A nurse is providing teaching to the family of a client who has stage II Alzheimer's disease. Which information should be included?

• A. Encourage the client to make many choices independently.
• B. Provide long, detailed instructions.
• C. Increase environmental distractions to occupy time.
• D. Limit choices offered to the client.

Answer: (D)

When someone has Alzheimer's disease in the mild-to-moderate range, cognitive processing and memory are still present but easily overwhelmed. The approach that best fits this stage is to limit the number of choices offered to the client. This reduces cognitive load, helps them make a decision without frustration, and supports safer, more independent actions by presenting simple, concrete options. For example, offering one clear choice at a time (like “Would you like tea or water?”) prevents indecision and confusion.

Other approaches would burden the person: encouraging many independent choices can be overwhelming and lead to anxiety or refusal; giving long, detailed instructions is hard for them to follow; increasing environmental distractions worsens confusion and safety risks. Keeping the environment calm and decisions simple helps maintain autonomy within the person’s capabilities.