A nurse is caring for a patient with middle stage Alzheimer's disease. Which of the following actions by the nurse may benefit the patient?

Choice D rationale Middle-stage Alzheimer's disease is characterized by increasing confusion, memory loss, and disorientation. Keeping familiar personal items at the bedside, such as family photographs or a favorite blanket, provides a sense of security and helps orient the patient to their identity. These "anchors" can reduce anxiety and "sundowning" behaviors by making the environment feel less clinical and more recognizable. This approach supports the patient's emotional well-being and helps maintain a connection to their past. Choice A rationale While providing activities is generally good, complex puzzles may be frustrating for a patient in the middle stage of Alzheimer's. At this stage, cognitive deficits often impair problem-solving skills and fine motor coordination. If a task is too difficult, it can lead to agitation and a sense of failure. The nurse should instead suggest simpler, failure-free activities that focus on sensory engagement or repetitive motions rather than complex cognitive challenges that require high levels of concentration. Choice B rationale Keeping lights on at all times is counterproductive and can disrupt the patient's circadian rhythm. Sleep-wake cycle disturbances are common in Alzheimer's patients, and constant light can lead to sleep deprivation and increased delirium. The environment should be bright during the day to encourage alertness and dimmed at night to signal that it is time for rest. Maintaining a natural light cycle is essential for reducing confusion and managing the behavioral symptoms of the disease. Choice C rationale Increasing the volume on the television can create an environment of sensory overload. Patients with Alzheimer's often have difficulty processing multiple or loud stimuli, which can lead to agitation, fear, or "noise-induced" confusion. A calm, quiet environment is generally preferred to minimize triggers for behavioral outbursts. The nurse should ensure that noise levels are kept at a comfortable, low level to promote a soothing atmosphere and help the patient remain calm and focused.