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IMPAIRED MEMORY Nursing Care Plan

Impaired Memory
Inability to remember or recall bits of information or behavioral
skills
Defining Characteristics*
Major (Must Be Present, One or More)
Reports experiences of forgetting
Inability to recall if a behavior was performed
Inability to learn or retain new skills or information
Inability to perform a previously learned skill
Inability to recall factual information
Inability to recall events
Related Factors
Pathophysiologic
Related to neurologic disturbances* secondary to:
Degenerative brain disease
Lesion
Head injury
Cerebrovascular accident
Related to reduced quantity and quality of information processed
secondary to:
Visual deficits
Hearing deficits
Poor physical fitness
Fatigue
Learning habits
Intellectual skills
Educational level
Related to nutritional deficiencies (e.g., vitamins C and B12, folate,
niacin, thiamine)
Treatment Related
Related to effects of medication (specify) on memory storage
Situational (Personal, Environmental)
Related to self-fulfilling expectations
Related to excessive self-focus and worry secondary to:
Grieving
Anxiety
Depression
Related to alcohol consumption
Related to lack of motivation
Related to lack of stimulation
Related to difficulty concentrating secondary to:
Stress
Pain
Distractions
Lack of intellectual stimulation
Sleep disturbances

Author's Notes
This diagnosis is useful when the client can be helped to function
better because of improved memory. If the client’s memory cannot
be improved
because of cerebral degeneration, this diagnosis is not
appropriate.
Instead, the nurse should evaluate the effects of impaired
memory on functioning, such as Self-Care Deficits or Risk for Injury. The
focus of interventions for these nursing diagnoses would be improving
self-care or protection, not improving memory.

Goal
The client will report increased satisfaction with memory, as evidenced
by the following indicators:
• Identify three techniques to improve memory.
• Relate factors that deter memory.

Interventions
Discuss the Client’s Beliefs About Memory Deficits
• Correct misinformation.
• Explain that negative expectations can result in memory deficits.
Assess for Factors That May Negatively Affect Memory (e.g.,
Pathophysiologic, Literacy, Stressors)
If the Client Has Difficulty Concentrating, Explain the Favorable
Effects of Relaxation and Imagery
Teach the Client Two or Three of the Following Methods to
Improve Memory Skills (Maier-Lorentz, 2000; Miller, 2009):
• Write things down (e.g., use lists, calendars, notebooks).
• Use auditory cues (e.g., timers, alarm clocks) in conjunction
with written cues.
• Use environmental cues (e.g., you might remove something
from its usual place, then return it to its normal location after
it has served its purpose as a reminder).
• Have specific places for specific items; keep items in their
proper place (e.g., keep keys on a hook near the door).
• Put reminders in appropriate places (e.g., place shoes to be
repaired near the door).
• Use visual images (“A picture is worth a thousand words”).
Create a picture in your mind when you want to remember
something; the more bizarre the picture, the more likely you
will remember.
• Use active observation—pay attention to details around you
and be alert to the environment.
• Make associations or mental connections (e.g., “Spring ahead
and fall back” for changing clocks to and from daylight savings
time).
• Make associations between names and mental images
(e.g., Carol and Christmas carol).
• Rehearse items you want to remember by repeating them
aloud or writing them on paper.
• Use self-instruction—say things aloud (e.g., “I’m putting my
keys on the counter so I remember to turn off the stove before
I leave”).
• Divide information into small chunks that can be remembered
easily (e.g., to remember an address or a zip code, divide it into
groups [“seven hundred sixty, fifty-five”]).
• Organize information into logical categories (e.g., shampoo and
hair spray, toothpaste and mouthwash, soap and deodorant).
• Use rhyming cues (e.g., “In 1492, Columbus sailed the ocean
blue”).
• Use first-letter cues and make associations (e.g., to remember
to buy carrots, apples, radishes, pickles, eggs, and tea bags,
remember the word carpet).
• Make word associations (e.g., to remember the letters of your
license plate, make a word, such as “camel” for CML).
• Search the alphabet while focusing on what you are trying to
remember (e.g., to remember that someone’s name is Martin,
start with names that begin with “A” and continue naming
names through the alphabet until your memory is jogged for
the correct one).
• Make up a story to connect things you want to remember (e.g.,
if you have to go to the cleaners and post office, create a story
about mailing a pair of pants).
When Trying to Learn or Remember Something:
• Minimize distractions.
• Do not rush.
• Maintain some form of organization of routine tasks.
• Carry a note pad or calendar or use written cues.
When Teaching (Miller, 2009):
• Determine if there are barriers to learning (e.g., stress, alcohol
use/abuse, pain, depression, low literacy).
• Eliminate distractions.
• Present information as concretely as possible.
• Use practical examples.
• Allow learner to pace the learning.
• Use visual, auditory aids.
• Provide advance organizers; outlines, written cues.
• Encourage use of aids.
• Make sure glasses are clean and lights are soft white.
• Correct wrong answers immediately.
• Encourage verbal responses.
• Try to organize self-care activities in the same order and same
time each day.
Geriatric Interventions
• Provide accurate information about age-related changes.
• Explain the difference between age-related forgetfulness and
dementia.

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