Esther C. Kane, C.D.S.
As a retired occupational therapist and senior home safety specialist, I would often be asked questions about cognitive impairment by family members of my patients.
It’s only natural that my patient and their family would be concerned about the cognitive changes that are occurring.
This term encompasses a significant decrease in cognitive function, including memory, attention, language, and problem-solving skills.
It’s essential to understand its implications, particularly for older adults, and how it intersects with cognitive disabilities and intellectual disability.
Is cognitive impairment considered a disability in older adults?
If your cognitive ability is such that it renders you unable to work. you might be eligible to receive long-term disability benefits.
What Is Cognitive Impairment?
Cognitive impairment is a medical term that signifies a decline in cognitive abilities.
It can result from various factors such as age-related changes, neurodegenerative diseases like Alzheimer’s or Parkinson’s disease, traumatic brain injuries, brain tumors and other neurological disorders.
A cognitive disability is not always due to a medical condition, it can certainly be a result of a traumatic injury such as a fall or injury to the head.
Some older people even suffer a decline in cognitive abilities due to anesthesia during a surgery. (01)
Symptoms can range from memory loss to struggling with social situations or daily activities.
Mild Cognitive Impairment
Mild cognitive impairment (MCI) is a stage between the normal cognitive decline associated with aging and the more severe decline of dementia.
The most common cognitive deficits that older persons suffer from include issues with memory, language, thinking, and judgment.
These often are more than typical age-related changes but not severe enough to interfere significantly with daily functional abilities.
Although I will say, from personal experience, that this decreased mental functioning can interfere with someone’s social skills. This can make it difficult to maintain friendships and engage in social situations.
Moderate and Severe Cognitive Impairment
Moderate cognitive impairment might require a person to need assistance with routine tasks and, such as managing medications or paying bills.
On the other hand, severe cognitive impairment requires full-time assistance with activities of daily living due to significant deficits.
Conditions like Alzheimer’s disease or severe traumatic brain injury fall into this category.
Is Cognitive Impairment a Disability?
The legal definition of a disability often includes limitations in major life activities due to a physical or mental condition.
Cognitive impairment, especially in its moderate to severe stages, certainly restricts these activities.
However, whether it is considered a disability can depend on the specific circumstances and legal jurisdictions.
For instance, in the United States, the Social Security Administration recognizes some forms of cognitive impairment, including certain cognitive disabilities and intellectual disability, as disabilities if they significantly limit a person’s ability to work.
Living with Cognitive Impairment
Living with cognitive impairment can significantly impact older adults and their families in various ways. Here are some potential effects:
- Daily Life Challenges: Cognitive impairment can make it difficult for older adults to perform everyday tasks such as cooking, cleaning, or managing medications. This can lead to a loss of independence.
- Communication Difficulties: Cognitive impairments often affect language and comprehension skills, making communication challenging.
- Memory Issues: Problems with short-term memory can lead to confusion, forgetfulness, and frustration.
- Behavioral Changes: Older adults with cognitive impairment might exhibit changes in personality, mood swings, agitation, or even aggression.
- Increased Caregiver Burden: Family members often take on the role of caregivers, which can be physically, emotionally, and financially demanding.
- Emotional Stress: Watching a loved one struggle with cognitive impairment can cause stress, anxiety, and depression among family members.
- Financial Strain: The cost of caregiving, medical treatments, and potentially long-term care facilities can put significant financial pressure on families.
- Social Isolation: As cognitive impairment progresses, it may become harder for the affected individual to maintain social relationships, leading to isolation.
- Safety Concerns: As cognitive abilities decline, safety becomes a concern. Older adults may forget to turn off appliances, get lost, or have difficulty navigating physical spaces.
- Healthcare Decisions: Families may face tough decisions about healthcare and end-of-life care for their loved ones with cognitive impairment.
Remember, these challenges can vary widely depending on the severity of the cognitive impairment and the individual’s overall health and support system.
Available Resources For Help
However, many resources are available to help individuals and their caregivers navigate these challenges.
Dealing with cognitive impairment in older adults can be challenging, but there are several strategies that can help manage the situation.
Here are some ways for older adults with cognitive impairment and their family members to cope:
- Develop a Support Plan: Creating a plan that outlines daily routines, medical appointments, and care strategies can provide structure and predictability. (03)
- Effective Communication Techniques: Use simple language, ask one question at a time, and break down complex tasks into smaller, manageable steps. (04)
- Create a Calm Environment: Speak in calm, reassuring tones to avoid agitating or confusing the person with cognitive impairment. (05)
- Home Safety Measures: Remove hazards and add safety features around the home to promote independent and safe movement. (06)
- Engage in Activities: Gardening, decorating the house, playing music, or attending small concerts can stimulate the mind and promote well-being. (07)
- Medical Assessment: Regular check-ups can help monitor the progress of cognitive impairment and adjust care plans as needed. (08)
- Emotional Support: Validate their emotions, show sensitivity, and avoid criticism to build a supportive environment. (09)
- Professional Help: If the situation becomes overwhelming, consider seeking help from professionals specializing in geriatric care or cognitive impairments.
- Assistive Technology: There are numerous devices and applications designed to support people with cognitive impairments.
Let’s not forget about Assistive Technology.
There are numerous devices and applications designed to support people with cognitive impairments.
- Memory Aids: Devices like digital calendars, medication reminders, or apps that help with task sequencing can assist those with memory issues
- GPS Trackers: For those with a tendency to wander or become disoriented, GPS trackers can provide a safety net and peace of mind for caregivers
- Communication Aids: Tools such as picture phones, easy-to-use smartphones, or communication apps can support those struggling with language or communication (02).
- Home Safety Devices: Automated lighting, fall detection sensors, and stove shut-off systems can ensure a safer living environment
Remember, every person’s experience with cognitive impairment is unique, and what works for one person might not work for another.
It’s crucial to be patient, flexible, and willing to adapt strategies as needed.
Cognitive Impairment and Social Security
If you or a loved one has a cognitive impairment severe enough to limit work ability, you may be eligible for Social Security disability benefits.
The application process can be complex, requiring comprehensive medical records and evidence of how the impairment affects daily activities.
Consulting with a healthcare provider or seeking legal advice can be beneficial to understand your eligibility and navigate the claims process.
Receiving these benefits can significantly ease the financial burden associated with cognitive impairment, allowing for necessary treatment and support.
Final Thoughts
In conclusion, understanding cognitive impairment and its potential recognition as a disability, including cognitive disabilities and intellectual disability, is vital for seniors and their caregivers.
This knowledge can open up avenues for support and financial assistance, improving the lives of those affected.
Sources:
01 – Wu L, Zhao H, Weng H, Ma D. Lasting effects of general anesthetics on the brain in the young and elderly: “mixed picture” of neurotoxicity, neuroprotection and cognitive impairment. J Anesth. 2019 Apr;33(2):321-335. doi: 10.1007/s00540-019-02623-7. Epub 2019 Mar 11. PMID: 30859366; PMCID: PMC6443620.
02 – Assistive Devices for People with Hearing, Voice, Speech, or Language Disorders.” National Institute on Deafness and Other Communication Disorders, U.S. Department of Health & Human Services, Dec. 2011, www.nidcd.nih.gov/health/assistive-devices-people-hearing-voice-speech-or-language-disorders.
03 – National Institute on Aging. ‘Caring for Older Patients with Cognitive Impairment.’ National Institute on Aging, U.S. Department of Health and Human Services, 15 Mar. 2023, www.nia.nih.gov/health/health-care-professionals-information/caring-older-patients-cognitive-impairment.
04 – Family Caregiver Alliance. “Caring for Adults with Cognitive and Memory Impairment.” Family Caregiver Alliance, 2023, www.caregiver.org/resource/caring-adults-cognitive-and-memory-impairment/.
05 – Crisis Care for Adults With Cognitive Impairment.” MSW@USC, University of Southern California, https://msw.usc.edu/mswusc-blog/crisis-care-adults-cognitive-impairment/.
06 – National Institute on Aging. “Tips for Caregivers and Families of People With Dementia” Alzheimer’s.gov, National Institutes of Health, https://www.alzheimers.gov/life-with-dementia/tips-caregivers.
07 – Swanger, William, MA, APR, Fellow PRSA. “Five Engaging Activities for Older Adults with Cognitive Issues.” Diakon Senior Living Services, Diakon Senior Living, https://www.diakonseniorliving.org/blog/1575387434-five-engaging-activities-older-adults-cognitive-issues/.
08 – Kernisan, Leslie. “Cognitive Impairment in Aging: 10 Common Causes & 10 Things the Doctor Should Check.” Better Health While Aging, Dec 2022, https://betterhealthwhileaging.net/cognitive-impairment-causes-and-how-to-evaluate/.
09 – 18 Tips for Dealing with Stubborn Aging Parents.” The Arbor Company, https://www.arborcompany.com/blog/18-tips-for-dealing-with-stubborn-aging-parents.
