The General Council of Nursing (CGE) has highlighted that nursing shortages contribute to delays in diagnosis of cognitive impairment and impair the quality of life of those affected and their families, in addition to other factors such as age, socio-economic status, educational level. or lifestyle, in addition to family history and medical conditions such as anxiety or stress, are some of the factors that make it difficult to detect cognitive impairment.
This was highlighted during the webinar “Comprehensive multidisciplinary intervention for cognitive impairment. Serious mental pathology”, conducted by the Higher Institute of Medical Education (ISFOS) of the General Council of Nursing (CGE) in collaboration with Boehringer Ingelheim.
Despite the prevalence of this disease in an increasingly aging country such as Spain, and the consequences for the quality of life of people suffering from it, there is a significant level of underdiagnosis of this disease, since the symptoms are so common that they go unnoticed by both the patient and his family. They warned that the situation creates barriers to nurse-led early detection of the disease – a key intervention tool – and initiation of treatment, implying that the condition will worsen more quickly.
Decreased memory, loss of attention, or slower processing speed are some of the symptoms of cognitive decline. This deterioration can lead to diseases such as Alzheimer’s disease or other types of dementia.
During the meeting, participants emphasized that nursing intervention is the key to early detection of the disease, and the nurse-family binary acts as therapeutic allies, forming a network of support and care that provides the stability that the patient needs.
“The brain, like the rest of the body, changes as we age. Many people find that they become more forgetful as they age. They may take longer to think of a word or remember a person’s name. The problem is that at first it is believed that “this is an age-related problem.” This is normal, and Alzheimer’s disease or other types of dementia are not thought to be the cause of this forgetfulness. As healthcare professionals, this is very important for nurses. and are informed about the needs of these patients, both in early detection and in cognitive stimulation, in monitoring their physical and mental health or in the emotional support they need,” explains ISFOS Director Pilar Fernandez.
Cognitive impairment is a cross-cutting problem and not only corresponds to this type of illness as we may think, but also affects others, such as serious mental illness.
“There are many other pathological conditions in which this cognitive decline occurs. In the field of mental disorders, there is a concept of a serious mental disorder, such as bipolar disorder or schizophrenia, in which the condition will occur one hundred percent. There are also other diseases, such as liver pathologies, for example due to the consumption of toxic substances, which lead to changes in the patient’s brain that lead to cognitive impairment,” says Mercedes Peña, head of the department of adult and community psychiatry at the hospital Gregorio Marañon (Madrid) and permanent lecturer. .
As José Manuel Montes, head of the psychiatry department at the Ramón y Cajal University Hospital, noted, the first sign of cognitive decline is personal. Patients usually notice this through loss of functionality.
“Once these areas are affected, and depending on the mental illness we’re talking about, there will be a greater or lesser impact on what we call cognition, which allows us to perceive the environment and make decisions about it. Here, memory, attention, concentration or the ability to plan, among other things, are affected,” he explained.
“Cognitive decline in most mental illnesses does not imply the same degree of impairment as that which may be seen in degenerative diseases such as dementia or Alzheimer’s disease. The cognitive decline associated with mental illness is more subtle and does not completely impact a person’s autonomy. subject, and their functionality, for example, at the working level,” the psychiatrist added.
On the other hand, in addressing the problem of cognitive impairment, the family plays a fundamental role, acting as the primary caregiver. He becomes a therapeutic ally to nurses as they are an extension of these professionals and their care. “They provide fundamental emotional and psychological support to the patient. Strong family relationships have been shown to create a higher quality emotional environment and this contributes to an improved patient’s quality of life. For nurses, their helping role is important, they are our therapeutic allies,” said Julio Gonzalez, an emergency psychiatric nurse at the Gregorio Marañon Hospital.
Once a diagnosis is made, nurses and family members form a patient support network. “This alliance is based on a binomial relationship where health care providers offer extensive medical education to caregivers,” he said. However, families also need special care. “When we identify this caregiver overload, we offer a therapeutic space for families to vent and talk about the difficulties they are facing. We give them a free and safe space where they can speak without feeling judged,” he added.
In this sense, nurses care not only for the patient, but also for the families who provide the primary care. “We run workshops on how to make more ergonomic changes in posture, we offer emotional workshops to work with them on mental health, as well as more practical health education activities so they know how to manage basic aspects of sleep hygiene, nutrition, exercise exercises. or cognitive stimulation. The role of nurses is fundamental not only in health education, but also as emotional support for the caregiver,” the nurse concluded.