Cognitive Problems

Category / Primary Body System

• Neurological / Cognitive Function

Problem

• Patient has alterations in cognitive function.

Goal

• Patient will continue to recognize caregivers and/or family members for the next 90 days.

Plan/Approach

1. Medication Management

   • Administer medications as ordered to manage any underlying conditions contributing to cognitive impairment.

2. Choice and Autonomy

   • Allow the patient to make choices (e.g., daily clothing) whenever possible to promote autonomy and decision-making.

3. Psychological Support

   • Provide psych consults as needed to address any psychological factors contributing to cognitive issues.

4. Communication Strategies

   • Use simple phrases when communicating to ensure understanding and reduce confusion.

5. Family Involvement

   • Encourage family participation in the patient’s care to provide emotional support and familiarity.

6. Emotional Expression

   • Give the patient time to express feelings as necessary to support emotional well-being.

7. Monitoring and Reporting

   • Monitor for increased confusion that is not baseline for the patient and notify MD/RNP if any changes are observed.

8. Consistency in Care

   • Utilize consistent caregivers whenever possible to provide stability and familiarity for the patient.

Rationale

1. Medication Management

   • Appropriate medication management can help stabilize or improve cognitive function.

2. Choice and Autonomy

   • Allowing the patient to make choices can enhance their sense of control and well-being.

3. Psychological Support

   • Addressing psychological factors can improve overall cognitive function and mental health.

4. Communication Strategies

   • Simple communication reduces the risk of misunderstanding and frustration, supporting better cognitive function.

5. Family Involvement

   • Family support can provide emotional stability and reinforce the patient’s identity and memory.

6. Emotional Expression

   • Allowing the patient to express their feelings supports mental health and can reduce cognitive stress.

7. Monitoring and Reporting

   • Early detection of increased confusion allows for timely intervention and management.

8. Consistency in Care

   • Familiar caregivers can reduce confusion and provide a stable environment, which is beneficial for cognitive function.

Actions

1. Medication Management

   • Administer prescribed medications on schedule and monitor for side effects.
   • Review medication regimen regularly with the healthcare team to ensure optimal treatment.

2. Choice and Autonomy

   • Encourage the patient to make daily choices such as selecting clothes, meals, and activities.

3. Psychological Support

   • Coordinate psych consults as needed and follow through with recommendations.

4. Communication Strategies

   • Use clear, simple phrases and repeat information as necessary to ensure understanding.

5. Family Involvement

   • Invite family members to participate in care activities and provide emotional support.

6. Emotional Expression

   • Give the patient opportunities to talk about their feelings and listen actively.

7. Monitoring and Reporting

   • Observe the patient for any signs of increased confusion and document observations.
   • Report any changes in cognitive function to the MD/RNP promptly.

8. Consistency in Care

   • Assign consistent caregivers to the patient whenever possible and ensure they are familiar with the patient’s care plan and preferences.