A client with Alzheimer's disease becomes more restless and confused in the late afternoon. What is this pattern often called?

Catastrophic reaction to a single loud noise that happened earlier in the day

A client with dementia cannot describe pain. Which sign suggests the client may be in pain?

Grimacing, moaning, or guarding one part of the body

Eating the whole meal quickly and then asking for a second plate

Sleeping quietly through the afternoon nap

Humming along to music on the radio

A client with dementia insists she must go home to feed her children, who are now adults. What is the best response?

Acknowledge her feelings, talk about her children, and gently redirect

Tell her firmly that her children are grown and she is confused

Argue until she agrees she is already at home

Ignore her and continue with the task

How should the aide give instructions to a client with moderate dementia?

Use one simple step at a time, with a calm voice

List all the steps of getting dressed at once

Speak quickly so the client does not lose interest

Write long instructions and leave them by the bed for the client to read later

A client with dementia keeps trying to leave the house at night. Which response is appropriate?

Report it so the team can plan safety measures like door alarms

Tie him to the bed so he cannot get up

Give him one of the family's sleeping pills

A client with dementia suddenly refuses her bath and becomes agitated. What is the best approach?

Stop, stay calm, and try again later or another way

Finish the bath quickly, holding her still if necessary

Raise your voice so she understands the bath is required

Tell her that if she does not cooperate she will have to go to a nursing home

Dementia care for home health aides: communication that works

A large share of home care clients live with dementia, and the questions about them test one counterintuitive idea: correcting a person with dementia rarely helps. The brain cannot hold on to the correction, so arguing produces distress, not understanding. What works is responding to the feeling, simplifying the task and keeping the client safe without force.

Do not argue or correct	Acknowledge the feeling behind the words, then redirect to something pleasant
Instructions	One simple step at a time, in a calm voice, showing as well as telling
Approach	From the front, at eye level, saying your name
Sundowning	More confusion or agitation in the late afternoon and evening. Calm routine, good light, less noise, daytime activity
Refusing care	Stop, stay calm, look for a cause such as cold, fear or pain, and try later or another way
Wandering	Report it so the team can plan door alarms, ID bracelets and routines. Never lock the client in or restrain them
Pain	May show as grimacing, moaning, guarding a body part, restlessness or new agitation
Sudden change	New or sudden worsening of confusion can mean infection, pain or a medication problem. Report it
Choices	Offer two simple options rather than open questions
Threats and force	Never. Threatening a client or holding them still for care is abuse
Medication	Never give the family's or anyone else's sleeping pills
Mealtimes	Check the mouth afterward for pocketed food

Where the point is lost: The trap answer is usually the truthful one delivered as a correction: 'Your children are grown and you are confused.' It is accurate and it fails, because the person cannot keep the information and is left upset. The tested answer validates and redirects, and when safety is at stake, as with wandering, the answer is to report so the care team can plan, never to restrain or lock the client in.