An older adult diagnosed with moderate dementia is seen in the geriatric clinic. As the nurse is evaluating the client, the client's wife states that her husband has developed an increasing number of episodes of incontinence. She does not know what is precipitating the episodes, and states "maybe he just doesn't remember that he needs to urinate or maybe it's me, it takes me a while to walk him to the bathroom." The nurse develops a plan of care for this client and includes which of the following interventions to manage the incontinence? (Select all that apply.)

Choice A: Reduce the proportion of older adults with untreated caries. This is a correct answer because it is one of the Healthy People 2020 oral health objectives for older adults¹. Untreated caries can lead to pain, infection, tooth loss, and reduced quality of life². Reducing the prevalence of untreated caries can improve the oral health and well-being of older adults.

Choice B: Reduce the proportion of adults with untreated dental decay. This is an incorrect answer because it is not specific to older adults. The Healthy People 2020 oral health objectives for adults include reducing the proportion of adults aged 35 to 44 years with untreated dental decay¹. However, this does not address the unique needs and challenges of older adults, such as increased risk of root caries, dry mouth, and periodontal disease².

Choice C: Prevent and control oral and craniofacial diseases, conditions, and injuries. This is a correct answer because it is the overall goal of the Healthy People 2020 oral health objectives¹. Oral and craniofacial diseases, conditions, and injuries can affect the function, appearance, and quality of life of older adults². Preventing and controlling these problems can help older adults maintain their oral health and general health.

Choice D: Improve access to preventive services and dental care. This is a correct answer because it is one of the Healthy People 2020 oral health objectives for older adults¹. Access to preventive services and dental care can help older adults prevent oral diseases, detect problems early, and receive appropriate treatment². However, many older adults face barriers to accessing oral health care, such as lack of dental insurance, transportation, or awareness³. Improving access to oral health care can reduce these disparities and improve the oral health outcomes of older adults.

Choice A reason: Awakens with periodic left-foot numbness is an alteration in sensory function that the nurse should address in the plan of care for stabilizing the blood sugar, as it may indicate peripheral neuropathy, which is a common complication of diabetes. Peripheral neuropathy is a nerve damage that affects the feet and legs, causing numbness, tingling, pain, or weakness. Peripheral neuropathy can increase the risk of foot ulcers, infections, and amputations. The nurse should educate the older adult about the importance of regular foot care, blood sugar control, and medication adherence.

Choice B reason: Enjoys spicy food more than bland food is not an alteration in sensory function that the nurse should address in the plan of care for stabilizing the blood sugar, as it is a personal preference that does not affect the blood glucose levels. However, the nurse should advise the older adult to limit the intake of salt, fat, and sugar, and to follow a balanced and nutritious diet that meets their needs and preferences.

Choice C reason: Has difficulty hearing conversations in crowded rooms is not an alteration in sensory function that the nurse should address in the plan of care for stabilizing the blood sugar, as it is a common age-related change that does not affect the blood glucose levels. However, the nurse should assess the older adult's hearing ability and provide appropriate aids and strategies to enhance their communication and socialization.

Choice D reason: Requires reading glasses at 2.0 strength is not an alteration in sensory function that the nurse should address in the plan of care for stabilizing the blood sugar, as it is a common age-related change that does not affect the blood glucose levels. However, the nurse should assess the older adult's vision and provide appropriate aids and strategies to improve their safety and quality of life.

Choice E reason: None of the above is not the correct answer, as there is one choice that is an alteration in sensory function that the nurse should address in the plan of care for stabilizing the blood sugar.