A home health nurse is caring for a new client who has hoarding disorder that involves food. Which of the following actions should the nurse take first?

Choice A reason: Encouraging the client to verbalize their feelings about hoarding is the first step because it establishes rapport and allows the nurse to understand the client’s perspective. Hoarding disorder is often associated with deep emotional distress, anxiety, and fear of loss. By exploring feelings first, the nurse builds trust and creates a foundation for further interventions. This therapeutic communication is essential before moving into education or referrals. Choice B reason: Referring the client to a support group is beneficial but should not be the first action. Without first establishing trust and understanding the client’s feelings, the client may resist external interventions. Support groups are effective later in the care plan once the client is ready to engage with others. Choice C reason: Discussing health risks is important but should follow after the nurse has explored the client’s feelings. Starting with risks may feel confrontational or judgmental, which could increase resistance. The nurse must first understand the client’s emotional attachment to hoarding before addressing risks. Choice D reason: Completing the Hoarding Scale Self-Report is a useful assessment tool, but it is not the first action. The client may not be ready to engage in structured assessments until rapport and trust are established.