____ Alzheimer’s Disease and Other Dementias: Symptoms, Stages, and Communication Strategies Expanded
ALZHEIMER’S DISEASE AND OTHER DEMENTIAS: SYMPTOMS, STAGES, AND COMMUNICATION STRATEGIES EXPANDED Self-Assessment Answers and Rationales
1. The correct answer is B. Rationale: If you find that you are experiencing symptoms or caring for a person with symptoms, it would be helpful to log them and track them over a few days. This will help to identify if a person is eating, hydrating, and staying socially connected. It is important to avoid assumptions about perceived brain changes. 2. The correct answer is D. Rationale: Since this type of dementia is a disruption of brain chemis- try, it can cause a change in personality and impulsiveness, as opposed to an initial memory loss. Tracking the person’s behavior, sleep habits, and nutrition/hydration can identify patterns that can be helpful to the physician. Additionally, since this type of brain disease is less common, an initial diagnosis of a more common psychological issue
9. The correct answer is D. Rationale: Playing games is good for your brain and overall physical health. A rule of thumb is that if a behavior is good for heart health, then the brain will also reap the benefits. 10. The correct answer is B. Rationale: A proper neurological exam should be done by a specialist, but many individuals do not have access to them. Primary care physi- cians often have the closest connection to patients; however, they may be reluctant to diagnosis. Reasons for this include lack of training, poor communication with the patient, lack of support from a caregiver, and concern for the lack of a cure. 11. The correct answer is A. Rationale: Clothing that is easy on/easy off will enable the patient to remain independent for a longer period of time. This will also reduce stress for the caregiver and can potentially reduce conflict and disruption. 12. The correct answer is A. Rationale: AD may cause defiant, contrary behavior and personality change. AD can be cruel, and there will be difficult times for the caregiver and loved ones. The patient may have little control over their agitation and unknowingly engage in dangerous behavior. Address the behavior and do not denigrate the patient—it is not their fault. 13. The correct answer is C. Rationale: IADL are the daily chores that people do to live independent lives—grocery shopping, fixing dinner, medication management, and transportation. AD ultimately robs patients of their ability to do these tasks, rendering them unable to independently take care of themself. 14. The correct answer is A. Rationale: Maintaining a sense of independence can be difficult, timely, and messy. Allow the person to feed themselves as long as possible, and don’t let mealtime be rushed or stressful. Providing extra time can be empowering for the patient and minimize stress for the caregiver. Messes can always be cleaned up. 15. The correct answer is D. Rationale: Providing a dignified living space for a person with AD can give them comfort, structure, and a sense of safety, minimizing opportuni- ties for increased confusion. Additionally, the familiarity of the space, with clearly defined colors, can help them identify their room/space. 16. The correct answer is A. Rationale: Listening to music can activate areas of the brain that stimulate memory, reminiscence, emotion, mood, and reward (Flo et al., 2022). It is a simple way to enhance the environment, adjust mood, and liven up a room. Music can also promote movement and social connectedness.
may seem appropriate at the onset 3. The correct response is D.
Rationale: Since MCI can have many different reasons for manifest- ing, it is very important to address it as a symptom, as opposed to an initial diagnosis. In some cases, MCI can be improved and a more serious diagnosis, without proper evaluation, can be devastating to
the patient and their loved ones. 4. The correct answer is B.
Rationale: The preclinical stage of AD starts 15–20 years prior to symptoms. While there is no cure for AD, lifestyle choices can slow symptoms and plaque and tangle development. Patients with early- onset AD may be able to do genetic testing to identify any predisposi- tion. Lifestyle changes that include diet, exercise, learning, and social connection may help to slow disease progression and reduce symptoms. 5. The correct answer is C. Rationale: Clinical research trials are constantly being implemented, and they rely on the participation of all types of people. Participation in AD research is vitally important for not only curative measures but for new opportunities to address symptoms. 6. The correct answer is C. Rationale: As AD progresses, it is imperative that the patient be kept safe while still having a sense of autonomy. This stage is pivotal in the life of the afflicted and maintaining a dignified life is important, while at the same time ensuring physical safety to avoid accidents and wandering. 7. The correct answer is D. Rationale: The patient can have input about their future as well as engage in life planning, including advanced care plans, making finan- cial arrangements, and engaging in healthy behaviors to potentially minimize symptoms and progression. Additionally, the patient may be able to participate in research that could help them and others. 8. The correct answer is D. Rationale: The brain relies on microglia to literally clean out debris, including amyloid plaque. The accrual of plaque is a trademark com- ponent of AD, and one of the reasons it is there is because the microglia fail to do their job and clean it out, thus leaving the person impaired.
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