Inability to remember or recall bits of information or behavioral
• Inability to determine whether a behavior was performed
• Inability to learn new skills or information or to perform
previously learned skills
• Inability to recall factual information and recent or past events
• Incidences of forgetting, including forgetting to perform a behavior
at a scheduled time
• Fluid and electrolyte
• Decreased cardiac output
• Excessive environmental
• Neurological disturbances
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Cardiac function
• Fluids and electrolytes
The patient/family will
• Express feelings about memory impairment.
• Acknowledge need to take measures to cope with memory
• Identify coping skills to deal with memory impairment.
• State speciﬁc plans to modify lifestyle.
• Establish realistic goals to deal with further memory loss.
SUGGESTED NOC OUTCOMES
Cognition; Cognitive Orientation; Concentration; Memory; Neuro-
logical Status: Consciousness
INTERVENTIONS AND RATIONALES
Determine: Observe patient’s thought processes during every shift.
Document and report any changes. Changes may indicate progressive
improvement or a decline in patient’s underlying condition.
Perform: Implement appropriate safety measures to protect patient
from injury. He or she may be unable to provide for his or her own
Call patient by name and tell him or her your name. Provide
background information (place, time, and date) frequently through-
out the day to provide reality orientation. Use a reality orientation
board to visually reinforce reality orientation.
Spend sufﬁcient time with patient to allow her to become comfort-
able discussing memory loss and establish a trusting relationship.
Be clear, concise, and direct in establishing goals to promote max-
imal use of patient’s remaining cognitive skills. Offer short, simple
explanations to patient each time you carry out any medical or
nursing procedure to avoid confusion.
Label patient’s personal possessions and photos, keeping them in
the same place as much as possible, to reduce confusion and create
a secure environment.
Inform: Inform patient that you are aware of his or her memory loss
and that you will help him or her cope with his or her condition to
bring the issue into the open and help patient understand that your
goal is to help him or her.
Teach patient ways to cope with memory loss (e.g., using a beeper
to remind her when to eat or take medications; using a pillbox
organized by days of the week; keeping lists in notebooks or a
pocket calendar; having family members or friends remind her of
important tasks). Reminders help limit the amount of information
patient must maintain in her memory.
Help patient and family members establish goals for coping with
memory loss. Discuss with family members the need to maintain the
least restrictive environment possible. Instruct them on how to main-
tain a safe home environment for patient. This helps ensure that
patient’s needs are met and promotes his or her independence.
Demonstrate reorientation techniques to family members and pro-
vide time for supervised return demonstrations to prepare them to
cope with patient with memory impairment.
Attend: Encourage patient to develop a consistent routine for
performing activities of daily living to enhance his self-esteem and
increase his self-awareness and awareness of his environment.
Encourage patient to interact with others to increase social
involvement, which may decline with memory loss.
Encourage patient to express the feelings associated with impaired
memory to reduce the impact of memory impairment on patient’s
self-image and lessen anxiety.
Manage: Help family members identify appropriate community sup-
port groups, mental health services, and social service agencies to
assist in coping with the effects of patient’s illness or injury.
SUGGESTED NIC INTERVENTIONS
Anxiety Reduction; Calming Technique; Cerebral Perfusion Promo-
tion; Dementia Management; Fluid and Electrolyte Management;
Memory Training; Neurologic Monitoring; Reality Orientation
Parahoo, K., et al. (2006, June). Expert nurses’ use of implicit memory in the
care of patients with Alzheimer’s disease. Journal of Advanced Nursing,