CDP Behavioral Symptom Management 2 — Questions and Answers
Question 1: A person with dementia repeatedly asks to 'go home' even while at home. Which response reflects best practice?
- Remind them firmly they are already home
- Explore the feeling behind the request and offer comfort (Correct answer)
- Redirect them to a different room to change their focus
- Explain their memory problem to help them understand
Correct answer: Explore the feeling behind the request and offer comfort
The 'go home' request often reflects an emotional need for safety or familiarity, so exploring feelings and providing comfort is more therapeutic than correcting or redirecting.
Question 2: Which environmental modification most directly reduces sundowning behaviors in dementia care settings?
- Increasing fluorescent overhead lighting after 3 PM
- Maintaining consistent bright natural or full-spectrum lighting throughout the day (Correct answer)
- Eliminating all afternoon activities to conserve energy
- Playing fast-tempo music in the evening hours
Correct answer: Maintaining consistent bright natural or full-spectrum lighting throughout the day
Consistent bright light exposure during daytime hours helps regulate the circadian rhythm, reducing the agitation and confusion associated with sundowning.
Question 3: A resident with moderate Alzheimer's disease becomes aggressive during morning care. The FIRST step the care team should take is to:
- Administer a PRN anxiolytic before each morning care session
- Conduct an ABC (Antecedent-Behavior-Consequence) analysis (Correct answer)
- Assign a different caregiver and document the incident
- Shorten the care routine to limit exposure time
Correct answer: Conduct an ABC (Antecedent-Behavior-Consequence) analysis
An ABC analysis identifies triggers and consequences of the behavior, forming the evidence base for any individualized non-pharmacological intervention plan.
Question 4: Which of the following best describes 'catastrophic reaction' in dementia?
- A slow, progressive worsening of agitation over several days
- A sudden, disproportionate emotional outburst in response to a minor stressor (Correct answer)
- A planned behavioral response to caregiver refusal
- Persistent crying that lasts more than two hours
Correct answer: A sudden, disproportionate emotional outburst in response to a minor stressor
A catastrophic reaction is a sudden, intense emotional or behavioral response triggered by an overwhelming stimulus or demand that exceeds the person's reduced coping capacity.
Question 5: When using validation therapy with a person who insists their deceased spouse is coming to dinner, the caregiver should:
- Gently correct the misperception with factual information
- Enter the person's reality and respond to the underlying emotion (Correct answer)
- Change the subject immediately to avoid reinforcing the belief
- Provide a calendar showing the current date
Correct answer: Enter the person's reality and respond to the underlying emotion
Validation therapy involves accepting the person's perceived reality and addressing the emotions expressed rather than correcting the content of their belief.
Question 6: A person with dementia hoards food in their room. The care team's MOST appropriate initial intervention is to:
- Lock the dining room to prevent access to extra food
- Assess for underlying causes such as past food insecurity or hunger (Correct answer)
- Remove hoarded items daily without explanation
- Inform family and discontinue snack privileges
Correct answer: Assess for underlying causes such as past food insecurity or hunger
Hoarding often reflects unmet needs such as hunger, anxiety, or past experiences; assessing the underlying cause guides an individualized, respectful intervention.
Question 7: Which nonpharmacological intervention has the strongest evidence for reducing physical aggression during personal care in dementia?
- Restraint use to prevent injury during care
- Person-centered, individualized care approaches with preferred music (Correct answer)
- Strict scheduling with no variation in routine
- Limiting personal care to once weekly to reduce triggers
Correct answer: Person-centered, individualized care approaches with preferred music
Person-centered care combined with preferred music and individualized approaches has robust evidence for reducing aggression by decreasing anxiety and increasing cooperation.
CDP Behavioral Symptom Management 2
A person with dementia repeatedly asks to 'go home' even while at home.
Which response reflects best practice?