tested: Goal setting in the care of patients with progressive neurocognitive disorders like Alzheimer's disease.
  • Stem keywords: short-term goal, patient, Alzheimer's disease
  • Lead-in keywords: is

Question ID

QLUQ-2iJkI3jWCUPPs950z

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 13809-13811

E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 154-156

E6 Comprehensive Textbook of Community Health Nursing 2nd Edition Shyamala D part 1 (pp 26-389 of 389) p. 26-389

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