The nurse is caring for an elderly woman with dementia who is frightened in the hospital room.Which is the best action by the nurse to communicate empathy and compassion?

A) Use the bedside intercom to inform her that you will be entering her room.
B) Use brief, light touch on the patient's arm or shoulder when greeting her.
C) Shut the patient's door in the hallway if there is noise or loud talking.
D) Firmly but kindly insist the patient accepts reality as you have presented it.

Close the door to reduce environmental distractions.Extraneous noises,lights,and even smells can compete for attention when talking with or providing instructions to the patient,especially if she is confused or cognitively impaired.A voice sounding from the intercom on the bedside call system might frighten the patient with confusion,delirium,or other cognitive impairments.It is better to talk face-to-face.Talk to the patient first; touch second.Touching a patient before establishing a basic trust might frighten the confused or cognitively impaired patient.Do not argue or insist the patient agree with you.The patient with altered perception or cognition might not have the capacity to understand or accept reality.Pushing him to agree with you can create anxiety or hostility.