A nurse is caring for a client who has been on hemodialysis for the past 5 years. The client is refusing hemodialysis and says, “I am tired of wasting my life; I would rather die." Which of the following statements should the nurse make?

A. While family support is important, the client’s autonomy and emotional state must be addressed first. B. Offering a referral for counseling or to a support person (e.g., social worker, mental health professional, chaplain) acknowledges the client’s feelings and provides a pathway for discussing goals of care and coping strategies. This response is therapeutic and supports informed decision-making. C. Dismissing the statement as anxiety minimizes the client’s distress. D. Deferring the conversation can leave the client feeling unheard and unsupported at a critical time.