Hopelessness Nursing Diagnosis and Nursing Care Plan

Hopelessness Nursing Care Plans Diagnosis and Interventions

Hopelessness NCLEX Review and Nursing Care Plans

When a patient sees no way out of their position and is unable to motivate themselves to overcome challenges, they become hopeless.

Patients with chronic conditions or catastrophic injuries who are unable to live life to their full potential frequently experience hopelessness in a clinical sense.

Patients may get frustrated and uninspired if they are unable to do their normal activities of daily living, keep a profession, or parent their children. Hopelessness develops when these sentiments endure and patients believe there is no way out.

According to research, hopelessness increases mortality, therefore it’s critical to assess and actively help the patient to resolve it when it is noticed.

It is possible to overcome hopelessness. Nurses can provide the nonjudgmental, listening support that many patients need to begin to understand and manage their emotions and concerns.

During hospitalization, nurses can give therapeutic treatments, connect patients to experts to continue working through feelings of loss or sadness, and teach them easy techniques to manage after discharge when they still feel hopeless.

Types of Hopelessness

  1. Alienation. This type of hopelessness originates from the belief that the patient has been forgotten by peers or significant people or does not belong to the group. The patient may feel different in certain ways, and because of these differences, bonding with others is difficult.
  2. Forsakenness. In this scenario, hopelessness comes from the notion that the patient has been abandoned when support is needed the most. The patient could also feel rejected or stigmatized, which makes them suspicious of others and the environment.
  3. Lack of inspiration. This type of hopelessness might arise when the patient is not cognitively challenged or creative. In any or all facets of life, the patient may feel blocked or unable to be creative.
  4. hopelessness. The patient may feel hopeless when he believes that he and the activities done has no effect or impact on people or the world. The patient may believe that he lacks the power or authority to make decisions or bring about change, and must rely on what others decide or do.
  5. Oppression. This type of hopelessness is linked to a sense of not being treated fairly or equally. For example, systemic and persistent racism or sexism can lead to oppression and hopelessness.
  6. Limitedness. The patient may believe that he lacks the necessary resources or talents to fulfill self-goals and objectives, or maybe limited by physical or financial constraints.
  7. Captivity. If the patient has ever been a physical prisoner or been in an abusive relationship where the patient didn’t feel free to behave or do as want, the patient may feel hopeless. This emotion can also arise if the patient believes that he deserved to be mistreated and punished.
  8. Helplessness. This type of hopelessness occurs when the patient believes that he cannot stand up for himself or act without the assistance of others.

Causes of Hopelessness

Hopelessness can be a symptom of a range of mental health issues, or it can be the result of dissatisfying, unpleasant, or bad life experiences.

Many behavioral and mental health difficulties, including depression, anxiety, bipolar illness, eating disorders, posttraumatic stress, drug abuse, and suicide thoughts, are linked to hopelessness.

Many people who feel hopeless may also be suffering from mental health problems like depression. Suicide thoughts might be triggered by feelings of hopelessness associated with depression.

  • ​​Isolation due to prolonged activity constraints
  • Deterioration health
  • Abandonment
  • loss of spiritual belief
  • Long-term anxiety
  • Chronic discomfort or pain
  • Poverty
  • Complicated treatments or illnesses

Defining Characteristics of Hopelessness

  • Reduced verbalization and passivity
  • Flat affect
  • Loss of appetite
  • Reduced sensitivity to stimuli
  • Decreased verbalization
  • Decreased affection
  • Negative verbal cues
  • Difficulty in making decisions
  • Lack of initiative or participation
  • Getting more or less sleep
  • Turning away from speaker
  • Shrugging in response to speaker
  • Angered outbursts

Nursing Care of Patients who are at Risk of Hopelessness

  1. Assess the patient for any recent physical or psychological changes. Determine any changes that would make the patient feel hopeless, such as a chronic or fatal illness, a recent job loss, or the death of a family member.
  2. Assess the patient for a history of mental health concerns such as signs of poor coping, long-term family dysfunction, a lack of family support or abandonment, or trauma.
  3. Determine the patient’s spiritual and cultural values and if the patient believes in a higher power and if there is a sense of disengagement, anger, or loss of faith.
  4. Examine the patient for suicidal thoughts. Promote patient safety and determine whether the patient is contemplating self-harm, determine whether the patient has attempted suicide before.
  5. Assess the patient’s knowledge, after establishing rapport, ask the patient about feelings and knowledge of the illness. The patient may not have an accurate or realistic knowledge of the circumstances, necessitating expert assistance.
  6. Determine the patient’s support system, including family, friends, and significant others. Isolation and hopelessness are influenced by a lack of support.
  7. Spend time listening to the patient because patients who are hopeless may believe that no one cares about their feelings. Assure the patient that someone is ready to listen and eager to assist them. It may take some time to establish a connection with the patient before they open up and tell the true feelings.
  8. Assist the patient in establishing short-term objectives. Encourage the patient to identify, plan, and achieve short-term goals. Taking small, attainable actions leads to accomplishment and a feeling of control.
  9. Encourage decision-making and participation, to take initiative even in minor things like deciding when they want to eat a meal or participating in washing and dressing.
  10. Provide a diversion technique, allow the patient to watch the TV, paint, color, read some books, solve puzzles, or play word games.
  11. Arrange the patient’s appointment with a mental health practitioner. Long-term hopelessness can progress to depression, necessitating specialized intervention to identify deeper causes and support the patient in developing coping and learning techniques to handle their situation.
  12. Encourage the patient to join team-building activities, and encourage the patient to communicate with others, yet merely being in the company of others can boost spirits, and connecting with the appropriate people can provide hope and alleviate loneliness.
  13. Determine what the patient enjoys doing to lift their spirits and assist the patient in doing so. Incorporate self-care methods and advise the patient to enjoy the outside atmosphere.
  14. Ensure that the patient continues to consume nutritious, well-balanced meals and gets a full night’s rest. Patients who are hopeless may lack appetite and suffer from malnutrition, which can exacerbate co-morbidities.
  15. Advise the patient to do exercise, as it releases endorphins, which make can help the patient feel better. Physical and mental health are linked, and ignoring one has a detrimental influence on the other.
  16. Encourage the patient to focus on their positive qualities, such as a good sense of humor, and to express gratitude for the things and people that make them happy.
  17. Encourage relatives or friends to become more involved and responsive to the patient’s condition if they are accessible. Refer the patient to support groups where they can engage with people in similar situations.

Prevention of Hopelessness

It is quite possible to manage hopelessness by doing the following:

  • Get enough sleep, at least 7-8 hours.
  • Have an adequate rest period.
  • Eat a healthy diet.
  • Engage in usual self-care activities.
  • Accomplish activities of daily living.
  • Do meditation, exercise and yoga.
  • Communicate and socialize with family and friends.
  • Attend to professional counselling.

Hopelessness Nursing Diagnosis

Hopelessness Nursing Care Plan 1

Heart Failure

Nursing Diagnosis: Hopelessness related to prolonged hospitalization secondary to heart failure as evidenced by fatigue, dyspnea, lack of involvement in the treatment plan and flat affect.

Desired Outcomes:

  • The patient will be able to demonstrate a sense of autonomy.
  • The patient will be able to manage self-care treatment efficiently.
  • The patient will be able to identify ways to exert control over own condition.
Nursing Interventions for HopelessnessRationale
Determine the variables that contribute to the patient’s feeling of hopelessness.  Identifying the characteristics that are linked to hopelessness might help in diagnosing probable causes and developing a collaborative care strategy.
Assess the patient for feelings of despair, melancholy, and indifference.These feelings of hopelessness might be present.
Assess the patient’s ability to make decisions.  The feeling of hopelessness arises from the realization that one has lost control over one’s own interests.
Recognize events or behaviors that may exacerbate the patient’s hopelessness.Patients’ choice to decline certain operations must be respected by healthcare practitioners. Patients are subjected to some routines without their agreement, creating a sensation of hopelessness.
Assess how hopelessness affects the patient’s physical health including the appearance, oral intake, hygiene, and sleep habit.Individuals may appear unable to construct fundamental components of life and self-care activities.
Engage in active listening with the patient and always be available to talk with the patient.This method fosters a supportive environment and communicates a loving message.  
Encourage the patient to recognize their own strengths and abilities.This will help the patient see their own inner strengths and identify which aspects they are strong in.
Provide the patient with more important and frequent decision-making chances.This method increases the patient’s autonomy
Assist the patient in rethinking the negative reactions to the event.The patient may have unreasonable expectations in light of the scenario.
Encourage and congratulate the patient while keeping track of self-improvement.This method fosters a supportive environment and communicates a loving message.
Assist the patient in distinguishing between controllable and uncontrollable circumstances.The patient may have unreasonable expectations in light of the scenario.  
Assist in the patient in planning and creation of a timeline for future expanded responsibilities including discharge instructions.Resuming components of self-care with realistic short-term goals boosts confidence.  
Allow appropriate preparation and explanation for diagnostic exams or processes to eliminate the unpredictability of events.A sensation of control can be gained by providing information prior to a process.    

Hopelessness Nursing Care Plan 2

Spinal Cord Injury

Nursing Diagnosis: Hopelessness related to traumatic stress secondary to spinal cord injury, as evidenced by expression of forced lifestyle changes, fear of rejection from other people, negative self-image, and verbalized feelings of hopelessness.

Desired Outcomes:

  • The patient will be able to accept the given situation.
  • The patient will be able to recognize and accurately assimilate changes into one’s self-concept without jeopardizing self-esteem.
  • The patient will make realistic strategies for adjusting to new roles and responsibilities.
Nursing Interventions for HopelessnessRationale
Help the patient to understand the functional impairment and that the likelihood of functional progress is challenging.  Long-term implications of an injury are unknown during the acute period, delaying the patient’s capacity to integrate the circumstance into his or her self-concept.
Listen to the patient’s comments and reactions to the circumstance.Provides information at the patient’s level of acceptance and provides clues about self-perception, role shifts, and needs.
Determine the patient and family dynamics including the patient’s place in the family and cultural variables.  Injury disrupts or changes the patient’s former function in the family unit, making it more difficult to integrate self-concept. Concerns of independence and reliance must also be addressed.
Encourage the patient’s family to treat the patient as usual such as discussing home situations or family news.  Involving the patient in the family decreases feelings of social isolation, helplessness, and uselessness, and allows the family to contribute to the patient’s well-being.
Educate the patient about the prognosis of the condition and therapeutic management, and give precise information at the patient’s level of understanding.Information should be focused on current and immediate needs at first, then integrated into long-term rehabilitation goals. It is necessary to repeat information until the patient has absorbed or integrated it.
Discuss with the patient and family the significance of the loss or change and assess the patient’s interactions with the family.The actual change in body image may differ from what the patient perceives. The family may subconsciously encourage distortions.
Accept the patient and show sympathy for the person. Encourage the patient, recognize and build on their talents, and praise for their accomplishments.Creates a therapeutic environment for the patient to develop self-acceptance.  
Include the patient and family in the care plan as much as possible, letting the patient make decisions and engage in self-care activities.  It is important that the patient is still in charge of their own life and gives the patient a sense of control over the circumstance. Sets the tone for the lifestyle, habit, and engagement that will be necessary for everyday care in the future. During this phase, the patient may refuse any aid or become entirely reliant.
Discourage the patient’s family and peers from offensive words or aggressive conduct, as it may elicit worries, anxieties, and emotions concerning the current situation as well as future expectations.Anxiety arises from a sense of loss, as well as a shift in masculine or feminine self-image and position. Forced reliance may be disastrous, especially when function and appearance alter.  
Be aware of personal sentiments and reactions in response to the patient’s sexual concern.  Disruptive behavior can lead to conflict between the patient and the staff, reinforcing negative sentiments and perhaps removing the patient’s motivation to work through the problem and engage in rehabilitation.
Arrange for a visit for the patient from someone who is similarly afflicted, if the patient wishes or the situation allows.Provides hope for the future and serves as a role model for the patient. Can be a valuable post-discharge resource during the tough transition time following an accident.
Arrange for patient’s appointment for counseling and psychotherapy if necessary.Adjusting to changes in body image and life may require further support.  

Hopelessness Nursing Care Plan 3

Suicide Behaviors

Nursing Diagnosis: Hopelessness related to long-term stress and abandonment secondary to suicide behaviors, as evidenced by impaired decision-making skills, loss of interest in life, and lack of motivation.

Desired Outcomes:

  • The patient will be able to verbalize the desire to live.
  • The patient will have a hopeful outlook for the future.
  • The patient will have a meaningful expression of life.
  • The patient will be able to provide three positive things done.
  • The patient will show two new problem-solving skills that the patient finds effective in life-changing decisions.
Nursing Interventions for HopelessnessRationale
Encourage the patient to study their negative thinking and recast it into objective, neutral thinking.Cognitive reframing allows the patient to see events in new ways, allowing for other approaches.
Work with the patient in identifying strengths.When people are overwhelmed, they are unable to see their lives or actions objectively.
Emphasize to the patient the importance of being realistic and perfect.Constructive interpretations of events and conduct allow for more realistic and gratifying future options.
Determine the things that have brought the patient significance and delight in the past. Discuss how the patient may combine these elements into the current lifestyle such religious or spiritual beliefs, group activities, creative endeavors.Patient talents and experiences that tapped into areas of power and creativity are reawakened. People derive genuine pleasure and joy from creative endeavors, as well as a great deal of life satisfaction.
Discuss with the patient about the future goals and desires. Determine short-term objectives for the future.Renewing realistic aspirations and hopes may offer life purpose and optimism for the future
Encourage the patients to make communication with religious or spiritual individuals or groups who have provided comfort and support in the past.People who are hopeless may feel abandoned and unable to reach out to loving individuals or groups.
Teach the patient steps of the problem-solving process.It’s important to emphasize that it’s not so much that individuals are incompetent, but rather that their coping mechanisms are unsuccessful.

Hopelessness Nursing Care Plan 4

Major Depression

Nursing Diagnosis: Hopelessness related to traumatic stress secondary to major depression, as evidenced by negative thinking, difficulty in establishing goals and social repression.

Desired Outcomes:

  • The patient will be able to express sentiments and accept life occurrences that are beyond control.
  • The patient will be able to use autonomous problem-solving skills to regain control life, but will not express or display suicidal ideas.
Nursing Interventions for HopelessnessRationale
Allow the patient to share thoughts and feelings.  The process of recognizing feelings that underlie and drive behaviors allows the patient to start taking control of their lives.
Give the patient hope by making realistic comments about their abilities and resources.Patients may feel hopeless, but hearing encouraging feedback from others might help.
Assist the patient in determining which aspects of life are within control.  An individual’s emotional state may interfere with problem-solving. Support may be necessary to identify areas under his or her control and to be confident in his or her control alternatives.
Assess the patient for any obstacles to self-care.      Although depression is a barrier in and of itself, the nurse can probe deeper into the reasons behind the patient’s poor self-care. The patient may lack the energy, time, and assistance, or may feel the tasks are unimportant.
Determine the patient’s support system.  Physical assistance with duties may not be required, but this should be determined as well. A support person can motivate a depressed patient to engage in self-care on a mental and emotional level.
Determine the patient’s medication regimen.The depressed patient likely takes anti-depressants as well as anti-anxiety and sleep aids. All of these things calm and make the patient sleepy. Determine how the patient takes these drugs to verify that they are not being overused.

Hopelessness Nursing Care Plan 5


Nursing Diagnosis: Hopelessness related to situational changes secondary to stroke, as evidenced by inappropriate use of defense mechanisms, change in usual communication habits, inability to meet basic needs, and difficulty in problem-solving.

Desired Outcomes:

  • The patient will be able to express acceptance of self in current situation.
  • The patient will be able to share the problem with significant others and any developments that have happened.
  • The patient will be able to express knowledge of own coping abilities.
Nursing Interventions for HopelessnessRationale
Assess the patient’s extent of altered perception and related degree of disability. Determine the functional independence measure.Individual considerations can help in developing a care plan, intervention choices, and discharge expectations.
Determine external pressures surrounding the patient, such as family, employment, and future healthcare requirements.  Assist in identifying particular requirements, offering information, and starting problem-solving. In establishing a suitable discharge destination, social aspects and functional state must be taken into account.
Identify the patient’s previous methods of dealing with life problems. Determine whether or not support systems are present.Allows the patient to employ previously effective habits, build on previous triumphs, and mobilize resources.
Monitor the patient for sleep disturbances, problems concentrating, inability to handle statements, lethargy, and withdrawal.May signal the start of depression (a typical stroke side effect), necessitating additional examination and treatment.
Note whether the patient refers to the affected side as “it” or denies the affected side and says it is “dead.”  The need for intervention and emotional support is indicated by rejection of bodily parts and bad sentiments about body image and ability.
Provide the patient with psychological support and set realistic short-term goals. Involve the patient’s significant others in the plan of care when possible and explain his deficits and strengths.Increases the patient’s sense of confidence and aids in treatment regimen compliance.  
Encourage the patient to communicate their emotions, such as hatred or anger, denial, despair, or a sensation of being detached.Accepts the patient’s recognition of and beginning to cope with these sentiments.  

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon


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Anna Curran. RN, BSN, PHN

Anna Curran. RN-BC, BSN, PHN, CMSRN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.

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