Male, 36 years old, Caregiver

1. Interventions: Outcome 2.) Assess: The R.N. will assess clients illness on financial status. Rationale: A primary conflict source among families is money management. (C-119) Independent: The caregiver affirms burden through counseling. Ration: The care giver receives problem solving techniques and suggestions (C119). Teaching: RN will teach promotion of optimal wellness and wellbeing of support systems Ration: RN's provide support in education for family caregivers as well as clients (K132). Collab: Engage others to work actively to increase state, federal, and private agencies financial support for resources to enhance caregiving in the home. Ration: These strategies emphasize the need for caregiver to protect their health with a balance of work, sleep, leisure, and support and identify sources of help in the community. (C120)

2. Interventions: Outcome 3.) Assess: The family response to the caregiver complaints with problem solving techniques. Ration: Assmentment will determine the effectiveness of implemented programs. (k121) Independent: Explore resources that will provide assistance with bathing and laundry. Ration: The number of people in a household influences how many secondary, informal caregivers assist the primary caregiver. Teaching: Explain the benefits of sharing with other caregivers. Ration: These strategies emphasize the need of the caregiver to balance workload (C120). Collab: Engage family to appraise situation Ration: Allow the family to share frusterations (C119)

3. Interventions: Outcome 1.) Assess: The R.N. will assess the caregiver's knowledge of identify activities for which assistance is needed. Rationale: The R.N. will assess what assistance is required. (K-137) Independent: The caregiver will refer to community agencies for adult day care services. Rationale: Caregivers need to be reminded of the importance of caring for themselves, by making time for themselves. (C-764, K-137) Teaching: The R.N. should remind the caregiver to take time to himself. Rationale. The caregiver should be reminded of the importance to care for himself. (K-137) Collaboration: The R.N. will assist the caregiver in exploring volunteer and agency sources. Rationale: Families with a member who is chronically ill may benefit from a weekend respite. (K-137)

4. 1.) Risk for caregiver role strain r/t: insufficient resources and/or finances. Definition: A state in which a client is experiencing physical, emotional, social, and/or financial burdens, in the process of giving care to another. (Pg. 114) 2.) Anxiety r/t: threat to self concept secondary to financial problems. Definition: A state in which and individual experiences a vague feeling of dread or apprehension, it is a response to external or internal stimuli that can have behavioral, emotional, cognitive, and physical symptoms. (Pg. 72) 3.) Impaired home maintenance r/t: multiple care requirements secondary to family member with deficits. Definition: A state in which a client of family experiences or is at risk to experience difficulty in maintaining a safe, hygienic, growth producing home environment. (Pg. 761)

5. Subjective: John reports: Roger has trouble sleeping, sometimes does not recognize him, he cannot get Roger to eat, Roger's condition has gotten worse, Roger cannot do anything, Roger wets the bed, Roger's skin is fragile, he gets bruises and sores that do not heal. John also states: He has difficulty keeping up the house, difficulty caring for Roger, dealing with his debt, says he does not have enough money, time, or energy, He says he will have to quit his job, he cannot leave the house, his friends no longer want to be seen with him, he is worried and upset, he does not know what to do. He also states that Roger's family calls, but do not offer any help.

6. Objective: House is cluttered by equipment and supplies, Urine and feces soiled linen and clothes in a pile on the floor in the bathroom, Smell of urine and feces in bedroom and bathroom, John is anxious and attentive to Roger's needs, John becomes visibly upset and leaves the room.

7. Outcomes: 1.) Caregiver will seek assistance with care for 2 hours at a time, 3 times a week. 2.) Caregiver will attend financial counseling within 7 days. 3.) Caregiver will phone family members within 48 hours, for home maintenance assistance.

8. Evaluations: 1.) Goal Met. Upon the R.N. observing, the caregiver adhered to seeking assistance for 2 hours, 3 days a week. 2.) Goal Met. The caregiver reported adherence to attending financial counseling within 7 days. 3.) Goal Met. The caregiver reported adherence to phoning family members within 48 hours, for assistance with home maintenance.