Altered Cognition in Older Adults: Causes, Assessment & Challenges - Essay Sample

Introduction

Altered cognition occurs mostly in older individuals. It occurs as a result of a failure in the normal functioning of some brain regions. Some medications such as sedatives and tranquillizers may cause improper functioning of brain cells. Metabolic and hormonal imbalances also affect cognitive functions. Psychiatric conditions also cause memory-related problems. A clinician should assess older adults with altered cognition by asking questions about memory and thinking capabilities, challenges when practising instrumental activities of daily living (IADLs).

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The Essence of Competent Practice to an Older Person with Altered Cognition

Responsible practice entails activities that promote clinical caring of the sick, injured individuals and people exposed to vulnerable conditions (Cowan et al., 2016). An older person living with altered cognition need efficient and effective clinical care to avoid stigma or unplanned death. Effects of poor health to older people with altered perception lead to deterioration of health and increases chances of readmission in the hospital. Memory impairment changes the way of thinking and acting in individuals (World Health Organization). Cognitive impaired people face significant challenges when managing their activities of daily living (ADLs) like dressing, eating, and bathing hence requires maximum supervision and attention. Most nurses are provided with guidelines that they use to assess and diagnose delirium, dementia and depression (Roberts, 2016). Individuals with cognitive impairment need proper care for them to maintain meaningful relations. They usually sense a care giver's impatience and irritations, and therefore caregivers ought to develop trust with such individuals by exhibiting a legitimate interest during the interaction. Efficient clinical care for cognitively impaired people facilitates their ability to express their needs that bring about behavioural, and mood symptoms (Roberts, 2016). Provision of good care older people with altered cognition improves their quality of life since they can easily tackle daily activities with supervision.

Clinical Manifestation of Cognitive Decline, Dementia, Delirium, Depression and Cognitive Impairment

Individuals with very mild cognitive decline experience normal forgetfulness in minor aspects like names as a result of ageing. The level of forgetfulness increases, concentration difficulties begin and overall decreased performance of activities occur as the cognitive decline advances to mild(World Health Organization). As the cognitive decline changes from mild to moderate, people find it difficult tackling tasks effectively and also the level of socialization declines since they withdraw themselves from friends and relatives (World Alzheimer Report 2010). Severe cognitive decline leads to loss of memory. This advances to middle dementia stage where individuals need abundant assistance to manage daily activities. They usually have little memory of events that happened recently. Their ability to speak reduces and they experience delusions, agitation and compulsion. Their level of anxiety increases too. This advances to late dementia stage where the ability to communicate vanishes entirely and they are usually assisted in most activities like eating. Psychomotor skills are also lost at this stage.

Risk Factors for Older People With Altered Cognition

Older people with altered perception mostly have impaired blood glucose level. An individual with depression is at risk of having insulin resistance and inflammation. They are, therefore, vulnerable to pre-diabetes. People with depression are prone to hypertension. Stroke is also a risk factor for people with dementia. They are also at risk of suffering from the cerebrovascular disease since diabetes is much related to vasculopathy and cerebrovascular (World Alzheimer Report 2010). Most of the risk factors are contributed by the inability to exercise and lack of sleep.

Nursing Diagnosis for an Older Person With Altered Cognition

Individuals who are purported to have cognitive decline, dementia, delirium, depression and cognitive impairment are usually taken for assessment in a health facility. They are assessed by being asked on when some symptoms like forgetfulness began. The clinician determines the type and stage of the illness. Inability to self-care and bathing indicates dementia due to failure to complete ADLs (World Alzheimer Report 2010). Impaired speech and communication skills indicate that cognitive decline is at a severe stage. Reduced social interaction is also as a result of cognitive impairment (World Alzheimer Report 2010). Agitation, anxiety and wandering behavioural shows the presence of dementia. If individuals are too violent and at risk of injuring others shows the possibility of cognitive impairment.

Priorities of Care for a Person With Altered Cognition

Early diagnosis of cognitive impairment and the 4D's makes it possible to tackle the illnesses in the best way. It takes several years for brain cells to die, leading to memory challenges and later diagnosis of dementia. Early diagnosis leads to better treatment of the disease (World Alzheimer Report, 2010). There have been clinician endeavours to develop drugs for the treatment of symptoms that result from altered cognition. These drugs enable people to survive with the conditions and also improve their way of living. Several methods have been implemented to reduce the risks associated with altered cognition. Exercising and healthy diet is linked to prevention and delay of dementia symptoms and cognitive impairment. Additionally, some Alzheimer's drugs, such as solanezumab is mostly used to delay or stop the death of brain cells. This usually works after an early diagnosis of the illnesses.

Clinical Criteria to Determine the Effectiveness of Nursing

After a patient is diagnosed with altered cognition, regular assessment is arranged to determine whether the clinical treatment has been effective. Good nursing reduces the risks associated with cognitive impairment such as hypertension and diabetes. Nursing actions ensures that the individuals get adequate sleep and therefore, chances of acquiring disorders related to inadequate sleep are rare. Most patients diagnosed with depression get better after proper treatment since it is highly treatable (Wimo et al., 2013). Antidepressants correct chemical imbalances hence can reduce depression symptom. If a patient starts managing ADLs, after treatment, then it's a clear indication that the nursing care had been effective.

New Clinical Situation

Patients with altered cognition at risk of acquiring other health-related disorders like hypertension. Similarly, individuals exposed to HIV/AIDS are also at risk of developing cognitive impairment and having dementia. Lack of exercise causes diabetes and hypertension to people exposed to cognitive impairment, and likewise, individuals exposed to hypertension are at risk of developing heart attacks (Wimo et al., 2013). Proper medical care improves the lives of altered cognition patients. Similarly, patients with cancer can still have a significant life improvement through the best medical care.

Conclusion

Though altered cognition is shared among the elders, other middle-aged individuals are also at risk of developing the same disorders. Proper medical care can improve the patient's quality of life and enable cognitive impaired people to manage ADLs. Early diagnosis of dementia and depression is essential since the symptoms associated with the disorders can be treated. Patients with cancer can still have a significant life improvement through best medical care.

References

Cowan, N., Elliott, E. M., Saults, J. S., Nugent, L. D., Bomb, P., & Hismjatullina, A. (2016). Rethinking speed theories of cognitive development: Increasing the rate of recall without affecting accuracy. Psychological Science, 17(1), 67-73.Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16371146

Roberts, M. J. (2016). The prolonged depression: how it happened, why it happened, and what happens next. Haymarket Books. Retrieved from https://www.ebay.com/p/204293198?iid=402005680046

Roberts, R. O., Christianson, T. J., Kremers, W. K., Mielke, M. M., Machulda, M. M., Vassilaki, M.,& Petersen, R. C. (2016). Association between olfactory dysfunction and amnestic mild cognitive impairment and Alzheimer disease dementia. JAMA neurology, 73(1), 93-101.Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710557/

Wimo, A., Jonsson, L., Bond, J., Prince, M., Winblad, B., & International, A. D. (2013). The worldwide economic impact of dementia in 2010. Alzheimer's & Dementia, 9(1), 1-11.Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23305821

World Alzheimer Report (2010): The global economic impact of dementia. Alzheimer's Disease International. Alz.co.uk. Retrieved 2 April 2020, from https://www.alz.co.uk/research/world-report-2010.