Fostering hope in the elderly congestive heart failure patient in criticalcare

This article presents a patient-centered framework applied to the elderly p atient with congestive heart failure (CHF). Although the elderly have been the focus of numerous articles, the needs of the elderly CHF patient in the critical care setting, especially concerning hope versus hopelessness, hav e been neglected. Guidelines for the clinical management of patients experi encing hopelessness are explored. The four dimensions of hopelessness discu ssed herein are experiential, spiritual/transcendence, irrational, and rela tional processes. Nursing diagnosis, interventions, goal-setting, and famil y support also are discussed. Helping the elderly CHF patient maintain hope when confronted with repeated hospitalizations is a challenge for the crit ical care nurse.