Cognitive impairment is a broad term referring to difficulties that a person has with memory, thinking, their ability to learn new things, concentrate and communicate with other people. Cognitive impairment can be associated with a range of conditions, including dementia, delirium, an acquired brain injury, intellectual disability, and others.
People with cognitive impairment face greater barriers to receiving safe, high-quality care, and increased risks of preventable harm during care. The recent Royal Commissions into Aged Care Quality and Safety, and Violence, Abuse, Neglect and Exploitation of People with Disability have concluded that people with cognitive impairment are vulnerable to harm when systems are not implemented which meet their needs and protect their human rights.
Dementia and the Care Reform Agenda
This is particularly true for people who live with dementia, who routinely face challenges in receiving safe, accessible care which meets their needs and respects their human rights. The Australian Institute of Health and Welfare estimated that:
- in 2021-2022, more than half of individuals living in residential aged care facilities had dementia;
- Australia’s ageing population will contribute to an increased in the number of people living with dementia, which is predicted to more than double by 2058; and
- in 2022 dementia was the second leading cause of death.
In late 2024, the Australian Government published its first National Dementia Action Plan which outlined a whole-of-government response to improve the quality of life and protect the rights of people with dementia. The Action Plan reiterated the reform agenda which has been ongoing across the health system, in aged care, and disability support services to better support people with cognitive impairment.
Actions and requirements relating to the care and support for people with cognitive impairment have been integrated into a number of practice standards, including the:
National Safety and Quality Health Service (NSQHS) Standards
- Actions 5.29 and 5.30 under the Comprehensive Care Standard
- Relevant to other actions including 1.15, 1.30, 4.10, 5.09, 5.33, 5.34, 5.35, and 8.05
NDIS Practice Standards
- Considerations for people with intellectual disability and others who may have cognitive impairment are at the core of the NDIS Practice Standards and Supplementary modules for specialist behaviour support service providers.
Strengthened Aged care Quality Standards
- Improving the quality, safety and accessibility of services for individuals with dementia was a key objective of strengthening the Aged Care Quality Standards.
- Actions under Outcome 5.6: Cognitive Impairment
- Actions under Outcomes 1.1, 2.2b, 2.9, 3.1, 3.2, 4.1b, 5.3, 5.4, 5.5 and 7.2
- The Commission has indicated in their recent draft Audit Evidence Collection tools, that they expect organisations to have a current Cognitive Impairment Policy.
Our New Cognitive Impairment Resources
To help providers address this important issue and implement appropriate procedures, we’ve put a lot of work into developing resources which incorporate a range of rights-based considerations for supporting people cognitive impairment.
Our New Cognitive Impairment Policy Template:
Our new policy template addresses key considerations including:
- Partnering with people with cognitive impairment, and safeguarding their rights to safe and effective care;
- Supported decision-making and advance care planning;
- Considerations for effective behaviour support planning and minimisation of the use of restrictive practices;
- Considerations for managing medications, including reducing the use of psychotropic medications; and
- Considerations for comprehensive care, including:
- Nutrition, eating and hydration
- Pain management
- Falls prevention
- Preventing and managing delirium
Updated Policy Templates:
We’ve added new sections to a number policy templates to incorporate additional considerations for supporting people with cognitive impairment, as well as linked them to relevant standards, including these ones:
- Info: Intimacy and Sexuality (Aged Care)
- Info: Nutrition, Meals and Hydration
- Policy: Advance Care Planning
- Policy: Clinical Deterioration
- Policy: Diversity and Cultural Inclusion
- Policy: Elder Financial Abuse
- Policy: Intake and Referral
- Policy: Intimacy and Sexuality (Aged Care)
- Policy: Key Elements of Client Safety and Wellbeing
- Policy: Managing Violence and Aggression
- Policy: Medication Management
- Policy: Nutrition, Meals and Hydration (Aged Care)
- Policy: Pain Management (Aged Care)
- Policy: Partnering with Consumers
- Policy: Safety and Security in Residential Aged Care Facilities
- Policy: Supported Decision-Making and Dignity of Risk
- Policy: Use of Restrictive Practices (Aged Care)
- Policy: Use of Surveillance Devices in Residential Aged Care Facilities
Our self-assessments supporting safe care for people with cognitive impairment
We have a number of self-assessments which support safe and accessible care for people with cognitive impairment including the specific requirements of the Delirium Clinical Care Standard and Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard.
We are continuously reviewing our resources to ensure that they incorporate best practice and especially based on input from our members. We have taken care to ensure that the updated resources are linked to relevant actions in key standards self-assessments as suggested evidence, to support ease of use.
You can access these resources by logging into your SPP account and searching for them in the Reading Room or with a relevant keyword like “cognitive impairment”, “dementia”, or “delirium”.
Interested in our cognitive impairment resources?
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