Acute Medicine | Palliative care | Management of cognitive deterioration

Management of cognitive deterioration
Session overview
Description
As the end of life approaches, patients with either advanced cancer or other progressive life-limiting illnesses may experience a reduction in their cognitive function, such as forgetfulness, confusion or agitation. This session provides a framework for the management of diminishing cognitive function.

This session was reviewed by Richard Kitchen and last updated in January 2021.

Learning objectives
By the end of this session you will be able to:

list the key groups of professionals involved in managing deteriorating cognitive function at the end of life
outline the main drug and non-drug interventions available to optimise cognitive function in the patient population with progressive levels of need
explain the usefulness and limitations of each intervention
recognise the communication and information needs of patients and their family or carers
outline key aspects of an integrated, incremental approach to managing progressive cognitive impairment

Prerequisites
Before commencing this session you should:

Assessment of physical and cognitive deterioration in function (215-0439)
Mental Capacity Act: aims and principles (215-0107)

Patients with both cancer and non-cancer diagnoses can experience deterioration in their cognitive function as the end of life approaches.

This session provides an integrated framework to guide you in the management of people with diminishing cognitive function. Key groups of professionals involved in the management of patients are discussed. Main drug and non-drug measures to optimise cognitive function are also considered.

In addition, this session addresses the information and communication needs of the patient, family and carers, and the importance of providing emotional support. Finally, it reminds the professional of the requirement for ongoing reassessment and adaptation of the management plan as the patient’s level of need increases.