Adult Treatment Planner
10: Cognitive Deficits
SNOMED Terms
- Amnestic disorder due to medical disorder
- Inhalant-induced persisting dementia
- Personality change due to medical disorder
- Sedative, hypnotic AND/OR anxiolytic-induced persisting amnestic disorder
- Sedative, hypnotic AND/OR anxiolytic-induced persisting dementia
Goals
- Develop an understanding and acceptance of the cognitive impairment.
- Develop alternative coping strategies to compensate for cognitive limitations.
Behavioral Definitions
- Concrete thinking or impaired abstract thinking.
- Lack of insight into the consequences of behavior (i.e., impaired judgment).
- Short-term memory deficits.
- Long-term memory deficits.
- Difficulty following complex or sequential directions.
- Loss of orientation to person, place, or time.
- Distractibility in attention.
- Impulsive behavior that violates social mores.
- Speech and language impairment.
Diagnoses
- Personality Change Due to (Axis III Disorder)
- Dementia NOS
- Dementia Due to (Axis III Disorder)
- Alcohol-Induced Persisting Dementia
- Alcohol-Induced Persisting Amnestic Disorder
- Amnestic Disorder NOS
- Alcohol Dependence
- Cannabis Dependence
- Amnestic Disorder Due to (Axis III Disorder)
- Cognitive Disorder NOS
- Diagnosis Deferred
- No Diagnosis
Objectives and Interventions
- Describe all symptoms that may be related to neurological deficit.
- Explore signs and symptoms of the client's possible neurological impairment (e.g., memory loss,
defective coordination, flawed abstract thinking, speech and language deficits, unsound
executive
functions, disorientation, impaired judgment, inattention, headaches, dizziness, blurry vision).
- Assess and monitor the client's cognitive behavior in individual sessions.
- Cooperate with and complete neuropsychological testing.
- Arrange for the client to have psychological testing administered to determine the nature and
degree
of cognitive deficits.
- Administer appropriate psychological tests (e.g., Wechsler Adult Intelligence Scale-III, Booklet
Category Test, Trailmaking, Haldstead-Reitan Battery, Michigan Neurological Battery,
Luria-Nebraska
Battery, Wechsler Memory Scale, Memory Assessment Scales) to determine the nature, extent, and
possible origin of the client's cognitive deficits.
- Obtain a neurological examination.
- Refer the client to a neurologist to further assess his/her organic deficits and determine
possible
causes.
- Understand and accept cognitive limitations and use alternate coping mechanisms.
- Inform the client of the results of the cognitive assessment and develop appropriate objectives
based on testing.
- Assist the client in coming to an understanding and acceptance of his/her limitations.
- Verbalize feelings associated with acceptance of cognitive impairment.
- Explore the client's feelings of depression and anxiety related to his/her cognitive impairment;
provide encouragement and support.
- Attempt to follow through to completion simple sequential tasks.
- Assign appropriate sequential tasks for the client to perform and redirect when needed so as to
assess his/her cognitive abilities.
- Implement memory-enhancing mechanisms.
- Assign and monitor memory-enhancing activities/exercises for the client (e.g., crossword
puzzles,
card games, TV game shows) and memory-loss coping strategies (e.g., lists, routines, post notes,
repeating items aloud to yourself, using mnemonic strategies).
- Identify when it is appropriate to seek help with a task and when it is not.
- Assist the client in coming to an understanding and acceptance of his/her limitations.
- Establish with the client and his/her significant other appropriate points for the client to ask
for
help.
- Write a plan identifying who will provide daily supervisory contact and when they will do it.
- Assist the client in identifying dependable resource people who can provide regular supervision.
- Develop a written schedule with the client for times of supervisory contact and identify who
will
provide it.
Index