CNA Care for Residents with Cognitive Impairment — Questions and Answers
Question 1: A resident with Alzheimer's disease becomes agitated when the CNA tries to help with bathing. What is the most appropriate response?
- Restrain the resident so the bath can be completed quickly
- Stop, calmly reassure the resident, and try again later or use a different approach (Correct answer)
- Skip the bath to avoid upsetting the resident further
- Administer extra medication to calm the resident
Correct answer: Stop, calmly reassure the resident, and try again later or use a different approach
When a cognitively impaired resident becomes agitated, the CNA should stop, use a calm and reassuring tone, and try again later or modify the approach. Forcing care escalates distress and is never appropriate.
Question 2: Which communication technique is most effective when speaking with a resident who has moderate dementia?
- Use complex, detailed explanations to keep the resident engaged
- Speak in short, simple sentences and use a calm, gentle tone (Correct answer)
- Correct the resident every time they say something inaccurate
- Speak loudly and quickly to maintain their attention
Correct answer: Speak in short, simple sentences and use a calm, gentle tone
Short, simple sentences with a calm tone are most effective for residents with dementia. Avoid complex language, arguing about facts, or raising your voice, as these approaches increase confusion and agitation.
Question 3: A resident with dementia says they need to go to work and tries to leave the facility. This is an example of:
- Sundowning
- Elopement behavior (Correct answer)
- Confabulation
- Delirium
Correct answer: Elopement behavior
Elopement behavior occurs when a cognitively impaired resident attempts to leave the facility, often acting on beliefs from their past (such as needing to go to work). This is a serious safety concern that must be reported.
Question 4: What is 'sundowning' in residents with dementia?
- A tendency to sleep most of the day
- Increased confusion, agitation, or behavioral changes that occur in the late afternoon or evening (Correct answer)
- A side effect of pain medication
- Improved mood and alertness in the evening hours
Correct answer: Increased confusion, agitation, or behavioral changes that occur in the late afternoon or evening
Sundowning refers to increased confusion, restlessness, agitation, or wandering that occurs in the late afternoon or evening in people with dementia. Structured routines and calm environments can help manage it.
Question 5: When orienting a resident with mild dementia, which approach is most therapeutic?
- Confronting and correcting all confused statements forcefully
- Ignoring confused statements entirely
- Using reality orientation gently by providing time, place, and person cues in a non-confrontational way (Correct answer)
- Telling the resident whatever they want to hear to avoid conflict
Correct answer: Using reality orientation gently by providing time, place, and person cues in a non-confrontational way
Gentle reality orientation involves providing calm, factual cues about time, place, and person. It should be non-confrontational and supportive — not argumentative. The goal is to reduce confusion without causing distress.
Question 6: Which of the following is an early sign of Alzheimer's disease that a CNA might observe in a resident?
- Sudden paralysis on one side of the body
- Gradual memory loss, especially for recent events (Correct answer)
- Rapid improvement in memory and orientation
- High fever and confusion lasting one day
Correct answer: Gradual memory loss, especially for recent events
Early Alzheimer's disease is characterized by gradual, progressive memory loss — particularly for recent events. Residents may repeat questions, forget names, or lose track of daily activities. Sudden changes suggest a different cause.
CNA Care for Residents with Cognitive Impairment
A resident with Alzheimer's disease becomes agitated when the CNA tries to help with bathing.
What is the most appropriate response?