Neurodegenerative Diseases
A client with Stage 1 Parkinson's disease (PD) identifies grocery shopping as a valued occupation but lists fatigue as a barrier and states that occasional tremors can be embarrassing. What intervention approach would be meaningful as the OTR prepares to accompany the client to the store for an occupation-based treatment session? A. Creating a list of needed items and making a route to navigate the store efficiently B. Providing the client with psychosocial support to focus on reducing the anxiety or shame associated with symptoms C. Having the client don wrist weights to reduce tremors while reaching for items to put in the shopping cart D. Instructing the client in the use of a rollator to take seated rest breaks or one of the store's power chairs to save energy
A A is the simplest approach; organizing a grocery list and planning the most efficient route through the store to obtain the needed items is an energy conservation technique that maintains dignity. B: Psychosocial support is an ongoing intervention tool but not the most effective for successful participation in this client-chosen task. C: Donning wrist weights may help some clients with PD reduce tremors, but adding weights might increase fatigue and may also draw attention to the disability. D: A client with Stage 1 PD does not typically present with balance deficits; using assistive devices or a wheelchair may help conserve energy, but it is most likely inappropriate for this patient and may enhance feelings of shame or disability.
An inpatient is in the recovery phase of Guillain-Barré syndrome. Currently, the patient uses a wheelchair for mobility and has Fair Plus (3+/5) strength of the upper and lower extremities, and Good (4/5) trunk control. The patient wants to be able to return home to care for a preschool-age child. What should be the PRIMARY focus of the patient's intervention during this phase of recovery? A. Gross motor movements and energy conservation for completion of PADL B. Fine motor activities and moderate resistance putty exercises to improve BADL C. Functional splinting and caregiver training for participation in routine ADL D. Compensatory strategies and assistive devices for childcare activities
A Addressing gross motor movements and energy conservation will allow the client to meet goals while addressing the primary needs of improving mobility, maximizing energy available for preferred activities, and increasing strength throughout upper and lower extremities. D: The expected recovery from Guillain-Barré syndrome is that clients will regain the majority of their previous strength levels; compensatory strategies are not appropriate because the focus should be on remedial intervention strategies.
A client presents with decreased orientation. What is the most effective strategy for an OTR® to implement to assist with this cognitive impairment? A. Use an orientation poster in a common area with personal and day-time information listed. IncorrectB. Provide auditory reminders throughout the day that provide basic personal and day-time information. C. Provide the client with orientation information only when requested to prevent undue anxiety. D. Allow the client to establish his or her own routine, even if that means allowing the client to dress for the day in the middle of the night.
A Visual reminders are an effective strategy for deficits in orientation. B, C, D: Auditory reminders may be effective, but visual reminders that can be referred to throughout the day are more effective. In general, ignoring orientation deficits in someone is not advisable.
An OTR is planning a community program for clients who have Parkinson's disease. The OT knows that group sessions are effective in decreasing the impact of postural instability for clients with Parkinson's disease. Which rationale would the OTR provide when seeking funding for the program? A. Clients perceive improved quality of life when attending group sessions. B. Clients perceive tremors as having more impact on self-care tasks. C. Clients perceive community support as having a positive impact on their self-care. D. Clients perceive that they are more able to participate in social activities.
A A benefit of group sessions for clients with Parkinson's disease is an improvement in their perception of their quality of life. B: Tremors have a more negative impact on postural stability than on self-care tasks. C: Clients perceive improved quality of life, not improved self-care performance, with group sessions. Self-care performance is addressed effectively through compensatory techniques, whereas postural instability is better addressed in group settings. D: Socialization has not been a reported outcome of group sessions.
Results from a manual muscle test indicate that a client who is in Stage II of amyotrophic lateral sclerosis has Good Minus (4/5) strength of the intrinsic muscles. The client reports that by the end of a meal, it becomes extremely difficult to hold and manipulate eating utensils. Which assistive device will be MOST EFFECTIVE for the client to use during self-feeding at this stage of the disease process? A. Foam tubing to build up handles of eating utensils B. Standard universal cuff with elasticized strap C. Lightweight plastic eating utensils with contoured grip D. Wrist support with palmar pocket for inserting utensils
A Built-up utensils will allow the client to use less grasp strength throughout the meal and will be effective in compensating for the decreased intrinsic muscle strength. B, D: The client has Good Minus strength in the intrinsic muscles and should be encouraged to continue using available grasp strength. Using a device that eliminates the need for the client grasp such as a universal cuff or palmar pocket wrist support would potentially decrease muscle strength. C: Decreasing the weight of the utensil would decrease the muscle strength needed to lift the utensil; however, the client is still required to use prolonged grasp strength to hold the utensil and would still fatigue with the task.
What strategy might an OTR® appropriately recommend to caregivers of a client with Alzheimer's disease to assist with fall prevention? A. Engage the client in daily, structured activity. B. Provide visual reminders in the home environment. C. Install grab bars in the bathroom. D. Engage the client in an exercise program.
A Engagement in activity-based interventions, along with daily structure, has been documented to assist in fall prevention. B, C, D: Visual reminders and installation of grab bars might be appropriate for clients with dementia, but the strongest evidence supports using structured activity to engage clients with AD to prevent falls.
A client with advanced amyotrophic lateral sclerosis (ALS) is new to a computerized communication device. On what would the OTR® treating this patient focus? A. Positioning, to ensure proximal support on a lap tray B. ROM exercises, to enable the patient to adequately reach the device C. Trunk strengthening, to enable upright sitting during use of the device D. Adapting the device with larger buttons and controls, to enable independent use
A The simplest and first approach would be to ensure positioning so that the client can see the device and having the neck and shoulder (proximal muscles) stabilized to allow the most distal control. The placement of the device is also important, with a lap tray to secure the device in bed or on the wheelchair. D: Adaptations such as larger buttons and controls may be appropriate if proper positioning alone is insufficient for independent use of the device.
Why should fall prevention strategies be implemented with clients with middle-stage dementia? A. Declines in temporal orientation may cause anxiety and confusion, leading to falls. B. Declines in judgment of distance, direction, and ground surfaces may increase risk of falls. C. Declines in sequencing cause disturbed gait patterns, leading to an increased risk of falls. D. Hallucinations or delusions coupled with overall motor decline may lead to an increased risk of falls.
B A client with middle-stage dementia will have decreased judgment along with decreased performance skills that may lead to falls.
A client with advanced amyotrophic lateral sclerosis (ALS) presents with a stiff forward-flexed neck that is at risk for developing a contracture and impairing social participation. Which intervention would the OTR use to BEST prevent a contracture? A. A physical agent modality such as diathermy or ultrasound B. Caregiver training on gentle neck stretching and how to help don a soft cervical collar C. A home exercise program of isometric neck exercises in all planes D. Education on proper positioning at rest and during functional tasks
B Because of ALS's progressive nature, many of the interventions for clients with ALS focus on patient and caregiver education to address the increasing symptoms and preventing secondary complications such as contractures. Caregiver training on gentle neck stretching and how to help don a soft cervical collar is the most appropriate because using the collar will help maintain the neck in a neutral position, and gentle stretches to the neck will lessen stiffness and discomfort. A: Using a physical agent modality, is more of a remedial approach that is not the most appropriate for someone with a rapidly declining health condition. C: For someone with advanced ALS, isometric exercises would also not be the best choice. D: Education is a key component of intervention; however, if the neck is at risk for developing contracture, it is likely already weakened and will need additional support.
An OTR® is performing caregiver training for a client with Stage 3 Parkinson's disease (PD) and family members because of the client's emerging need for increased assistance with ADLs and mobility. Which instruction would MOST appropriately help family members deal with a freezing episode? A. Educate the family to have the client silently count each step while walking. B. Recommend that the family use a rhythmic beat to each step as they walk with the client. C. Advise the family to place vertical strips on the floor where freezing episodes are likely to occur at home. D. Encourage the family to give the client tactile cues to promote weight shifting to resume walking.
B External cueing and feedback from caregivers is an important strategy to improve safety and in this case reduce freezing episodes. The rhythmic nature of counting out loud or using a beat helps promote smoother movements that are more coordinated. Strips on the floor or carpet where freezing occurs is one intervention approach. The strips should be horizontal. D: A person with Stage 3 PD likely has balance deficits, and forcing weight shifting may increase the client's risk of fall.
A client with early-stage amyotrophic lateral sclerosis (ALS) wants to remain physically active and continue to go to the local gym. Which action would the OTR® take? A. Advise against exercise, which would exacerbate symptoms and accelerate muscle loss; instead, educate the client on fatigue management. B. Recommend modified workouts that consist of endurance and light strengthening with education on how to prevent overexertion. C. Agree that the client would benefit from continued physical exercise at the gym. D. Suggest instead a home exercise program of light calisthenics and stretching.
B In the early stages of ALS, smaller distal muscles are weak, but gross proximal muscles have not yet been affected. ROM exercises, light strengthening, and endurance training are all effective at this point. It is important for the OTR® to advise on precautions such as avoiding overexertion, stopping if a client experiences muscle cramps or spasms, and monitoring fatigue. Moreover, the client states a goal is to continue frequenting the gym, which likely also offers social benefits.
A client has severe intention tremors secondary to multiple sclerosis. Which adaptive strategy would be MOST BENEFICIAL for this client to use when eating? A. Placing plastic eating utensils in a universal cuff B. Stabilizing both arms on a counter or table top C. Using a mobile arm support or suspended sling D. Fastening a 5-lb (2.27-kg) weight on each forearm
B Intention tremors occur during voluntary movement, and providing proximal stabilization may be effective in decreasing the intensity of the tremor with eating. A: A universal cuff is used when grasp ability is diminished and would not be beneficial to decrease tremor. C: Mobile arm supports or slings are used to improve mobility of the upper extremity during activities and would not be beneficial to decrease tremor. D: Use of weighted utensils may lessen tremors, but the added weight of the utensil may contribute to a person's fatigue.
A client was recently diagnosed with multiple sclerosis and has been referred to occupational therapy for evaluation. When assessing the client's occupational performance, which information should the OTR® consider? A. ADL assessments completed on the first visit B. Observations of the client's performance over a period of time C. Results of specific measures, such as the manual muscle test D. Observation of the client's routine early in the morning
B Observing the client over a period of time allows the OT to identify variability in endurance and fatigue a client with MS may experience. Assessments completed on the first visit may not accurately reflect a client's current abilities because of the significant impact of decreasing endurance and increasing fatigue on occupational performance. C: Client skills (e.g., motor and praxis skills, sensory-perceptual skills, emotional regulation, and cognition) provide information about factors that may influence occupational performance. However, assessing client skills does not directly assess occupational performance. D: Variability in endurance and fatigue throughout the day means that a client's performance early in the morning may not provide an accurate picture of the client's functioning.
What is the most important safety recommendation for clients with middle-stage Alzheimer's disease (AD)? A. Do not allow this client to complete ADLs independently because the client might not dress appropriately for the weather. B. Do not leave this client alone because the client might get lost, even in a familiar environment. C. Provide this client with activity to engage the client throughout the day to minimize behavioral disturbances. D. Provide this client with redirection to minimize behavioral outbursts and prevent self-injurious behaviors.
B The most important safety issue would be leaving a client with AD alone, because the client might become lost or confused, even in familiar environments.
A client will initiate dressing at the appropriate time of the day but will not attend to the day, temperature, or season. The client is able to don clothing slowly but has difficulty with fasteners or fails to see errors in the back (i.e., not tucking in the shirt). At what stage of the Allen Cognitive Level Screen is this client? A. 4.4 B. 4.0 C. 3.6 D. 3.2
B The question describes typical dressing behaviors of clients at Mode 4.0; a client would attend to visible sensory cues and ignore what is not in plain sight (e.g., not tucking in the back of the shirt). A: Clients at Mode 4.4 will be able to locate clothing and initiate dressing at a customary time of the day and dress in sequence. Clients may wear the same clothing over and over again because they like it and have worn it before. C: At Mode 3.6, clients must be trained to initiate dressing at the customary time of day. D: At Mode 3.2, clients will need cues to sequence through a dressing routine.
An OTR® is assessing bed mobility with a client with Guillain-Barré syndrome (GBS) 2 weeks into the plateau phase. The patient reports dizziness on performing supine to sit at the edge of the bed and begins to lie back down. What step is MOST appropriate for the OTR to take? A. Encourage the patient to remain upright and allow for the dizziness to subside by performing simple ROM exercises to promote circulation. B. Assist the patient back to bed safely, lower the head of the bed, and monitor vitals, comparing the current blood pressure with the resting blood pressure. C. Assist the patient back to bed slowly, elevate the lower extremities, and immediately search for the nurse to assess the patient. D. Educate the patient on the importance of sitting upright and out of bed to help regulate the nervous system and prevent secondary complications.
B People with GBS are at risk for autonomic nervous system dysfunction such as postural hypotension or experiencing a significant drop in systolic blood pressure on moving from a horizontal to an upright position. Common among people who endure a prolonged time in bed, the change in position causes blood to rush to the lower extremities, resulting in feelings of lightheadedness or dizziness. The best option is to slowly and carefully assist the patient back to supine, monitor blood pressure, position the patient in Trendelenberg (lower the head of the bed and raise the lower extremities), recheck blood pressure, and then alert nursing, leaving the call bell in reach. A: The patient is already attempting to lie down to reduce the dizziness. Trying to prevent this will only increase the patient's anxiety and may result in an unsafe situation. C: It would be inappropriate to leave the room while the patient is experiencing postural hypotension, especially without having first monitored the patient's blood pressure to have information to report to nursing. D: Educating the patient on the importance of sitting upright and out of bed to help regulate the nervous system and prevent secondary complications is a valid intervention component, but it is not the most appropriate choice at this time.
The caregiver of a client with middle-stage dementia requests assistance from the OTR. The caregiver wants to ease the client's morning personal care routine. What is the BEST recommendation related to the bathroom environment that the OTR can provide to the caregiver? A. Paint the bathroom a bright yellow. B. Use labels for hot and cold on the faucets in the bathroom. C. Use low levels of light to reduce eyestrain. D. Keep all bathroom items clearly visible to the client.
B Labeling physical structures with symbols, such as arrows for direction, is helpful to people with dementia. D: Leaving items out and visible might create too much visual clutter, which can increase confusion in people with dementia.
On an inpatient rehabilitation unit, the OTR® and the evaluating physical therapist observe a new patient with Parkinson's disease eating breakfast seated in a bedside chair. The OTR® observes a fork on the floor and milk spilled on the patient's gown and tray. The patient begins coughing, spitting up pieces of pancake, and then says hello with unswallowed food in the mouth. What action would be MOST appropriate for the OTR® to take while evaluating the patient? A. Consult with the patient to propose adaptive feeding equipment to minimize spilling and dropping food. B. Educate the patient on the role of occupational therapy for feeding and speech therapy for swallowing, and make an appropriate referral. C. Collaborate with the patient and the physical therapist to create the optimal seating and positioning of the patient to the tray for proximal stability. D. Discuss with the patient and the nutritionist an immediate need to switch to a mechanical soft diet.
B is the most important immediate action, because a speech therapist is a critical interdisciplinary team member who can evaluate for dysphagia and advise on appropriate diet changes or recommend further testing such as a video swallow. It is appropriate to discuss with the client whether the client wants increased independence with feeding via adaptive techniques or equipment, and providing education on the role of occupational therapy with feeding would help initiate this part of the intervention planning process. A: Adaptive feeding equipment is an important consideration for developing an intervention plan for occupational therapy, but the apparent dysphagia is more urgent and requires immediate attention from the proper team members. C: Addressing proximal stability by enhancing positioning with the bedside chair to the table and tray may help reduce tremors and improve distal stability to manipulate the utensils, but again the dysphagia is a more pressing issue at this time. D: Changing a patient's diet is outside the scope of occupational therapy practice.
A client with dementia quits bathing routines before completing them and has difficulty measuring shampoo and lotion. The areas of the body that are usually washed are more distal (hands, arms). The client might attempt to wash the back, but not consistently. At what stage is this client, according to the Allen Cognitive Level Screen? A. 4.0 B. 3.8 C. 3.6 D. 3.4
C At Level 3.6, the client will be able to wash most distal portions of the body and those that are easily seen but will not always follow the sequence thoroughly. The client may quit before completion and may have difficulty with measuring soaps, lotions, and deodorant. A, B: At Levels 4.0 and 3.8, the client will typically recognize the need for a bath and will bathe thoroughly as long as no major problems develop during the bathing process (i.e., lack of soap). D: At Level 3.4, the client will typically wash only areas easily seen and reached. The client may wash one area repetitively and may forget to rinse or dry off.
What is an effective strategy to improve the ability of a client with dementia to find the client's bedroom in a long-term care facility? A. A unique symbol that is familiar to the client B. The client and the client's family in a recent photo C. A picture of the client labeled with the client's name D. A symbol in the client's favorite color
C Displaying a photograph would be the best option because the other options would rely on the client's memory.
An OTR in home health care is seeing a client who has Stage III Alzheimer's disease. The client lives with an adult daughter and likes to wander around the house and has fallen twice in the middle of the night. The house is a single-level home with both front and back entrances. It has five steps at the back door leading to the garage, with railings on both sides, and has no step at the front entrance. The client's daughter is determined to have the client remain at home with her as long as possible. The daughter has expressed fear that the client might fall down the stairs at the back door while wandering. To prevent the client from using the back door, what would the OTR MOST likely recommend? A. Painting a big "STOP" sign on the back door B. Painting the door yellow to contrast with the environment C. Using a poster to camouflage the back door and the door knob D. Installing a motion-detecting light at the stairs to the garage
C Evidence has shown that camouflaging a door and its doorknob can decrease way-finding behavior when an client with Alzheimer's disease wanders. A: A big "STOP" sign requires that the client be able to recognize and understand it. This ability will not be preserved in a client with Stage III Alzheimer's disease; therefore, this option will not be useful in deterring the client from using the back door.
What is an effective strategy to facilitate maximal independence in self-feeding with a client who has middle- to late-stage dementia? A. Change the client's diet to foods that are palatable and easy to chew. B. Change the consistency of foods to allow for easier chewing and swallowing. C. Provide hand-over-hand guidance for food retrieval and utensil-to-mouth motions. D. Provide constant verbal cues throughout feeding to improve attention to the self-feeding task.
C Hand-over-hand guidance is an effective strategy to encourage maximal independence through participation in daily living tasks, including self-feeding. A, B: Changing the diet and changing the consistency of foods might encourage the client to eat more but will not specifically address maximal independence in self-feeding. D: Although structured prompting is effective in assisting clients with dementia, continual verbal cues might be overwhelming.
A client with middle-stage dementia has maintained the ability to complete repetitive tasks common in middle adulthood. For example, if given a basket of socks, the client will reflexively fold them until the task is complete. Given this information, what recommendation would be appropriate for the OTR® to give caregivers? A. Provide challenge to the client by placing the laundry basket at various heights to improve trunk stability and balance. B. Provide challenge to the client by putting various types of clothing into the laundry basket, which will aid in maintaining this skill. C. Provide the client with a basket of socks at a set time each day, determined by the client's arousal level, to give structure to the client's day. D. Provide the caregivers with information about how they can use a basket of socks to decrease agitation in the client.
C Interventions to control the daily structure of a person with dementia have been documented to provide balance between the times the person is in high arousal versus low arousal. A, B: Providing too much challenge to a client with dementia might increase agitation; providing structure to the client's day is the best option to decrease agitation and promote better balance. D: Engaging a client in a task once the client is agitated might be difficult; providing structure to the client's day is the best option to decrease overall agitation and promote better balance.
A client with multiple sclerosis (MS) experiences ataxic movements when performing fine motor self-care tasks. During treatment addressing oral hygiene, what might the OTR FIRST do? A. Instruct the client in weighted adaptive equipment to reduce tremors B. Have the client trial a static wrist splint to reduce the number of joints needed to stabilize and perform motor tasks C. Position the client's trunk and upper extremities to provide proximal support for the shoulders and elbows D. Massage the client's trigger points to release muscular tension
C Proximal support of the trunk, shoulder, and elbow may help increase distal control of the hands and fingers. This client may be positioned to lean against a table and prop the elbows on it, which may provide enough support to allow for improved control of the hands while performing oral hygiene.
An OTR is working with a client with Alzheimer's disease (AD) in a skilled nursing facility. The client's adult child, who is the client's primary caregiver, appears to be stressed and fatigued and has asked the OTR for advice about how to best manage the parent's progressive decline in function. What would be the BEST approach the OTR could use? A. Refer the caregiver to a physician for treatment. IncorrectB. Refer the caregiver to the social worker for community resources. C. Provide the caregiver with education about the progression of AD. D. Suggest that the caregiver use the massage services at the facility.
C The most appropriate approach for an OTR when dealing with caregivers of clients with AD is to provide education about the progression of AD along with strategies to improve the caregiver's self-efficacy in caring for the client.
An OTR has completed the Allen Diagnostic Module with a client who has a mental illness. Evaluation results indicate the client is functioning at a 4.6 level (Goal-Directed Actions). Based on this information, which strategy should the OTR use to MOST EFFECTIVELY promote the client's success during a grooming task? IncorrectA. Demonstrate and ask the client to imitate the OTR's movements. B. Guide the client through the physical movements of the task. C. Lay out the items needed for the task prior to the start of the session. D. Use verbal praise during each task to encourage on-task behavior.
C Visual field becomes significant at Level 4 and keeping items in plain view and minimizing clutter of the environment will facilitate a client's performance of self-care tasks. A: Imitation of manual actions that are demonstrated by the practitioner occurs at Level 3; this client is functioning at a higher level than that, so this would not be an effective strategy. B: Guiding the client through the physical actions of an activity is required at Level 2, and this client is functioning at a higher level than that so this would not be an effective strategy. D: At Level 5, clients become more aware of social and physical consequences of their action, and verbal praise may become more useful as a strategy. This client functioning at Level 4 will not be receptive to verbal praise.
At what stage of Alzheimer's disease (AD) will procedural memory impairments FIRST be noticed? A. Mild cognitive impairment B. Early stage C. Middle stage D. Late stage
C During the middle stage, all memory worsens, including procedural memory
A client with early-stage Huntington's disease is displaying excessive voluntary movements. The client prefers to bathe in the shower. What recommendation would be appropriate to improve the client's ability to bathe as independently as possible? A. The client should sponge bathe. B. The client should receive an assist from the home health aide. C. The client should use safety bars and a tub bench. D. The client should use soap on a rope.
C Safety bars and a tub bench will allow increased safety and independence in the shower. A, B: Suggesting that the client sponge bathe or receive an assist from the home health aide does not address the client's independence in the client's preferred method of bathing. D: Soap on a rope could be helpful, but it would not be the OTR®'s primary recommendation; grab bars and a tub bench would be more important for safety. In addition, once a tub bench is installed, the client might find that symptoms are minimized, because good posture and a supportive seating surface are recommended to reduce symptoms of HD.
A client with Huntington's disease presents with decreased motor planning. What is the most effective intervention for an OTR to implement with this cognitive impairment? A. Provide alternative suggestions for safe mobility, including use of a wheelchair for community mobility. B. Provide the client with strategies to self-assess performance on tasks. C. Suggest that the client reduce participation in tasks that are difficult. D. Have the client imagine performing the task in a smooth, coordinated manner.
D Mental imagery is an effective strategy to improve motor abilities for clients with decreased motor planning.
Which behavioral symptom might a client with early-stage dementia have? A. Pacing B. Difficulty choosing appropriate clothing C. Vulgar or rude language D. Suspicion
D A client with early-stage dementia might become suspicious; it is common for clients to think misplaced items have been stolen or that their spouse may be unfaithful. A, B, C: Pacing, difficulty choosing appropriate clothing, and vulgar or rude language are all common behavioral symptoms of middle-stage dementia related to loss of impulse control and difficulty communicating needs.
A client presents with decreased memory resulting from dementia. What is the MOST EFFECTIVE strategy for an OTR to implement to intervene with this cognitive impairment? A. Chunking or grouping similar items together B. Repeating information over and over again to oneself C. Rhymes to recall information D. Cue cards or signs in key places
D Adaptations, as opposed to targeted interventions, are the most effective strategy for decreased memory in clients with dementia. A, B, C: Chunking, repeating information, and rhymes are effective strategies for clients whose memory loss is not progressive in nature.
A client with a diagnosis of dementia has memory loss. The OTR® observes that the client has visual hallucinations. In addition, the client has decreased spontaneous motor movements and rigidity. What type of dementia does this client MOST LIKELY have? A. Frontotemporal dementia B. Alzheimer's disease C. Vascular dementia D. Dementia with Lewy bodies
D Distinguishing features of dementia with Lewy bodies are visual hallucinations and Parkinson-like motor symptoms.
An OTR® is speaking to a group of nurse aides employed in a skilled nursing facility regarding dressing of residents who have Stage III Alzheimer's disease. What should the OTR® tell the aides about the expected level of dressing performance for these residents? A. Environmental aids should be used to assist the residents with completing dressing tasks. B. One-step commands are needed to start dressing and every few minutes thereafter until the task is complete. C. Total assistance is required for the residents to complete all dressing activities. D. Verbal cueing and physical assistance are needed throughout the dressing task.
D In Stage III of Alzheimer's disease, an individual requires frequent physical and verbal assistance throughout ADLs as memory and physical status continue to decline. A: Environmental aids at Stage III are used to compensate for deficits in perception related to safety with mobility. An individual with Stage III Alzheimer's disease would require the physical and verbal assistance of another person to complete ADLs. B: One-step commands are not needed until Stage IV of Alzheimer's disease. C: Total assistance is not needed generally until the end of Stage IV of Alzheimer's disease.