Social Isolation — AIDS

Nursing Diagnosis: Social Isolation

May be related to

• Altered state of wellness, changes in physical appearance, alterations in mental status
• Perceptions of unacceptable social or sexual behavior/values
• Inadequate personal resources/support systems
• Physical isolation

Possibly evidenced by

• Expressed feeling of aloneness imposed by others, feelings of rejection
• Absence of supportive SO: partners, family, acquaintances/friends

Desired Outcomes

• Identify supportive individual(s).
• Use resources for assistance.
• Participate in activities/programs at level of ability/desire.

Nursing Interventions	Rationale
Ascertain patient’s perception of situation.	Isolation may be partly self-imposed because patient fears rejection/reaction of others.
Spend time talking with patient during and between care activities. Be supportive, allowing for verbalization. Treat with dignity and regard for patient’s feelings.	Patient may experience physical isolation as a result of current medical status and some degree of social isolation secondary to diagnosis of AIDS.
Limit/avoid use of mask, gown, and gloves when possible, e.g., when talking to patient.	Reduces patient’s sense of physical isolation and provides positive social contact, which may enhance self-esteem and decrease negative behaviors.
Identify support systems available to patient, including presence of/relationship with immediate and extended family.	When patient has assistance from SO, feelings of loneliness and rejection are diminished. Note:Patient may not receive usual/needed support for coping with life-threatening illness and associated grief because of fear and lack of understanding (AIDS hysteria).
Explain isolation precautions/procedures to patient and SO.	Gloves, gowns, mask are not routinely required with a diagnosis of AIDS except when contact with secretions/excretions is expected. Misuse of these barriers enhances feelings of emotional and physical isolation. When precautions are necessary, explanations help patient understand reasons for procedures and provide feeling of inclusion in what is happening.
Encourage open visitation (as able), telephone contacts, and social activities within tolerated level.	Participation with others can foster a feeling of belonging.
Encourage active role of contact with SO.	Helps reestablish a feeling of participation in a social relationship. May lessen likelihood of suicide attempts.
Develop a plan of action with patient: Look at available resources; support healthy behaviors. Help patient problem-solve solution to short-term/imposed isolation.	Having a plan promotes a sense of control over own life and gives patient something to look forward to/actions to accomplish.
Be alert to verbal/nonverbal cues, e.g., withdrawal, statements of despair, sense of aloneness. Ask patient if thoughts of suicide are being entertained.	Indicators of despair and suicidal ideation are often present; when these cues are acknowledged by the caregiver, patient is usually willing to talk about thoughts of suicide and sense of isolation and hopelessness.