Alzheimer’s Delirium and Dementia Q 6
During the home visit of a client with dementia, the nurse notes that an adult daughter persistently corrects her father’s misperceptions of reality, even when the father becomes upset and anxious. Which intervention should the nurse teach the caregiver?
A. Anxiety-reducing measures
B. Positive reinforcement
C. Reality orientation techniques
D. Validation techniques
Correct Answer: D. Validation techniques
Validation techniques are useful measures for making emotional connections with a client who can no longer maintain reality orientation. These measures are also helpful in decreasing anxiety. The basic idea behind validation therapy is that people who are in the late stages of life may have unresolved issues that drive their behaviors and emotions. The way caregivers or family members respond to these behaviors and emotions can either make them worse or help resolve them.
Option A: Anxiety-reducing measures and positive reinforcements will also be appropriate, but validation techniques will provide both anxiety reduction and positive reinforcement for the client. Assess a patient’s feelings about his behavioral problems, negative feelings about self, ability to communicate, anxiety, depression, and feeling of powerlessness. Determines extent of loneliness and isolation and reasons for it.
Option B: Nonpharmacologic treatments may include a general approach (caregiver education and training in problem-solving, communication and task simplification skills, patient exercise, and/or activity programs), or a targeted approach in which precipitating conditions of a specific behavior are identified and modified (eg, implementing nighttime routines to address sleep disturbances).
Option C: Reality orientation techniques are not useful when the client can no longer maintain reality contact and becomes upset when misperceptions are corrected. Avoid or terminate emotionally charged situations or conversations. Avoid anger and expectation of the patient to remember or follow instructions. Do not expect more than the patient is capable of doing. Catastrophic emotional responses are prompted by task failure when the patient feels expected to perform beyond ability and becomes frustrated and angry. Responding calmly to the patient validates feelings and causes less stress.