Care of Cognitively Impaired Residents Flashcards

A good way to reduce confusion or agitation for residents with dementia is

Answer: follow a familiar schedule every day.

A consistent and predictable daily schedule provides structure and reduces anxiety for residents with dementia. Familiar routines help them anticipate events, minimize confusion, and create a sense of security, which can significantly reduce agitation and promote a calmer environment.

A nurse aide finds a resident looking in the refrigerator at the nurses’ station at 5 a.m. The resident, who is confused, explains that he needs breakfast before he leaves for work. The best response by the nurse aide is to __________.

Answer: ask the resident about his job and if he is hungry

When a confused resident expresses a desire related to their past life, such as going to work, it's best to validate their feelings and gently redirect them. Asking about their job and if they are hungry acknowledges their current state of mind and opens an opportunity to address an immediate need (hunger) in a compassionate way, rather than confronting their confusion directly.

When you approach a resident with dementia, how should you behave?

Answer: With a relaxed and cheerful manner.

Approaching a resident with dementia in a relaxed and cheerful manner helps create a calm and positive environment. This demeanor can reduce anxiety and confusion in the resident, making them more receptive to care and interaction. A positive attitude fosters trust and cooperation, which is essential when caring for individuals with cognitive impairments.

When preparing to give peri-care to an incontinent female resident with dementia, the CNA knows

Answer: all of the above

When providing peri-care to a resident with dementia, it's crucial to anticipate a range of reactions due to their confusion, fear, or perceived invasion of privacy. They may become combative, tearful from embarrassment, or feel sexually assaulted if they don't understand the procedure. Therefore, CNAs must be prepared for any of these responses and approach care with sensitivity and caution.

If a resident's behavior becomes combative, the nurse aide should

Answer: Communicate calmly while stepping out of the way.

If a resident becomes combative, the nurse aide's priority is safety for both the resident and themselves. Communicating calmly can help de-escalate the situation, while stepping out of the way prevents injury and gives the resident space. This approach avoids confrontation, which can worsen combative behavior, and allows the CNA to assess the situation safely before seeking further assistance.

A 90 year-old resident tells you that his mother is coming to visit on Sunday. What is your most appropriate response?

Answer: "Are you wishing you could see your mother?"

When a resident with dementia expresses a belief not rooted in reality, like their deceased mother visiting, it's important to validate their feelings rather than correct them. Asking 'Are you wishing you could see your mother?' acknowledges their emotional need and allows them to express feelings of longing or sadness. This therapeutic communication technique, known as validation therapy, avoids causing distress or confusion by directly contradicting their reality.

Which of the following can be a cause of intellectual disability?

Answer: All of the above

Intellectual disability can stem from a variety of factors, including genetic conditions like Down syndrome, complications during birth such as oxygen deprivation, and severe childhood illnesses like meningitis or lead poisoning. These diverse causes highlight that intellectual disability is not a single condition but rather a broad term encompassing various etiologies that affect brain development and function. Therefore, all listed options are potential causes.

If a resident becomes confused, you should

Answer: Help the resident recognize familiar items.

When a resident becomes confused, helping them recognize familiar items can provide comfort and reorientation. This technique, known as reality orientation, uses tangible cues to ground the resident in their environment and reduce anxiety. It's a gentle way to bring them back to the present without causing distress, unlike restraints or isolation which can worsen confusion and agitation.

Reality orientation therapy should include

Answer: Addressing the resident by their proper name

Reality orientation therapy aims to help residents stay connected to their current environment and identity. Addressing a resident by their proper name reinforces their personal identity and shows respect, which is a fundamental aspect of this therapy. It helps to ground them in reality and reduces confusion, unlike using informal names or creating imaginative stories that can further disorient them.

What of the following can lead to intellectual disability?

Answer: All of the above

Intellectual disability can result from a range of factors that impact brain development. Birth complications, such as prematurity or oxygen deprivation, can cause brain damage. Genetic conditions like Down syndrome directly affect cognitive development. Additionally, severe childhood illnesses, including infections or injuries, can lead to intellectual impairments. Therefore, all the listed options are recognized causes.

A client always wants to wear her favorite clothes when getting dressed. What makes a good solution?

Answer: Ask the family to get several identical outfits.

Residents with dementia often find comfort and security in routines and familiar items, like a favorite outfit. Rather than forcing them to change or hiding their clothes, asking the family to provide several identical outfits allows the resident to maintain their preference while ensuring hygiene and variety. This approach respects their autonomy and reduces potential agitation or distress associated with change.

A resident has trouble recalling the date and their location. How best can you assist the resident?

Answer: Tell the resident often what day it is and where the resident is.

For residents experiencing memory loss or confusion about time and place, consistent and gentle reorientation is beneficial. Regularly stating the date and location helps reinforce reality and can reduce anxiety. This approach provides clear, factual information without overwhelming the resident, supporting their cognitive function and sense of security.

The main cause of a resident's belligerent behavior is

Answer: confusion

Belligerent behavior in residents, especially those with dementia, is most often a manifestation of confusion, fear, or an inability to communicate their needs. They may be disoriented, misinterpret their environment, or feel threatened, leading to aggressive outbursts. Attributing such behavior to stubbornness or resentment overlooks the underlying cognitive impairment and can lead to inappropriate responses.

What crucial information must the nurse's assistant know if a resident exhibits paranoid behavior?

Answer: Delusions are a normal part of the progression of the dementia process.

It is crucial for a nurse's assistant to understand that delusions and paranoid behaviors are common symptoms in the progression of the dementia process. These are not intentional acts but rather a result of brain changes affecting perception and cognition. Recognizing this helps the CNA respond with empathy and appropriate de-escalation techniques, rather than trying to reason with the resident or dismiss their feelings.

You learn from a 90-year-old resident that his mother will be dropping by on Sunday. What is the best course of action?

Answer: "Are you wishing you could see your mother?"

When a resident with dementia expresses a belief not based in reality, such as their deceased mother visiting, the best approach is to validate their feelings rather than correct them. Asking 'Are you wishing you could see your mother?' acknowledges their emotional state and allows them to express their longing or sadness without being contradicted. This therapeutic communication technique, known as validation therapy, helps maintain trust and reduces distress.

Which of the following statements about dementia is FALSE?

Answer: People with dementia act uncooperative in order to be spiteful.

The statement that people with dementia act uncooperative to be spiteful is false. Uncooperative behaviors in individuals with dementia are typically a result of their cognitive impairment, confusion, fear, or an inability to communicate their needs or understand instructions. They are not intentionally trying to be difficult, but rather are struggling with the effects of their disease.