A patient with terminal cancer is admitted to a family-centered hospice. The spouse visits daily and discusses wedding plans; which provisional nursing diagnosis best applies to the spouse?

• A. Ineffective coping related to lack of grieving
• B. Anxiety related to complicated grieving process
• C. Hopelessness related to knowledge deficit about cancer
• D. Caregiver role strain related to spouse's complex care needs

Answer: (A)

Coping with a loved one’s terminal illness involves how a family member processes the loss and adjusts to impending death. When a spouse repeatedly shifts focus to wedding plans and daily life events rather than expressing or working through feeling about the illness, it signals avoidance of the grieving process. This pattern reflects ineffective coping because the person isn’t engaging in adaptive emotional processing or seeking support to manage the impending loss.

In hospice care, recognizing this coping pattern helps the team address emotional needs, encourage expression of grief, and connect the spouse with counseling or bereavement resources. The other possibilities don’t fit as well: anxiety linked to a complicated grieving process would imply persistent, pervasive worry rather than avoidance; hopelessness tied to a knowledge deficit doesn’t align with the behavior shown; caregiver role strain would center on burdens of caregiving tasks rather than emotional processing of loss.