ACC Managing Behavioral Symptoms 3 — Questions and Answers
Question 1: Which communication strategy is MOST helpful when a person with Alzheimer's is experiencing paranoia?
- Confronting the false belief with logical evidence
- Using a calm tone and avoiding arguing about reality (Correct answer)
- Involving other residents to reassure the person
- Increasing medication doses immediately
Correct answer: Using a calm tone and avoiding arguing about reality
A calm, non-confrontational tone reduces anxiety and avoids escalating paranoid episodes, as arguing rarely resolves delusional thinking.
Question 2: The goal of validation therapy in dementia care is to:
- Confirm factual accuracy of a person's statements
- Acknowledge and respect the person's feelings and reality (Correct answer)
- Validate caregiver decisions to family members
- Use positive reinforcement to shape behavior
Correct answer: Acknowledge and respect the person's feelings and reality
Validation therapy acknowledges the person's emotional reality and feelings rather than correcting factual errors, reducing distress.
Question 3: A person with Alzheimer's frequently removes their clothing in common areas. The MOST appropriate initial response is to:
- Apply physical restraints to prevent undressing
- Document the behavior and notify family immediately
- Assess for physical discomfort such as heat, pain, or ill-fitting clothing (Correct answer)
- Move the person to a locked room
Correct answer: Assess for physical discomfort such as heat, pain, or ill-fitting clothing
Inappropriate undressing often has a physical trigger such as discomfort, overheating, or poorly fitting garments that should be assessed first.
Question 4: Which activity is MOST likely to reduce agitation in a person with late-stage Alzheimer's disease?
- A competitive board game to stimulate cognition
- Gentle sensory stimulation such as hand massage or soft music (Correct answer)
- A group discussion about current events
- A written journaling exercise
Correct answer: Gentle sensory stimulation such as hand massage or soft music
In late-stage Alzheimer's, sensory-based activities like gentle touch or familiar music provide comfort without requiring cognitive engagement.
Question 5: Which statement about using antipsychotic medications for behavioral symptoms in Alzheimer's is ACCURATE?
- They are the first-line treatment recommended by all dementia guidelines
- They carry a black-box warning for increased mortality in elderly dementia patients (Correct answer)
- They have no side effects in older adults with dementia
- They cure the underlying cause of behavioral symptoms
Correct answer: They carry a black-box warning for increased mortality in elderly dementia patients
Antipsychotics carry an FDA black-box warning for increased risk of death in elderly patients with dementia and should be used only when non-pharmacological approaches fail.
Question 6: A person with Alzheimer's becomes upset when their daily routine is disrupted. The BEST strategy is to:
- Explain why the change was necessary using detailed reasoning
- Minimize routine disruptions and provide advance, simple notice when changes occur (Correct answer)
- Allow the person to dictate all care scheduling
- Avoid all changes indefinitely
Correct answer: Minimize routine disruptions and provide advance, simple notice when changes occur
Consistent routines reduce anxiety in Alzheimer's; when changes are unavoidable, simple, calm advance notice helps ease the transition.
Question 7: Rummaging and hoarding behaviors in Alzheimer's are BEST managed by:
- Locking all drawers and storage areas
- Providing a designated safe area with meaningful objects for sorting (Correct answer)
- Removing all personal belongings from the person's room
- Increasing supervision to stop the behavior immediately
Correct answer: Providing a designated safe area with meaningful objects for sorting
Providing a safe, designated rummaging area channels the behavior constructively, reducing risk while honoring the person's need to explore.
ACC Managing Behavioral Symptoms 3
Which communication strategy is MOST helpful when a person with Alzheimer's is experiencing paranoia?