An older adult client who is dying says to the nurse, "My son is 40 years old, but he works in a very poorly paying job and is always borrowing money from me. I don't know how he's going to manage without me." Which response by the nurse would be therapeutic?

• A. Could you share your feelings with your son just as you have with me?
• B. You should help him more directly.
• C. It is not your responsibility to worry about him.
• D. You must prepare for a future without him.

Answer: (A)

Therapeutic communication is about inviting the patient to express feelings and explore emotional concerns rather than jumping to advice or judgments. In this end-of-life situation, the patient is expressing worry, burden, and anticipatory grief about a child who is financially dependent and the prospect of facing life without her.

The response that invites the patient to share her feelings with her son uses open, reflective language that validates what she’s feeling and encourages further emotional expression. By asking to share feelings with her son "just as you have with me," the nurse helps her articulate emotions she’s experiencing—grief, concern for her son’s independence, and fear about the future—so she can process them and possibly address them with her son. This supports the patient’s autonomy, reduces isolation, and fosters coping at a vulnerable time.

Other options prompt direct action, minimize her worries, or imply resignation, which can shut down emotional processing. For example, telling her to help him more directly advises behavior rather than addressing her emotional experience; saying it’s not her responsibility dismisses her feelings; telling her to prepare for a future without him can feel abrupt and fatalistic.