Understanding Older People’s Cognitive Function

Nurses are central to the care of older people in the hospital. One issue of particular importance to the experience and outcomes of hospitalized older people is their cognitive function.

A new article reports findings from a focused ethnographic study demonstrating how documentation systems—documents and the social processes surrounding their use—contribute to how nurses come to understand the cognitive function of hospitalized older people.

The study found that documents contribute to nurses’ understanding by serving as a frame of reference, by directing assessments, and by constraining communication. The findings highlight the potential to improve the documents nurses use in hospitals.

Researchers found that the documents that nurses used to communicate, report and archive aspects of their work were shaping how they understood the cognitive function of older patients. This is an element of health care settings that can potentially be improved to better reflect the current best evidence about how to support people who have, or are risk of having, cognitive impairment. As the COVID-19 pandemic is drawing more and more attention to the situation of older people in our communities, and the ways that health care settings are structured to provide their care, it is an opportune time to consider ways to reorient these settings to the needs of an older population.