How to Write a Nursing Care Plan for Dementia

A nursing care plan for dementia is a structured and individualized document that outlines specific needs, goals, and interventions for managing patients’ health conditions. Creating a care plan for patients with dementia is complex, with numerous considerations, like risk for falls, danger of self-harm, and self-care deficit. Additionally, patients with dementia are at a greater risk of depression and may have co-occurring diseases that require management, so it’s important that you write a comprehensive care plan.

If you’re a dementia practitioner or are wonder how to write a nursing care plan for dementia, this article is for you. We’ll discuss how you can create effective care plans addressing the specific challenges these patients face.

Dementia Quick Facts

According to the World Health Organization, here are some facts about the realities of this condition:

• Over 55 million people have dementia worldwide.
• Dementia is the 7th leading cause of death and one of the major causes of disability among older people.
• Alzheimer’s disease is the most common form of dementia and may contribute to 60%–70% of cases.
• Dementia costs global economies $1.3 trillion dollars.
• Women are disproportionately affected by dementia, facing greater disability and mortality from it. Despite this, they shoulder 70% of caregiving responsibilities for individuals with dementia.

Nursing Care Plan for Dementia: Key Considerations

To create a thorough nursing care plan for dementia, it is important to understand the condition. Dementia is a progressive neurological disorder characterized by a decline in cognitive function that presents unique challenges for both those affected and their caregivers.

The main symptom of dementia is a progressive decline in cognitive function that interferes with daily life. This may manifest in various forms, some of which include:

• Memory loss
• Difficulty communicating
• Confusion and disorientation
• Impaired judgment and reasoning
• Personality changes
• Difficulty with daily tasks
• Agitation and mood swings
• Wandering
• Trouble with coordination and motor skills

Dealing with patients who have dementia presents unique challenges and may require a holistic approach. Challenges include:

• Communication. Dementia disrupts verbal communication, prompting caregivers to rely on non-verbal cues and alternative methods.
• Behavioral issues. Patients may exhibit erratic behaviors such as agitation, aggression, or wandering, necessitating tailored interventions.
• Memory impairment. Patients face varying degrees of memory loss, highlighting the importance of repeated reminders and cues for daily tasks.
• Swallowing issues. Patients may struggle with swallowing, increasing the risk of choking or aspiration pneumonia.
• Safety risks. Impaired memory and judgment increase the likelihood of accidents and wandering, highlighting the need for safety measures.
• Emotional support needs. Dementia can lead to mood swings, confusion, and frustration, requiring emotional support.
• Care coordination difficulties. Effective dementia care involves collaboration among healthcare professionals, family members, and support services to address the complex needs of the patients.
• Family assistance. Dementia takes a toll on a patient’s family. Imagine the frustration of watching a relative lose access to memories and not recognize you. Being prepared to assist the family during this challenging journey is essential.

Dementia Care Plan Goals

Since there is no known cure for this disease, the goals of a nursing care plan for dementia typically focus on enhancing the patient’s quality of life, promoting safety, and managing symptoms effectively. Some care plan goals for dementia include:

• Enhance memory, attention, and problem-solving abilities through cognitive exercises and activities.
• Facilitate effective communication through alternative methods such as using gestures, pictures, or simplified language.
• Minimize the risk of falls, wandering, and other accidents by implementing appropriate safety measures and supervision.
• Address agitation, aggression, and other challenging behaviors through non-pharmacological interventions like redirection, validation therapy, or sensory stimulation.
• Assist with personal care tasks, meal preparation, and mobility to promote independence and maintain functional abilities.
• Provide caregivers with knowledge and skills to effectively manage symptoms, cope with caregiver stress, and access support resources.
• Evaluate medication effectiveness and side effects, optimizing pharmacological interventions to manage symptoms while minimizing adverse effects.

Sample Care Plan for a Dementia Patient

Many individuals diagnosed with dementia continue to reside in their own homes, where they receive care. Let’s use nursing care for dementia patients in-home as an example to explore the process of building a care plan. There are five main components of a care plan:

1. Assessment
2. Nursing diagnoses
3. Planning
4. Implementation
5. Evaluation

1. Assessment

To create a care plan, start by assessing the patient. Check their medical history, diagnosis, lab results, and list of medications.

Examples of nursing assessment findings for dementia patients:

• Disorientation to time, place, or person
• Bruising due to falls
• Dry mucous membrane and tenting skin due to dehydration
• Poor self-care
• Agitation and anxiety
• Cognitive decline over time

2. Nursing Diagnoses

In a care plan, a nursing diagnosis is a clinical judgment concerning a patient’s response to actual or potential health problems or life processes. It provides a framework for planning and implementing nursing care to improve patient outcomes.

Examples of nursing diagnoses for dementia patients:

• Risk for injury, related to impaired judgment and mobility as evidenced by a history of falls or near-misses, wandering behavior, and environmental hazards in the home.
• Self-care deficit, related to cognitive decline and physical limitations as evidenced by difficulty performing activities of daily living (ADLs) independently, such as grooming, bathing, and dressing.
• Imbalanced nutrition, related to cognitive impairment and decreased ability to independently prepare meals as evidenced by poor appetite, weight loss, and inadequate dietary intake.

3. Planning

Planning involves setting goals that serve as benchmarks for evaluating the effectiveness of nursing interventions and guiding the overall plan of care. There are two types of goals — short-term and long-term — and it’s essential for them to adhere to the SMART criteria.

Examples of desired outcomes for dementia patients:

• Patient will consume at least 75% of meals and fluids offered throughout the day.
• Patient will demonstrate a decreased frequency of agitated episodes from 5 times a day to twice a day within 4 weeks.
• Patient will experience a decrease in falls from once a week to none within 2 months through environmental modifications and assistance during mobility.

4. Implementation

Nursing interventions are specific actions that a nurse performs as a part of the nursing process to address the needs of a patient, such as direct patient care, education, counseling, advocacy, and coordination of care with other healthcare team members.

Examples of nursing interventions for dementia patients:

• Nursing team will provide assistance with eating and drinking as needed to prevent dehydration and malnutrition.
• Nursing team will provide a calm and structured environment with familiar routines to reduce anxiety triggers.
• Nursing team will implement calming techniques such as deep breathing exercises or gentle music therapy.
• Nursing team will engage patients in activities that stimulate memory, cognition, and problem-solving skills, such as puzzles, games, reminiscence therapy, and music therapy.

5. Evaluation

This step refers to the process of assessing the effectiveness of the interventions implemented. It involves systematically evaluating the progress made toward achieving the desired outcomes and goals in the care plan.

Examples of nursing evaluations for dementia patients:

• Patient demonstrates improved memory recall compared to baseline and engages in coherent conversations with caregivers and family members.
• Patient consistently utilizes handrails when walking and transfers safely between bed and chair. Falls risk assessment indicates a decrease in fall incidents compared to previous periods.
• Patient maintains adequate hydration and nutrition levels. Weight measurements indicate stable or improved nutritional status over time.

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