A nurse is providing teaching to the caregiver of an older adult client who has Alzheimer's disease and is being cared for at home. The client wanders at night and has a history of previous falls. Which of the following instructions should the nurse include in the teaching? (Select all that apply)

Introduction: Alzheimer's disease causes progressive neurodegeneration, leading to cognitive impairments that include disorientation and wandering. Home safety for these clients focuses on environmental modification to prevent falls and unauthorized egress, ensuring a secure perimeter while minimizing physical hazards that could lead to injury during nocturnal activity. A. Placing locks at the top of doors is an effective safety measure because clients with Alzheimer's disease often lose the ability to look up or scan their entire environment. They are less likely to notice or be able to operate a lock placed outside of their normal line of sight, preventing unsafe wandering outside. B. Encouraging physical activity right before bedtime is contraindicated as it can overstimulate the client and worsen "sundowning" behaviors or insomnia. To promote better sleep and reduce nighttime wandering, physical activity should occur earlier in the day, followed by a calm, structured routine in the evening hours. C. Placing a client in a reclining chair for sleep is not a recommended safety intervention for wandering or falls. Recliners can be unstable, and the client may still attempt to get up, increasing the risk of a fall from a higher or awkward position. It does not address the underlying issue of wandering safely. D. Positioning the mattress on the floor is a recognized fall-prevention strategy for clients who are prone to wandering or falling out of bed. By removing the height of a traditional bed frame, the risk of injury from a fall is significantly reduced, providing a safer environment for the client at night. E. Installing sensor devices on outside doors is a critical safety intervention. These devices alert the caregiver immediately if the client attempts to leave the home, allowing for a rapid response to prevent the client from becoming lost, exposed to the elements, or involved in an accident outdoors.