Section A: The scope of cognitive
impairment across the lifespan
Defining and outlining the
explain what is meant by the following
Minor mental problems: problems
recalling memories and problems thinking
Group of symptoms: memory loss,
thinking difficulty, mood swings and thinking differently.
Learning disability refers
to people to struggle to learn life skills. Examples include communication,
money management, and reading, writing or caring for them. Some people are born
with it, other develop it after an accident
What is the prevalence of dementia
and learning disabilities in the UK population?
700000 people have it
1.5 million People in UK
have learning disability.
Identify the most common types and
dementia (4 most common types)
Dementia from Parkinson’s disease
Dementia with Lewy bodies.
learning disabilities (3 most
Identify 3 or 4 areas of
everyday functioning affected by cognitive impairment at different stages of
the life course; briefly explain how each area of functioning is affected:
Lifelong impairments (i.e. those
with which people are born or which develop early in life)
Unable to think clearly
Acquired impairments (those
which develop or are acquired during adulthood)
Mood swings and aggression
Wandering or getting lost.
Signs, symptoms and
responses to learning disabilities
What might be early signs of learning
disabilities within the first five years of life?
Problems pronouncing words
Can’t hold concentration for
How might a child’s development
feel bad, which gives low self-esteem. They will also have many physiological
issues, which will inhibit their learning because they can’t learn like their
How might family life be affected?
parent and child affected. The child may cry or have tantrums. This can be very
stressful because of this since this is hard for the parents to understand.
Signs, symptoms and
responses to dementia
What early signs and symptoms
could indicate that a person might be developing dementia? It might be helpful to reflect on a person who has dementia that you
may have come across personally, professionally or via the media to answer this
Discuss why you would need to
respond sensitively if you encountered someone with the early stages of
dementia. How would you ensure your response was sensitive?
account of the person’s feeling is very important to their psychological state.
They most likely already are frustrated that they can’t do many actions that
healthy people can do. I need to take
into account that they may have physical/mental disabilities, trying to avoid
problems which bring up or highlight their problems. I would discuss the
benefits and be more optimistic if they bring up their concerns.
Section B: Living well with cognitive
Person-Centred Care is about treating each
person as an individual and providing care and support to meet their needs
whilst respecting their personal beliefs and values. It acknowledges that every
person, including those living with cognitive impairment, is different and that
how these impairments affect each person will be different.
Consider your own beliefs and
values. Think about what you would consider to be important for others to know
about you as an individual to enable them to offer you person centred care. For
example, do you have particular routines for self-care, or favourite food and
i) What would you want
others to know?
would tell the healthcare professional, my lifestyle routine and habits. In order
to receive the optimal healthcare, the healthcare professional would need to
know how I lived to find the possible reasons why issues are caused.
ii) Why would this
be important for others to know? What impact might it have on your care and
wellbeing if this was not carried out?
It’s important to
know my lifestyle routine because they can figure out what can be changed to in
order to recover. Habits would also be revealed, habits cause an unhealthy
lifestyle. Not mentioning my lifestyle
routine and habits will lead to non-person centred care. Care has to be
tailored towards an individual or it won’t be effective
Cultural Diversity: Identify 2 or 3 ways in which cultural background and ethnicity
might impact on a person with cognitive impairment in terms of functioning and
wellbeing? For example, think about the
influence that personal history, country of origin, religion and first language
might have on an individual’s experience of living with cognitive impairment
and accessing care.
ethnicities may be more susceptive to cognitive impairment than others. Family
medical records should be accessed. Certain ethnicities will react differently,
for instance there is a stigma in Chinese culture that medication gives many
side effects, makes a person weak and old. Certain religions, i.e.
Christianity, reject medicine, and instead choose prayer. Certain regions are
more susceptible to dementia which will make people living in that area to be
more aware of the disease and may trust healthcare professionals especially if
they’ve had multiple close friends, family members affect
Within your professional role consider
how you might be involved in delivering person centred care in relation to
people of any age living with cognitive impairment. Give two examples considering
different life stages.
communication to meet needs of old person, nonexclusive and using more
traditional communication methods, since the elderly will most likely not go
online and look for information.
Information given in short, concise bits. Children are unlikely to understand
very complex medical information. Information easily accessible online for the
parents if the child forgets the advice.
d) Describe how views and attitudes of others might impact on the lives
of people (children, young people and adults) with cognitive impairments, their
families and carers.
For children with cognitive impairments, family and healthcare
professional relationships are important in dementia’s early stages. Factors
which affect how people with cognitive impairment include: exclusion,
discrimination. A person with cognitive impairment will more likely be closed
off and have problem integrating if they were bullied as children over their
Identify some of the barriers
faced by people with cognitive impairments, and their families and carers. How
does the social model of disability help to identify these barriers?
Some barriers face by people with cognitive impairment includes
discrimination, prejudice, and loneliness. Social model of disability tries to
lead to a positive self-image.
Why is it important to address
inequalities and social stigma for people of any age with cognitive impairments
and identify adjustments which may be necessary to support them
People with cognitive impairment will start
to believe their negative stereotypes. Addressing the social stigma with cognitive
impairment will greatly improve adherence to medication/support. If the person
with the cognitive impairment is positive and believes they can recover, there
is a bigger chance.
Support for people with cognitive
impairment and their families
There are a range of organisations that
support people with cognitive impairment or their families, carers, and
professionals such as Carers’ Support Groups, Dementia Cafés, Activity Groups,
Advocacy Services, Memory Services, Information and Advice Services, Assistive
Technology, Benefits Advice, Befriending etc.
With your profession in mind, identify
three services to which you might refer or signpost a person who has a
cognitive impairment and briefly explain why.
Dementia UK- Support for
families with dementia and nurses who are dementia trained
Talking Point- Alzheimer
Society’s forum. Used to share dementia advice and information. A self support
Alzheimer’s Society- Charity
which provides information on dementia/Alzheimer, living with the disease and
where to get help.
What is meant by advocacy?
Public support for a specific situation/ policy
Why might this be important in supporting people of any age with a
cognitive impairment may be unable to express in words their needs and wants.
They may not even know what is missing from social services. Advocacy will bring attention to their
issues, allowing more funding and hopefully lead to a solution.
Section C: Enhancing Well-being through Communication
During the IPL1 session we spoke about some
of the challenges that people with information processing difficulties or cognitive
impairments might face with communication and how, as professionals, we might
improve our communication techniques to support more effective communication. On
the websites and links below there is information about communication
List below 10 strategies for communicating
with individuals who have communication and interaction difficulties which will
be useful for you in your professional role.
1. Raise awareness
of dementia and encourage people to seek help-
information for people with dementia and their carers
3. Easy access to
care, support and advice after diagnosis
structured peer support and learning networks
community personal support services for people living at home
6. Improve the
quality of care for people with dementia in general hospitals
7. Consider how
housing support, housing related services, technology and telecare can help
support people with dementia and their carers
8. Improve the
quality of care for people with dementia in care homes
9. An informed and
effective workforce for people with dementia
assessment and regulation of health and care services and of how systems are
Case Study 1
Mrs Smyth is a 70 year old lady with
advanced Alzheimer’s disease and arthritis; she lives at home with her daughter
and son-in-law. Her daughter had her first baby two days ago and is now home.
Over the past few months Mrs Smyth’s mobility has reduced and she spends most
of her time in bed. She now uses incontinence pads and relies on regular carers
visiting four times a day to manage her personal care needs. She has difficulty communicating verbally.
The carers and family report that Mrs Smyth
has become ‘aggressive’, biting and scratching when they carry out continence
care and other personal care tasks. They say that she is constantly calling out
and they cannot understand why.
She often refuses medication, and her diet
and fluid intake has reduced.
What do you think some of the
concerns might be around Mrs Smyth’s physical, psychological and social
Some concerns around Mrs. Smyth
physical’s wellbeing appear to be reduced mobility, communication fatigue,
problems with personal care. Her psychological and social wellbeing includes
issues communicating and using incontinence pads. She tries to communicate by
calling out but others find it odd and are unable to comprehend what she is
saying. Her biting and scratching is alienating her family members and carers.
What might Mrs Smyth be trying
to communicate? E.g. pain, distress, anxiety?
It is very
difficult to know exactly what Mrs Smyth is communicating. She would most
likely is communicating some sort of discomfort and may feel frustrated that
she is unable to express it properly.
Considering your professional
role, how might you support Mrs Smyth, her carers and her family in their
I as a healthcare professional can use a written piece
of paper/ keyboard to communicate. If she is unable to write/type physically,
although not ideal method of communicating, at least the exact thoughts of Mrs
Smyth can be transcribed onto a piece of paper. A bell can be used call for
attention. This can reduce the loud yelling and aggressive behaviour.
Case Study 2:
Josh is a 9-year-old boy with Down’s
syndrome who lives with his mother; he has two older brothers. His parents
separated when he was five years old. He visits and stays with his father every
Josh had a bike accident when he was 7
years old. He sustained a head injury, was unconscious for 72 hours and spent 4
weeks in the local hospital, followed by a further two months’ recovery at home.
He does not remember what happened and appeared to have recovered well from his
accident, although he sometimes complains about headaches and not being able to
see. At these times his speech is
difficult to understand.
Josh’s school has been raising concerns
over the last year about his behaviour, such as aggression towards his
classmates and difficulties in learning. Last week he became angry when his
teacher asked him a question in class, and he walked out of the classroom. In
the school’s view, he is becoming increasingly ‘unmanageable’, and his teachers
are worried about him. Similarly, Josh’s
parents are very concerned about his increasingly unruly behaviour and anxious
about his future.
What do you think some of the
concerns might be around Josh’s physical, psychological and social
ailments disabilities include: headaches, loss of vision
psychological and social wellbeing issues include: having behaviour considered
antisocial by teachers. Aggression towards classmates and having ‘unruly’
behaviour according to his parents
What might be causing Josh’s
behaviour? What could be some of the consequences?
could be a combination of irritation, social factors and the surrounding
environment. The deterioration of brain cells will cause this physical
irritation. Some of the consequences of deterioration are an exaggeration of
the symptoms. Josh may not be able to express their physical pain in words due
to cognitive function loss.
Considering your professional
role, how might you support Josh and his family to manage Josh’s behaviour?
I would first try
to find the cause and exactly why Josh reacts the way he does at the time. He
will also face pain, which should not be accounted as the cause. I would try to
take his feelings into account first; this will explain many of the actions.
Encouraging his family and friends to be patient and take breaks when they have
a moment. Ensuring the safety of Josh should be the priority of both
professionals and family.
Case Study 3:
Martin is a 57-year-old retail manager who experienced
a stroke at work 6 months ago. He has been employed by the same retail company
since he was 17-years old and has worked his way up. He is a popular and
Martin seems to be recovering well. He can
walk without assistance, and move around the house as normal. However, his
speech is slower than before and he has difficulty pronouncing some words when
under stress. He has not regained full control of his bladder and has
difficulty with stairs. He wants to return to work in 4 weeks’ time.
His daughter Jade is worried about him as
she feels he is anxious, moody and depressed.
He is like a different person altogether: not the loving Dad she grew up
with. Their relationship has become very difficult and Jade has stopped her 2
year old son from visiting due to concerns that Martin will frighten him.
What do you think some of the
concerns might be around Martin’s physical, psychological and social
Martin has the
following physical ailments: Bladder control, motor impairment
difficulty with communicating. He has had mood changes. His speech is suffering
and unable to pronounce certain words. He is suffering from early stages of
What might be causing Martin’s distress?
Martin may have
the early stages of dementia. He seems have some of the early symptoms. He is
unable to express his physical pain and therefore it is causing distress with
How might your profession be
involved in supporting Martin and his family?
with Martin and not constantly reminding him of his reduced abilities and Explaining
the situation to her daughter may make her more reasonable toward her father’s
new problems. I could also try to
improve communication methods by allowing Martin to write down his needs.
Your future role
Using the skills and knowledge that you
have developed during the 2 hour IPL team-working session and information you
have discovered as part of completing this workbook, describe one approach you
will adopt in working with people with cognitive impairment in your future role
as a healthcare professional.
Next Steps: Is there any additional study you could do to equip yourself to
work effectively with people with information processing and/or cognitive or
communication impairments, and their families or carers?
I have read a book called “Activities to do
with your parent who has Alzheimer’s Dementia” This book gave a great insight
into seeing the life in eyes of person who suffered from dementia.