A nurse is evaluating the effectiveness of cognitive stimulation therapy for a client with mild dementia.

Which of the following outcomes indicates that the therapy is beneficial?

The correct answer is A.

“I should acknowledge my loved one’s feelings and try to redirect their attention.” This statement indicates understanding of validation therapy, which is a way to approach older adults with empathy and understanding.

Validation therapy focuses on helping the person work through the emotions behind challenging behaviors, such as hallucinations, by listening, acknowledging, and rephrasing their feelings.Validation therapy also involves using reminiscence, sensory stimulation, and redirection to engage the person in a meaningful way.

Choice B is wrong because it contradicts validation therapy.

Confronting the person’s hallucinations and explaining that they are not real can increase their anxiety, confusion, and agitation.It can also damage the trust and rapport between the caregiver and the person with dementia.

Choice C is wrong because it also goes against validation therapy.

Ignoring the person’s hallucinations and changing the topic of conversation can make them feel dismissed, invalidated, and isolated.It can also prevent them from expressing and resolving their emotions.

Choice D is wrong because it is not part of validation therapy.

Agreeing with the person’s hallucinations and pretending that you see them too can reinforce their delusions and make them more persistent.It can also confuse the person and make them doubt your honesty and credibility.

Lewy body dementia is a progressive dementia that results from protein deposits in nerve cells of the brain.

It affects movement, thinking skills, mood, memory, and behavior.It is characterized by fluctuating cognition, visual hallucinations, parkinsonian symptoms, sleep disturbances, and autonomic dysfunction.

A. “I should acknowledge my loved one’s feelings and try to redirect their attention.” B.

“I should confront my loved one’s hallucinations and explain that they are not real.” C.

“I should ignore my loved one’s hallucinations and change the topic of conversation.” D.

“I should agree with my loved one’s hallucinations and pretend that I see them too.”

The correct answer isA, C and E.

These are the factors that the nurse should ask about when suspecting vascular dementia.

Vascular dementia is caused by different conditions that interrupt the flow of blood and oxygen supply to the brain and damage blood vessels in the brain.People with vascular dementia almost always have abnormalities in the brain that can be seen on MRI scans.These abnormalities can include evidence of prior strokes, which are often small and sometimes without noticeable symptoms.

Choice Ais correct becausehypertension(high blood pressure) is one of the risk factors for vascular dementia, as it can damage the small blood vessels in the brain and reduce blood flow.Controlling blood pressure may help lower the chances of developing vascular dementia.

Choice Bis wrong becausefamily history of Alzheimer’s diseaseis not a factor for vascular dementia, but for Alzheimer’s disease, which is a different type of dementia.Alzheimer’s disease is caused by abnormal protein deposits in the brain, not by impaired blood flow.

Choice Cis correct becausetransient ischemic attacks(TIAs), also known as mini-strokes, are another risk factor for vascular dementia, as they can damage brain cells and affect cognition.TIAs are temporary episodes of reduced blood flow to the brain, causing symptoms similar to a stroke but lasting only a few minutes or hours.

Choice Dis wrong becauseexposure to environmental toxinsis not a factor for vascular dementia, but for other types of dementia, such as Lewy body dementia or Parkinson’s disease dementia.These types of dementia are caused by abnormal protein deposits in the brain or nerve cell damage, not by impaired blood flow.

Choice Eis correct becausediabetes mellitusis another risk factor for vascular dementia, as it can damage the blood vessels and increase the risk of stroke and heart disease.Controlling blood sugar may help lower the chances of developing vascular dementia.

Sources:.

:Vascular Dementia: Causes, Symptoms, and Treatments | National Institute on Aging.

:Vascular dementia - Symptoms & causes - Mayo Clinic.

:causes of vascular dementia - NHS - NHS.

A. History of hypertension B.

Family history of Alzheimer’s disease C.

History of transient ischemic attacks D.

Exposure to environmental toxins E.

History of diabetes mellitus