The health care provider for a client with degenerative Alzheimer-type dementia recognizes the client has moved from the initial stage to the moderate stage based on which of the following clinical manifestations? Select all that apply
A) Extreme confusion and disorientation
B) Incontinence of urine and bowel
C) Need for direct supervision for ADLs
D) Social withdrawal from all family and friends
E) Inability to problem solve simple tasks
Ans: A, C, E
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Although different staging schemas exist, three broad stages of Alzheimer dementia have been identified, each of which is characterized by progressive degenerative changes. The early stage is characterized by short-term memory loss, lack of spontaneity, and social withdrawal. The moderate stage of dementia is marked by extreme confusion, disorientation, and personal hygiene (ADLs) is neglected. During this stage, there are also changes in higher cortical functioning needed for language, spatial relationships, and problem solving. In severe Alzheimer disease, in the terminal stage, the person typically becomes incontinent.
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