Common cognitive issues

Problems with thinking (Cognitive Impairment)

Cognitive impairment refers to difficulties with the brain’s ability to perform important thinking tasks in areas such as:

• Memory
• Attention
• Processing information
• Executive functioning (eg, planning, problem solving, sorting, knowing when to stop and start tasks) 

Sometimes these changes are temporary (between a few days and a few months), but for some people they can be long-lasting. Depending on the range and severity of the impairment (eg, mild to severe), there can be negative consequences for work and school, relationships, and day-to-day tasks like cooking or driving, as well as health-related tasks like remembering to take medication.

For many people, there are gradual improvements within the first year of recovery after critical illness. For some, recovery can take a little longer and unfortunately some people do not show signs of improvement and the changes may be permanent.

Signs of cognitive impairment are sometimes obvious and sometimes very subtle. Examples include:

• Problems with memory including difficulties such as remembering names, finding words, and remembering items from a shopping list.
• Forgetting events such as doctor’s appointments or social engagements despite reminders
• Frequently losing focus in conversations
• Making decisions / behaving out of character Use poor judgment
• Feeling easily overwhelmed by tasks or responsibilities that used to be easy to manage
• Problems managing money or medications
• Making errors and acting impulsively

People most likely to get Cognitive Impairment

Some individuals are more likely than others to develop cognitive impairment after critical illness, such as those who:

• Have pre-existing cognitive problems
• Have delirium for a long time
• Have lengthy and complex hospital and ICU stays
• Are older adults

What can I do about it?

Sometimes the problems improve with time, but regardless of whether impairments are temporary or permanent, there are things that you can do to either improve your thinking or reduce the impact of the impairment, such as:

• Wear glasses/ hearing aids if you need them
• Writing things down, in a notebook or on your phone
• Getting help from others
• Trying to engage in hobbies and interests, even if it’s not in quite the same way as before
• Keeping things simple – not taking on too much all at once
• Having a manageable and predictable daily routine
• Avoiding distractions when doing a task - for example, if you need to concentrate on something, sit in a quiet area and turn off the TV/radio
• Doing task in small chunks and taking breaks
• Getting  plenty of rest and sleep
• Addressing issues like anxiety and depression – these conditions can worsen cognitive problems and in some cases, if they improve, cognitive abilities can improve
• Discuss requesting a formal cognitive assessment or medical evaluation (your GP can try to arrange this)
• Having regular physical activity / exercise
• Talking with others in a similar situation - perhaps join an online forum or a local support group

Medical professionals of various kinds specialize in the diagnosis and management of cognitive impairment including neurologists and neuropsychologists. If you or a family member has questions or concerns about your cognitive functioning, getting information and advice from professionals can help. We suggest you talk with your GP to work out what support is available. Your GP can make a referral to another healthcare professional to help you with your problems. If you attend an outpatient critical care recovery clinic, talk to health professionals at the hospital about your memory or focus problems