ACC Managing Behavioral Symptoms 2 — Questions and Answers
Question 1: A person with Alzheimer's becomes agitated every afternoon around 3 PM. This pattern is best described as:
- Delirium tremens
- Sundowning (Correct answer)
- Diurnal psychosis
- Nocturnal confusion
Correct answer: Sundowning
Sundowning refers to increased confusion, agitation, or behavioral symptoms that occur in the late afternoon or evening.
Question 2: Which non-pharmacological approach is MOST effective for redirecting a person with Alzheimer's who is repeatedly asking to go home?
- Firmly telling them they are already home
- Locking all doors to prevent escape attempts
- Engaging them in a familiar, meaningful activity (Correct answer)
- Explaining their memory condition in detail
Correct answer: Engaging them in a familiar, meaningful activity
Redirecting to a familiar, meaningful activity addresses the emotional need behind the request without confrontation or deception that may increase distress.
Question 3: A caregiver notices that a resident with Alzheimer's becomes combative during bathing. The BEST first step is to:
- Skip bathing to avoid conflict
- Administer a sedative before each bath
- Identify and modify specific triggers during the bath routine (Correct answer)
- Require two staff members to restrain the resident
Correct answer: Identify and modify specific triggers during the bath routine
Identifying triggers such as water temperature, lighting, or privacy concerns allows caregivers to modify the routine to reduce combativeness.
Question 4: Repetitive questioning in Alzheimer's disease is MOST commonly driven by:
- Deliberate manipulation of caregivers
- Underlying emotional needs such as anxiety or insecurity (Correct answer)
- A desire to test the caregiver's patience
- Neurological pain signals
Correct answer: Underlying emotional needs such as anxiety or insecurity
Repetitive questions typically reflect emotional states like anxiety, fear, or the need for reassurance rather than intentional behavior.
Question 5: When a person with Alzheimer's accuses a caregiver of stealing, the MOST therapeutic response is to:
- Present receipts or evidence proving innocence
- Argue calmly until the person accepts the truth
- Acknowledge their feelings and help search for the item together (Correct answer)
- Document the accusation as a formal complaint
Correct answer: Acknowledge their feelings and help search for the item together
Validating feelings and assisting in a search addresses the emotional distress without escalating conflict or reinforcing confusion.
Question 6: Which environmental modification BEST reduces wandering risk for a person with Alzheimer's?
- Placing bold, contrasting colored tape over door handles (Correct answer)
- Increasing overhead lighting throughout the facility
- Removing all furniture from hallways
- Posting written reminders not to leave
Correct answer: Placing bold, contrasting colored tape over door handles
Visual cues such as camouflage tape over door handles can reduce a person's perception of exits as departure points, decreasing wandering attempts.
Question 7: A person with Alzheimer's suddenly becomes more agitated and confused than usual over 24 hours. The caregiver should FIRST suspect:
- Disease progression requiring hospice evaluation
- A new behavioral symptom of Alzheimer's
- An underlying medical condition such as infection or pain (Correct answer)
- A reaction to loneliness
Correct answer: An underlying medical condition such as infection or pain
Acute changes in behavior often signal an underlying medical issue such as urinary tract infection, pain, or medication side effect rather than simple disease progression.
ACC Managing Behavioral Symptoms 2
A person with Alzheimer's becomes agitated every afternoon around 3 PM.
This pattern is best described as: