Summary: <p>Communicating with the Cognitively Impaired<br> Instructor: Dr. Dawn-Elise Snipes, PhD<br> Executive Director: AllCEUs.com, Counselor Education and Training<br> Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery</p> <p> </p> <p>Objectives<br> ~ Define cognitive impairment<br> ~ Explore symptoms of cognitive impairment in<br> ~ Alzheimer’s<br> ~ Dementias<br> ~ Fetal Alcohol Spectrum Disorders<br> ~ Review APA Treatment Guidelines for counselors working with persons with Alzheimer’s<br> ~ Identify methods for effective communication<br> ~ Learn how to handle difficult behaviors<br> ~ Identify specific issues and interventions for a person with a FASD<br> Symptoms of Cognitive Impairment<br> ~ The development of multiple cognitive deficits manifested by both<br> ~ (1) memory impairment (impaired ability to learn new information or to recall previously learned information)<br> ~ (2) one (or more) of the following cognitive disturbances:<br> ~ (a) aphasia (language disturbance)<br> ~ (b) apraxia (impaired ability to carry out motor activities despite intact motor function)<br> ~ (c) agnosia (failure to recognize or identify objects despite intact sensory function)<br> ~ (d) disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting)<br> Symptoms of Cognitive Impairment<br> ~ Other Symptoms<br> ~ Attention<br> ~ Perception<br> ~ Insight and judgment<br> ~ Organization<br> ~ Orientation<br> ~ Processing speed<br> ~ Problem solving<br> ~ Reasoning<br> ~ Metacognition</p> <p>Causes of Cognitive Impairment<br> ~ Wernike-Korsakoff’s Syndrome<br> ~ Vascular Dementia<br> ~ Stroke<br> ~ Impeded blood flow to brain<br> ~ Alzheimers<br> ~ Fetal Alcohol Spectrum Disorders<br> ~ Brain Injury (Car accident, football, fall, boxing)<br> ~ (Temporarily) Hyper or Hypo-glycemia<br> Screening for Cognitive Impairment<br> ~ The AD8 (PDF, 1.2M) and Mini-Cog(PDF, 86K) are among many possible tools.<br> ~ Patients should be screened for cognitive impairment if:<br> ~ The person, family members, or others express concerns about changes in his or her memory or thinking<br> ~ You observe problems/changes in the patient’s memory or thinking<br> ~ The patient is age 80 or older(12)<br> ~ Low education (IQ, FASD, stroke…)<br> ~ History of type 2 diabetes<br> ~ Stroke<br> ~ Depression<br> ~ Trouble managing money or medications<br> ~ Episodes of delirium (confusion/disorientation)</p> <p>Important Aspects of Management<br> ~ Important aspects of psychiatric management include<br> ~ Educating patients and families about<br> ~ the illness<br> ~ treatment<br> ~ sources of additional care and support (e.g.,support groups, respite care, nursing homes, and other long-term-care facilities)<br> ~ the need for financial and legal planning due to the patient’s eventual incapacity (e.g., power of attorney for medical and financial decisions, an up-to-date will, and the cost of long-term care)<br> Important Aspects of Management<br> ~ Behavior oriented treatments<br> ~ Identify the antecedents and consequences of problem behaviors<br> ~ Reduce the frequency of behaviors by changing the environment to alter these antecedents and consequences.<br> ~ Stimulation-oriented treatments<br> ~ recreational activity, art therapy, music therapy, and pet therapy, along with other formal and informal means of maximizing pleasurable activities for patients<br> ~ Emotion-oriented treatments<br> ~ supportive psychotherapy can be employed to address issues of loss in the early stages of dementia<br> ~ Reminiscence therapy has some modest research support for improvement of mood and behavior<br> ~ Tolerate, Anticipate, Don’t Agitate<br> Communication<br> ~ Written, oral, body language/signs<br> ~ Let the client write, draw or speak to communicate<br> ~ Use real objects when possible. (i.e. an apple)</p>
