CDP Communication Strategies 3 — Questions and Answers
Question 1: A resident with late-stage dementia no longer produces intelligible speech. Which approach remains meaningful?
- Limit interactions since verbal communication is impossible
- Maintain nonverbal presence through gentle touch, eye contact, and facial expression (Correct answer)
- Speak only to the family about care needs from this point forward
- Use written cards as the sole communication method
Correct answer: Maintain nonverbal presence through gentle touch, eye contact, and facial expression
Nonverbal presence — touch, facial expression, eye contact — conveys connection and safety even when verbal exchange is no longer possible.
Question 2: When someone with dementia exhibits sundowning with increased confusion in the late afternoon, the BEST communication strategy is:
- Introduce complex orienting information to reground them in reality
- Simplify interactions, use a calm routine, and reduce environmental stimulation (Correct answer)
- Increase social activity to distract from the confusional state
- Administer PRN sedation before attempting communication
Correct answer: Simplify interactions, use a calm routine, and reduce environmental stimulation
Simplified interactions and reduced stimulation align with the person's reduced capacity during sundowning periods.
Question 3: The primary reason to avoid using 'elderspeak' (baby talk, sing-song tone, collective 'we') with dementia patients is that it:
- Is too difficult for people with dementia to understand
- Conveys disrespect, reduces self-esteem, and can increase resistiveness (Correct answer)
- Slows the pace of care delivery unnecessarily
- Violates HIPAA communication standards
Correct answer: Conveys disrespect, reduces self-esteem, and can increase resistiveness
Elderspeak communicates low regard for the person and has been linked to increased behavioral symptoms and reduced cooperation.
Question 4: A person with dementia repeats the same story multiple times. The most therapeutic response is to:
- Inform them they already told you to interrupt the pattern
- Listen with the same interest each time and respond to the emotional theme (Correct answer)
- Change the subject immediately to prevent reinforcement
- Record the repetition frequency and report it as a behavioral symptom
Correct answer: Listen with the same interest each time and respond to the emotional theme
Responding with consistent interest honors the emotional need the story represents, even when the narrative repeats.
Question 5: Which of the following best describes 'chaining' as a communication technique in dementia care?
- Linking tasks together in a list for the person to complete independently
- Breaking a task into small steps and verbally cueing one step at a time (Correct answer)
- Connecting environmental cues to behavioral responses through conditioning
- Pairing communication with physical restraints to ensure compliance
Correct answer: Breaking a task into small steps and verbally cueing one step at a time
Chaining breaks tasks into sequential one-step cues, reducing cognitive load and supporting procedural memory.
Question 6: To communicate effectively with a person who has visuospatial deficits from dementia, caregivers should:
- Stand behind the person to avoid startling them when speaking
- Approach from the front and within the person's central visual field (Correct answer)
- Use gestures and pointing exclusively instead of verbal cues
- Avoid using objects as visual cues since they may cause confusion
Correct answer: Approach from the front and within the person's central visual field
Approaching within the central visual field compensates for peripheral and depth-perception deficits common in Alzheimer's disease.
Question 7: When a dementia patient refuses personal care and becomes combative, the communication strategy of 'bridging' involves:
- Using physical assistance to bridge the gap between refusal and compliance
- Connecting the care task to a familiar positive memory or routine to gain acceptance (Correct answer)
- Bridging two caregivers to split the care task for efficiency
- Documenting the refusal and deferring care to a later shift
Correct answer: Connecting the care task to a familiar positive memory or routine to gain acceptance
Bridging links the care activity to a positive memory or familiar context, making it meaningful and less threatening to the person.
CDP Communication Strategies 3
A resident with late-stage dementia no longer produces intelligible speech.
Which approach remains meaningful?