In home care, when an older adult depends on care from their adult son who has become withdrawn and has multiple bruises in various stages of healing, what question should the nurse ask?

In home care, when an older adult depends on care from their adult son who has become withdrawn and has multiple bruises in various stages of healing, what question should the nurse ask?

• A. What can you tell me about how these bruises occurred?
• B. Have you noticed the bruises usually occur after falls?
• C. Does the bruising affect daily activities or pain today?
• D. Would you be willing to have a home visit from a social worker?

Answer: (A)

Opening with an open, nonjudgmental question about the injuries helps you gather essential information and assess safety. When a dependent older adult has bruises in various stages of healing and the caregiver appears withdrawn, you want a narrative that reveals how these injuries happened. Asking, “What can you tell me about how these bruises occurred?” invites the caregiver to describe events in their own words, which can uncover inconsistencies, caregiving stress, or potential harm and guide next steps in safety planning and further assessment. If you focus on how the bruises usually happen (like falls) or on the current pain and daily activity, you’re narrowing the conversation and may miss signs of abuse or coercion. Asking about a social worker visit is a useful follow-up step, but it doesn’t address the immediate concern of what caused the injuries. The open-ended question about the cause is the best first move to understand the situation and protect the older adult.

Opening with an open, nonjudgmental question about the injuries helps you gather essential information and assess safety. When a dependent older adult has bruises in various stages of healing and the caregiver appears withdrawn, you want a narrative that reveals how these injuries happened. Asking, “What can you tell me about how these bruises occurred?” invites the caregiver to describe events in their own words, which can uncover inconsistencies, caregiving stress, or potential harm and guide next steps in safety planning and further assessment.

If you focus on how the bruises usually happen (like falls) or on the current pain and daily activity, you’re narrowing the conversation and may miss signs of abuse or coercion. Asking about a social worker visit is a useful follow-up step, but it doesn’t address the immediate concern of what caused the injuries. The open-ended question about the cause is the best first move to understand the situation and protect the older adult.