What should a nurse do when a patient has cognitive impairment?

• A. Speak louder and slower without adjusting content.
• B. Rely exclusively on family for all explanations.
• C. Use written text only.
• D. Adapt communication techniques to ensure understanding.

Answer: (D)

When a patient has cognitive impairment, the key is to tailor communication so the patient can understand and participate in care. Use plain language, short sentences, and one idea at a time, speaking slowly and with a calm, respectful tone. Allow extra time for responses, minimize background distractions, and use nonverbal cues, demonstrations, and simple visuals to convey meaning. Confirm understanding with a teach-back approach—ask the patient to explain the information in their own words. Involve family members as helpful partners, but communicate directly with the patient and ensure they remain engaged in decisions. Relying on louder speech, or using written text alone, or turning explanations over entirely to family doesn’t improve understanding and can undermine autonomy. Adapting the approach helps safety, accuracy of care, and the patient’s dignity.