Caring for people with Cognitive Impairments

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Researchers have estimated that 16-23% of families across the U.S. may be caring for an adult with some form of a cognitive impairment. Cognitive impairments include diseases and disorders that affect the person’s ability to decisions, remember, and comprehend information given to them on a daily basis.

Some diseases or disorders that affect cognitive thinking are various forms of Dementia, strokes, head injuries or Autism, Fragile X. Although each disorder has its own distinctive symptoms, they often share common behaviors, dysfunctions, and problems with ADL regardless of the diagnosis.

Some cognitively impaired people may require special care, which include behavior management, supervision, specialized communication techniques, management of incontinence, and assistance with their activities of daily living (ADLs), e.g. bathing, eating, and more.

While each caregiving situation is different, personal care workers are more likely to experience a pattern with ADLs assistance. Some of these individuals may be verbal, and social, while others may be non-verbal, aggressive, combative, and intolerant of their caregiver. For this reason, it is important that home health agencies prepare their staff to adequately care for these special needs clients even under unpleasant situations.

Quality Care at Home
Without proper training of field staff they may learn how to manage their (CI) cognitively Impaired client through trial and error. Some may be fearful of their client’s unusual behavior that can set the staff and the client up for failure in building a relationship that will allow great quality of care.

Special training in learning how to communicate with CI clients and managing difficult behaviors is needed, and the PCW should not be sent into a home without knowing how to care for these clients period! Any agency that does not adequately prepare their staff to manage CI has no respect for their client or staff needs.

Managing Problem Behaviors
Brain-impaired individuals may experience a range of behavioral problems including communication difficulties, perseveration (fixation on/repetition of an idea or activity), aggressive or impulsive behaviors, lack of motivation, memory problems, incontinence, poor judgment and wandering.

Helpful suggestions for managing these problems include keeping language simple and asking one question at a time. Break down tasks and questions. For example, instead of asking, “would you like to come in and sit down and have a snack?”, use simple commands such as, “come here,” (pause) “sit down,” (pause) and “here’s a snack.”

 Wandering and poor judgment may signify the need for 24-hour supervision. Be sure to run through the home safety checklist with the family or representative. In addition, learn who they should contact in their community in case the client does wander off. You may want to assist families in finding extra help from friends, family, church groups, social service agencies, senior centers and support groups. If wandering or aggressive behaviors continue to be a problem, then maybe a qualified care facility may be necessary.

Sign up for the March 23rd Training session to assist you and your field staff better manage CI people.