Nursing Care Plans For Dementia
- Assess the onset and characteristics of symptoms (determine type and stage of disorder).
- Establish cognitive status using standard measurement tools.
- Determine self-care abilities.
- Assess threats to physical safety (eg, wandering, poor reality testing).
- Assess affect and emotional responsiveness.
- Assess ability and level of support available to caregivers.
- Impaired Communication related to cerebral impairment as demonstrated by altered memory, judgment, and word finding
- Bathing or Hygiene Self-Care Deficit related to cognitive impairment as demonstrated by inattention and inability to complete ADLs
- Risk for Injury related to cognitive impairment and wandering behavior
- Impaired Social Interaction related to cognitive impairment
- Risk for Violence: Self-directed or Other-directed related to suspicion and inability to recognize people or places
Interventions and Evaluation Nursing Care Plans For Dementia
NO | DIAGNOSIS | OUTCOME | INTERVENTION | EVALUATION |
| 1 | Impaired Communication related to cerebral impairment as demonstrated by altered memory, judgment, and word finding | Demonstrate congruent verbal and nonverbal communication. | - Speak slowly and use short, simple words and phrases.
- Consistently identify yourself, and address the person by name at each meeting.
- Focus on one piece of information at a time. Review what has been discussed with patient.
- If patient has vision or hearing disturbances, have him wear prescription eyeglasses and/or a hearing device.
- Keep environment well lit.
- Use clocks, calendars, and familiar personal effects in the patient’s view.
- If patient becomes verbally aggressive, identify and acknowledge feelings.
- If patient becomes aggressive, shift the topic to a safer, more familiar one.
- If patient becomes delusional, acknowledge feelings and reinforce reality. Do not attempt to challenge the content of the delusion.
| - Demonstrates decreased anxiety and increased feelings of security in supportive environment
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| 2 | Bathing or Hygiene Self-Care Deficit related to cognitive impairment as demonstrated by inattention and inability to complete ADLs | Independence in Self-Care | - Assess and monitor patient’s ability to perform ADLs.
- Encourage decision making regarding ADLs as much as possible.
- Label clothes with patient’s name, address, and telephone number.
- Use clothing with elastic and Velcro for fastenings rather than buttons or zippers, which may be too difficult for patient to manipulate.
- Monitor food and fluid intake.
- Weigh patient weekly.
- Provide food that patient can eat while moving.
- Sit with patient during meals and assist by cueing.
- Initiate a bowel and bladder program early in the disease process to maintain continence and prevent constipation or urine retention
| Maintains maximum degree of orientation and self-care within level of ability |
| 3 | Risk for Injury related to cognitive impairment and wandering behavior | Safety appears | - Discuss restriction of driving when recommended.
- Assess patient’s home for safety: remove throw rugs, label rooms, and keep the house well lit.
- Assess community for safety.
- Alert neighbors about the patient’s wandering behavior.
- Alert police and have current pictures taken.
- Provide patient with a MedicAlert bracelet.
- Install complex safety locks on doors to outside or basement.
- Install safety bars in bathroom.
- Closely observe patient while he is smoking.
- Encourage physical activity during the daytime.
- Give patient a card with simple instructions (address and phone number) should the patient get lost.
- Use night-lights.
- Install alarm and sensor devices on doors.
| Safety precautions and close surveillance maintained; no injury |
| 4 | Impaired Social Interaction related to cognitive impairment | Socialization increase | - Provide magazines with pictures as reading and language abilities diminish.
- Encourage participation in simple, familiar group activities, such as singing, reminiscing, doing puzzles, and painting.
- Encourage participation in simple activities that promote the exercise of large muscle groups.
| Attends group activities; sings, exercises with group |
| 5 | Risk for Violence: Self-directed or Other-directed related to suspicion and inability to recognize people or places | Risk for violence is not appears | - Respond calmly and do not raise your voice.
- Remove objects that might be used to harm self or others.
- Identify stressors that increase agitation.
- Distract patient when an upsetting situation develops.
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