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.)

Choice A reason: Placing the client in a reclining chair is not a recommended safety intervention for clients with Alzheimer's disease who wander. This approach may restrict movement temporarily but does not prevent wandering or falls. It may also increase agitation or lead to pressure injuries due to immobility. The goal is to promote safety while preserving dignity and autonomy, not to restrain. Choice B reason: Encouraging physical activity prior to bedtime may inadvertently increase stimulation and disrupt sleep patterns. For clients with Alzheimer's disease, overstimulation in the evening can worsen sundowning symptoms, leading to increased confusion and agitation. Instead, calming routines and a structured environment are preferred before bedtime. Choice C reason: Installing sensor devices on outside doors is a proactive safety measure. These devices alert caregivers when the client attempts to exit, helping prevent wandering outside the home, which poses significant risks such as exposure, injury, or getting lost. This intervention supports supervision without physical restraint. Choice D reason: Putting locks at the top of doors is effective because clients with Alzheimer's may not notice or be able to reach them. This reduces the likelihood of the client opening doors and wandering unsupervised. It’s a discreet and non-invasive way to enhance environmental safety. Choice E reason: Positioning the mattress on the floor minimizes the risk of injury from falls. Clients who wander or are confused may fall out of bed, and lowering the sleeping surface reduces the impact. This intervention is especially useful when bed rails are contraindicated due to entrapment risks.