Cognitive Disorders

The clarity and purpose of an individual’s personal journey depend on the ability to reflect on its meaning. Cognition represents a fundamental human feature that distinguishes living from existing. This mental capacity has a distinctive, personalized impact on the individual’s physical, psychological, social, and spiritual conduct of life. For example, the ability to “remember” the connections between related actions and how to initiate them depends on cognitive processing. Moreover, this cognitive processing has a direct relationship to activities of daily living. Although primarily an intellectual and perceptual process, cognition is closely integrated with an individual’s emotional and spiritual values. When human beings can no longer understand facts or connect the appropriate feelings to events, they have trouble responding to the complexity of life’s challenges. Emotions take a back seat to profound disturbances in cognitive processing that either cloud or destroy the meaning of the journey. The labyrinth of current knowledge about cognitive disorders requires a compassionate understanding of the client and family. Nursing interventions are focused on protecting patient dignity, preserving functional status, and promoting quality of life for cognitively impaired clients. There are three main cognitive disorders: delirium, dementia, and amnestic disorder. Cognitive disorder not otherwise specified is a category defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision that allows for the diagnosis of cognitive disorders that do not meet the criteria for delirium, dementia, or amnestic disorders (American Psychiatric Association [APA], 2000). Cognitive disorders not otherwise specified are presumed to be caused by a specific medical condition, a pharmacologically active agent, or possibly both (Sadock & Sadock, 2004).
Delirium “is characterized by a disturbance of consciousness and a change in cognition such as