A 79-year-old client with Alzheimer’s disease is exhibiting significant memory impairment, cognitive impairment, extremely impaired judgment in social situations, and agitation when placed in a newsituation or around unfamiliar people.
The nurse should include the following strategy in the client’s care:
A . Maintain routines and usual structure and adhere to schedules.
B . Encourage the client to attend all structured activities on the unit, whether she wants to or not.
C . Ask the client to go to an activity once. If she gives no response right away, change the question around, asking the same thing.
D . Give the client two or three choices to decide what she wants to do.
Answer: A
Explanation:
(A) Alzheimer’s clients cope poorly with changes in routine because of memory deficits. Schedule changes cause confusion and frustration, whereas adhering to schedules is helpful and supportsorientation.
(B) Insisting that the client go to all unit activities may antagonize her and increase her agitation because of cognitive impairments. It may be better to allow the client time for calming down or distraction rather than to insist that she attend every activity.
(C) When repeating a question, allow time first for a response; then use the same words the second time to avoid further confusion.
(D) The nurse should avoid giving several choices at once. Cognitively impaired clients will become more frustrated with making decisions.
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