SN instructed on Alzheimer's. Patient shouts at moments; Assessed patient’s ability for thought processing. Observed patient for cognitive functioning, memory changes, disorientation, difficulty with communication, or changes in thinking patterns. Assessed patient’s ability to cope with events, interests in surroundings and activity, motivation, and changes in memory pattern. Instructed caregiver to orient patient to environment as needed, if patient’s short term memory is intact. Using of calendars, radio, newspapers, television and so forth, are also appropriate. Assessed patient for sensory deprivation, concurrent use of CNS drugs, poor nutrition, dehydration, infection, or other concomitant disease processes. Maintain a regular daily schedule routine to prevent problems that may result from thirst, hunger, lack of sleep, or inadequate exercise. Provide positive reinforcement and feedback for positive behaviors. SN instructed family in methods to use with communication with patient: listen carefully, listen to stories even if they’ve heard them many times previously, and to avoid asking questions that the patient may not be able to answer. Divert attention to a client when agitated or dangerous behaviors like getting out of bed by climbing the fence bed. Eliminate or minimize sources of hazards in the environment. Caregiver verbalized fair understanding.