Care of Cognitively Impaired Residents

You are caring for a resident who is waiting at her window with her suitcase. The resident states that she is waiting for her husband who died 5 years ago to pick her up. What is your best response?

"I understand you're waiting for your husband, but he won't be able to come today. Would you like to talk about your memories of him?"

Your resident that has dementia and usually gets her stories mixed up tells you that the toilet in her bathroom is leaking. What is your response to this resident?

"I'll take a look and see what's going on."

You have a resident who lost his dentures tell you, "I know they stole my dentures!" What is your best response to this resident?

"Let's look for your dentures together."

You have a resident that tells you, "please make that baby under my bed to stop crying!" What is your best response to this resident?

"Tell me more about the baby."

You have a resident with dementia who ate all of her breakfast. You check on her 30 minutes after breakfast and she tells you "they still haven't brought my breakfast and I'm starving!" What is your best response to this resident?

"You already ate your breakfast, remember?"

You have a resident that tells you he knows he's being spied on. This behavior is not uncommon for residents with dementia. What is your best response for this resident?

Acknowledge the resident's feelings and offer support

Sometimes providing peri care to a resident can cause the female resident to feel sexually assaulted. How can you best help the resident feel safe and secure while providing peri care?

Allow the resident to perform as much of the task as possible on their own

Agitation, anxiety, anger, and aggression are the 4 A's seen in what disease?

Alzheimer's disease

Simple sentences (I.e. one or two word sentences) are beneficial in residents with what disease?

Alzheimer's disease

You have a resident with Alzheimer's standing at the door trying to figure out the code to the door. What is your best response to this resident?

Ask the resident if they need assistance

You have a resident that lost her favorite stuffed animal. What is your BEST intervention for this resident?

Ask the resident to describe the stuffed animal

What is the Global Deterioration Scale (GDS) used for?

Assessing cognitive function in patients with dementia

What is the best response when a resident with dementia continues to call another resident his girlfriend, even though she is not happy about it?

Explain to the other resident that the resident with dementia is confused and doesn't mean any harm

You have a resident that has a fear of using her wheelchair. What is your approach for this resident?

Gradually introduce the wheelchair and offer reassurance and support

What is the term for a resident who is looking in his bathroom for the person chasing him?

Hallucination

You have a resident with dementia that is being admitted to your facility that has never lived in a SNF before. How can you help this resident feel more comfortable as she transitions into her new home?

Introduce the resident to all of the staff and residents Give the resident a tour of the facility Provide the resident with a familiar object or photo ^ All of the above

Why is following a schedule beneficial to the resident who has dementia?

It provides structure and familiarity for the resident

You are caring for a resident who likes to wear a specific pair of pants everyday. What is a good solution for this resident?

Let the resident wear the same pants every day

Reassuring, responding, and refocusing are the three R's for what?

Managing behavioral symptoms of dementia

Which of the following may be seen in a resident with a GDS (Global Deterioration Scale) score of 6?

Moderately severe dementia

What is the best intervention for ensuring that the patient with Alzheimer's is getting proper nutrition?

Offering a variety of foods at each meal

What is the best approach to take with cognitively impaired residents who have difficulty sleeping?

Provide a consistent bedtime routine and environment

What is the best way to keep the patient oriented to place and time?

Provide a consistent routine and schedule for the patient

You have a resident with dementia who continues getting up from her wheelchair after you've asked her not to several times. What is your best response to her?

Provide a verbal reminder in a calm and respectful manner

What is the best way to prevent or decrease agitation and/or confusion on a resident with dementia?

Providing a structured routine and environment

What is your response to a resident who continues wandering into other resident's rooms?

Redirect the resident to a different activity or location

You are caring for a resident with dementia that is saying sexual things aloud. What is your best response to this resident?

Respond in a calm, matter-of-fact manner

You are caring for a resident with dementia that has chronic pain issues. What sign may you see in this resident when they are in pain but unable to verbalize that they're in pain?

Restlessness

What is the BEST way to diffuse the situation when a resident with dementia is being combative and kicking at the staff?

Speak softly and calmly to the resident

What is the term used to describe confusion in a patient with dementia after the sun goes down?

Sundowning

What is the best response when a resident tells her daughter that she hasn't had any of her morning medications, even though she took them earlier?

Tell the daughter that the resident did take her medication earlier

Why is it important to monitor and often feed residents with late-stage Alzheimer's?

They are prone to choking and aspiration They may forget to eat or have difficulty feeding themselves They may have trouble swallowing or digesting food ^ All of the above

Bulletin boards and calendars can be helpful for residents how?

They can help residents keep track of appointments and events They can provide a place for residents to display their artwork They can serve as a reminder of the current date and time ^ All of the above

It is typical for a patient with Alzheimer's to become confused and combative. What is the proper way to handle a combative resident?

Try to de-escalate the situation by using a calm and reassuring approach

You have an incontinent resident that is crossing her legs and pulling at her clothes. You know this is a sign of what?

Urinary urgency

You have a resident that is having difficulty remembering what year it is. How do you respond to this resident?

Use a validating approach and acknowledge the resident's feelings

Which of the following would NOT be included in a reality orientation program?

Use of physical restraints

What is the best approach to explaining activities when caring for a confused patient?

Use simple, clear language and repeat instructions

Which of the following may be included in communication with a patient with Alzheimer's disease?

Using simple, concrete language and nonverbal cues

What is your best response to a resident with mild dementia who is afraid of having an accident during activities and does not want to drink?

Validate her feelings but encourage her to continue drinking fluids regularly