A client with advanced Alzheimer's disease keeps searching the unit for her mother who died many years ago. How should the nurse respond?
Explanation & Rationale
Choice A reason: Redirecting to an activity uses distraction to reduce agitation in Alzheimer’s, where hippocampal and cortical degeneration causes disorientation and memory loss. Engaging in familiar activities leverages preserved procedural memory, calming the client without confronting their delusion, which aligns with neurobiological strategies to manage confusion and distress. Choice B reason: Stating the mother died confronts the client’s delusion, likely increasing agitation due to impaired reality testing from Alzheimer’s-related cortical damage. This approach disregards the client’s cognitive limitations, as memory deficits prevent processing such corrections, potentially worsening emotional distress and behavioral symptoms. Choice C reason: Asking why the client seeks her mother probes a delusion rooted in Alzheimer’s-related memory loss and hippocampal dysfunction. This may confuse or frustrate the client, as they cannot articulate reasons due to cognitive impairment. Redirection is more effective than exploring motives in advanced dementia. Choice D reason: Assuming upset and addressing emotional distress may escalate agitation, as Alzheimer’s impairs emotional regulation due to amygdala and prefrontal cortex damage. While empathetic, this response risks focusing on the delusion, which the client cannot process, making redirection to an activity a more effective, neurobiologically informed approach.