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Cognitive and Psychosocial Assessments (Purposes of the cognitive and…
Cognitive and Psychosocial Assessments
Overview
- Differ to physical and functional assessments which are viewed as routine. Whereas, the purpose of a cognitive and psychosocial assessment is to address the body-mind-spirit- needs of older adults.
Purposes of the cognitive and psychosocial assessment process
Detecting asymptomatic or unacknowledged health problems at an early stage.
Identifying signs and symptoms of psychosocial dysfunction such as anxiety, depression, memory problems or a change in mental status.
Identifying stressors and other risk factors, especially those that are amendable to interventions that affect cognitive, emotional or social function.
Obtaining information about the persons usual personality and coping mechanisms.
Assessing cognitive abilities
Identifying residents personal goals for psychosocial wellness.
Identifying social supports and other coping resources that could be further supported or strengthened.
Scope of the psychosocial assessment
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Identify the unique meaning of life events with particular attention on identifying any effects on health.
Initial questions may focus on prior life events which promotes discussion.
Questions to assess the meaning of medical conditions and functional limitations are essential.
Nurses should try to identify a persons concerns about the functional consequences of an illness or disability.
Nurses may commonly hear information that differs to their own values, beliefs or cultural expectations. Thus requiring nurses to be aware of their own feelings, have a non-judgemental attitude and show empathy.
Procedure of the cognitive and psychosocial assessment
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Information can be obtained from interviewing older adults and their carers and through observations.
Focus on immediate needs, but should consider a persons ongoing care needs
In acute care settings assessments are preformed at the time of admission to establish a baseline for planning nursing care.
As soon as a person is medically stable nurses should begin assessing cognition and psychosocial issues as an important component of person-centred care.
Information can be obtained from family members or other sources when an older adults cognitive function is compromised.
Tools for effective cognitive and psychosocial assessments -
Trusting relationship
Listening ear
Intuitive mind
Sensitive heart
Good communication skills
Communication skills for cognitive and psychosocial assessments -
Identifying Communication barriers
External and internal distractions can interfere with the ability to focus on the conversation.
To much information being requested at one time
To many people trying to communicate at one time.
Environmental noise
Physical discomfort
Adverse medication effects
Enhancing Communication with Older Adults
Use a simple introduction which can establish rapport if done effectively.
Introduce yourself verbally, explain your role, ask the person their preferred name.
Touch
Attentive listening communicates respect and caring
asking open-ended questions and non-verbally responding
Non-verbal responses such as sustained eye contact if culturally appropriate
Periodically clarify the messages
Creating an environment that supports good communication
Face-to-face positioning
Awareness of an individuals comfort zone
Provide as much privacy as possible
Eliminating distracting noises
Mental Status Assessment
an organised approach to collecting data about a persons cognitive and psychosocial function
Observes and assesses physical appearance, alertness and attention, motor function, social skills, orientation, memory, speech and language characteristics and executive function.
Mini-Cog
an evidence based screening tool that consists of a three item recall test and a simple clock drawing test that is used as a reliable and valid screening tool for cognitive impairment
Abbreviated Mental Test [AMT]
includes 10 items that assess memory and attention.
Folstein Mini-Mental State Examination [MMSE]
assess orientation, memory, attention, abilities to name, follow verbal and written commands, write a sentence spontaneously and copy a complex polygon.
Montreal Cognitive Assessment [MoCA]
Includes 30 items assessing short-term memory recall, visuospatial abilities, three-dimensional cube copy and executive functions.