COMPROMISED FAMILY COPING
Usually supportive primary person (family member or close friend)
provides insufﬁcient, ineffective, or compromised support, comfort,
assistance, or encouragement that may be needed by the patient to
manage or master adaptive tasks related to health challenge
• Attempts to assist the patient with unsatisfactory results
• Displays of protective behavior disproportionate to the patient’s
abilities or need for autonomy (family member)
• Expresses concern about the family’s response to health problem
• Reports preoccupation with personal reaction to the patient’s
• Exhaustion of supportive
• Lack of reciprocal support
capacity of signiﬁcant people
• Temporary preoccupation by a
• Incorrect information by a pri-
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Emotional status
The family members will
• Assume responsibility for roles and activities formerly held by the
• Express feelings about assuming responsibility of care for an older
The patient and family members will
• Identify and make use of appropriate community services.
• Express satisfaction with improved ability to cope with current crisis.
SUGGESTED NOC OUTCOMES
Caregiver Emotional Health; Caregiver–Patient Relationship; Care-
giver Stressors; Family Coping; Family Normalization
INTERVENTIONS AND RATIONALES
Determine: Identify the primary caregiver in family and assess roles
of other family members. Determine usual coping mechanisms
employed by this patient and family. Describe patterns of communi-
cation used in problem solving. Identify what support systems exist
for the family and patient outside the family. Identify strengths and
weakness in the family’s communication patterns. Assessment data
will assist with establishment of interventions.
Perform: Direct development of short- and long-term goals by the
patient and family members. Initially, the family members will need
help from the caregiver until they understand more about the
process of planning.
Identify appropriate community services for the family to assist
Inform: Educate patient and family members about the process of
aging to assist patient and family to understand how changes in the
patient have affected the family.
Teach family members ways of maximizing the use of coping
strategies that seem to have worked for them in the past. Teach new
coping strategies and have family members role model them. Prac-
tice will help the family practice the behaviors in real situations.
Attend: Avoid becoming involved in a power struggle between
patient and family members. The patient may no longer be able to
ﬁll ordinary roles and the sudden shift in roles may lead to a power
Encourage family members to express feelings about caring for an
older family member. Be nonjudgmental when listening to the
family; discuss the issues associated with caring for an older person.
If the nurse is judgmental, the family members may not be comfort-
able discussing their problem.
Provide emotional support for primary caregiver. Some families
may hesitate to accept outside help. Other families may be unwilling
to make even small sacriﬁces to care for an older family member. If
family members have not been supportive or caring for the elder
member before, they are unlikely to change.
Manage: Refer to community agencies (e.g., adult day care, respite
care, and geriatric outreach services) that can assist the family in
caring for the elder. Communicate to the hospice nurse where the
patient is at present in coping with the terminal illness.
Refer to case manager or social service to assist with ongoing
coordination of the patient’s needs after hospitalization.
Refer to a member of the clergy or a spiritual counselor when
deemed appropriate. Patients will often be more inclined to talk to a
SUGGESTED NIC INTERVENTIONS
Caregiver Support; Coping Enhancement; Family Involvement
Promotion; Respite Care
Garity, J. (2006). Caring for a family member with Alzheimer’s disease: Cop-
ing with caregiver burden post-nursing home placement. Journal of Geron-
tological Nursing, 32(6), 39–48.