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Chronic Confusion: Chronic confusion refers to dementia or long-term irreversible decline, which is not supported since the client was alert before transfer.

Impaired Memory: This would imply difficulty recalling past events or new information, but the main issue here is sudden restlessness and agitation, not memory loss.

Acute Confusion: The sudden onset of agitation and restlessness after a transfer suggests delirium, a temporary and reversible condition often triggered by environmental change, hospitalization, or acute illness.

“You wouldn’t be getting a bath at the train station.” This is dismissive and confrontational, which may increase confusion and agitation.

“Let’s finish your bath before the train arrives.” This reinforces the delusion rather than reorienting the client to reality.

“Don’t you know where you are?” This is scolding and non-therapeutic; it shames the client instead of supporting them.

Keep lights in the room dimmed during the day to decrease stimulation: Dim lighting can worsen disorientation, especially during the day when natural light helps maintain orientation to time.

Keep the environmental noise level high to increase stimulation: Excessive noise increases agitation, worsens confusion, and contributes to sensory overload in delirious clients.

Use restraints for client safety: Restraints increase agitation and confusion, are a last-resort intervention, and do not promote a therapeutic environment.

Insisting that every patient participate in as many self-care activities as possible: Promoting independence is important for function and dignity, but “insisting” ignores individual ability, safety and cognitive status. Encouragement and graded participation after safety/assessment are appropriate, but forcing participation could increase risk of harm.

Emphasizing and reinforcing individual patient strengths: Strength-based approaches support self-esteem, motivation and engagement in care, and help with adaptation to sensory loss. However, they don’t address immediate safety risks and should follow or run alongside core safety measures.

Encouraging reminiscence and life review in groups: Group reminiscence promotes socialization, orientation and emotional well-being (especially for those with cognitive changes), but it’s an intervention for psychosocial health rather than immediate safety. It’s appropriate once the environment and sensory needs are secure.