A home care nurse is speaking with the adult child of a client who has Alzheimer’s disease and is having difficulty managing their parent’s wandering behavior at night. The nurse should instruct the client’s child to take which of the following actions?

Choice A reason: Installing locks at the tops of doors is the safest and most appropriate intervention for managing wandering in a client with Alzheimer’s disease. Wandering is a common behavioral symptom of dementia, and environmental modifications are considered first-line strategies. Placing locks out of the client’s line of sight and reach reduces the likelihood of nighttime wandering while maintaining dignity and safety. This intervention prevents accidents such as falls, exposure to outdoor hazards, or becoming lost, without resorting to restraints or unnecessary medications. It is consistent with evidence-based practice and promotes a safe home environment. Choice B reason: Restraining the client at bedtime is not appropriate and is considered unsafe and unethical. Physical restraints increase the risk of injury, agitation, and psychological distress. They can lead to complications such as pressure injuries, decreased mobility, and worsening confusion. Restraints are only used in extreme circumstances when all other interventions have failed and the client poses an immediate danger to themselves or others. In this scenario, wandering can be managed with safer alternatives, making restraints inappropriate. Choice C reason: Administering phenobarbital 120 mg at bedtime is not recommended for managing wandering in Alzheimer’s disease. Phenobarbital is a barbiturate with sedative properties, but it carries significant risks including respiratory depression, dependence, and cognitive impairment. It is not a standard treatment for dementia-related behaviors and would expose the client to unnecessary pharmacological risks. Medication management for Alzheimer’s focuses on cognitive enhancers or antipsychotics when indicated, not sedatives for wandering. Choice D reason: Encouraging physical activity in the evening is not appropriate because it can increase restlessness and agitation, worsening nighttime wandering. Clients with Alzheimer’s benefit from structured activity earlier in the day, which promotes better sleep at night. Evening activity may overstimulate the client, disrupt circadian rhythms, and contribute to sleep disturbances. Therefore, this intervention would likely exacerbate the problem rather than resolve it.