An 85-year-old female who is confused, malnourished, dehydrated, and reluctant to explain how a fall happened has a daughter who interrupts the interview. Which intervention is a priority?

An 85-year-old female who is confused, malnourished, dehydrated, and reluctant to explain how a fall happened has a daughter who interrupts the interview. Which intervention is a priority?

• A. Take the history from the daughter because the client is confused.
• B. Provide the daughter with nutritional teaching.
• C. Request a psychiatric evaluation for the client.
• D. Interview the client alone first and assess for abuse.

Answer: (D)

Prioritizing safety and potential abuse is essential with an elderly patient who is confused, malnourished, and dehydrated. Interviewing the client alone first gives her a private space to describe how the fall happened and to reveal any feelings of fear or coercion without the daughter influencing her account. This helps you assess her capacity to speak for herself and to detect possible abuse or neglect, which is critical for immediate protective actions if needed. Collateral information from the daughter can be gathered once the private interview has occurred, but it shouldn’t override the need to hear directly from the patient and evaluate safety. Nutritional teaching and scheduling a psychiatric evaluation are important, but they don’t address the urgent risk of abuse and safety that must be assessed first.

Prioritizing safety and potential abuse is essential with an elderly patient who is confused, malnourished, and dehydrated. Interviewing the client alone first gives her a private space to describe how the fall happened and to reveal any feelings of fear or coercion without the daughter influencing her account. This helps you assess her capacity to speak for herself and to detect possible abuse or neglect, which is critical for immediate protective actions if needed. Collateral information from the daughter can be gathered once the private interview has occurred, but it shouldn’t override the need to hear directly from the patient and evaluate safety. Nutritional teaching and scheduling a psychiatric evaluation are important, but they don’t address the urgent risk of abuse and safety that must be assessed first.