Alzheimer’s Delirium and Dementia Q 7
Mr. Lim who is diagnosed with moderate dementia has frequent catastrophic reactions during shower time. Which of the following interventions should be implemented in the plan of care? Select all that apply.
A. Assign consistent staff members to assist the client.
B. Accomplish the task quickly, with several staff members assisting.
C. Schedule the client's shower at the same time of day.
D. Sedate the client 30 minutes prior to showering.
E. Tell the client to remain calm while showering.
F. Use a calm, supportive, quiet manner when assisting the client.
Answer: A, C, and F
Maintaining a consistent routine with the same staff members will help decrease the client’s anxiety that occurs whenever changes are made. A calm, quiet manner will be reassuring to the client, also helping to minimize anxiety. Maintain a regular daily schedule routine to prevent problems that may result from thirst, hunger, lack of sleep, or inadequate exercise. Limit decisions that the patient makes. Be supportive and convey warmth and concern when communicating with the patient. The patient may be unable to make even the simplest choice decisions and this will result in frustration and distraction. By avoiding this, the patient has an increased feeling of security. Patients frequently have feelings of loneliness, isolation and depression, and they respond positively to a smile, friendly voice, and gentle touch.
Option B: Moving quickly with several staff members will increase the client’s anxiety and may precipitate a catastrophic reaction. Assess a patient’s ability to cope with events, interests in surroundings and activity, motivation, and changes in memory pattern. The elderly may have a decrease in memory for more recent events and more active memory for past events and more active memory for past events and reminisce about the pleasant ones. The patient may exhibit assertiveness or aggressiveness to compensate for feelings of insecurity, or develop more narrowed interests and have difficulty accepting changes in lifestyle.
Option D: The use of sedation is not indicated and may increase the risk of client injury from the side effect of drowsiness. Assess and identify a patient’s previous history of grooming and bathing, and attempt to maintain similar care. Promotes familiarity with routine bathing time and type of bath or shower, and lessens further confusion and agitation. Ensure all needed items are present in the bathroom prior to the patient’s arrival. Ensure that water temperature in the tube is appropriate. Prevents the need to leave the patient unattended, which may result in injury. Elderly are easily child and have fragile skin that is susceptible to scalding.
Option E: Telling the client to remain calm is inappropriate because a client with dementia cannot respond to such a direction. Divert attention to a client when agitated or dangerous behaviors like getting out of bed by climbing the fence bed to promote safety and prevent risk for injury. Eliminate or minimize sources of hazards in the environment. Maintain security by avoiding a confrontation that could improve the behavior or increase the risk for injury.