In dealing with the client's guilt about placing her husband in a nursing home due to Alzheimer's progression, what would the worker do first?

• A. Accept and understand the client's guilt, allowing her to ventilate.
• B. Challenge the client's guilt and suggest she had no reason to feel guilty.
• C. Encourage the client to focus on practical caregiving tasks.
• D. Recommend immediate individual therapy.

Answer: (A)

Guilt in caregivers typically arises from the emotional pull between love for a spouse and the realities of progressive illness. The first move is to acknowledge and normalize that feeling, offering a nonjudgmental space for the client to express what she’s experiencing. When the worker accepts and understands the guilt and invites the client to ventilate, it helps reduce shame, builds trust, and shows that her emotions are legitimate responses to a demanding situation. This empathic stance sets up a supportive relationship and makes it easier to move toward practical coping steps or problem-solving later, if the client wants them.

Challenging the guilt or telling her she has no reason to feel guilty can shut down honest expression and damage rapport, making it harder for her to cope. Jumping straight to practical tasks without first addressing the emotional weight can leave distress unspoken and unresolved. Recommending therapy right away might be appropriate later, but a therapist referral isn’t the immediate first step if the client’s feelings haven’t been heard and validated.