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Andrew Pollack-Gray

Nursing Notes

Developmental and Neurological Conditions

4 min read

Patient Needs

Residents with developmental, neurological, or mental health conditions may need individualized assistance with mobility, communication, self-care, safety, and social participation.

Care should reflect the resident’s actual abilities and preferences, not assumptions based on a diagnosis.

Intellectual Disability

A developmental condition involving limitations in intellectual functioning and adaptive skills.

Possible needs:

  • Additional time to understand instructions.
  • Clear, concrete communication.
  • Assistance with selected ADLs.
  • Support for independence and decision-making.

Cerebral Palsy

A group of disorders affecting movement, posture, and muscle coordination, caused by changes or injury to the developing brain.

  • May affect balance, movement, muscle tone, and speech.
  • Some residents may have difficulty swallowing.
  • Intellectual ability varies; cerebral palsy does not automatically imply intellectual disability.
  • Symptoms are generally nonprogressive in origin, although functional needs can change over time.

Epilepsy

A neurological condition involving recurrent unprovoked seizures or other recognized epilepsy criteria.

  • Seizures may involve convulsions, altered awareness, unusual movements, or temporary behavioral changes.
  • Some individuals have identifiable seizure triggers.
  • Antiseizure medications may help control seizures.

Parkinson’s Disease

A progressive neurological condition involving loss of dopamine-producing neurons and other nervous-system changes.

Possible features:

  • Tremor, rigidity, and slowed movement.
  • Difficulty walking or initiating movements.
  • Swallowing difficulties.
  • Changes in sleep, thinking, or mood.

Not every resident develops dementia, hallucinations, or severe disability.

Mental Health Conditions

Conditions that can affect mood, thoughts, perceptions, behavior, and daily functioning.

Examples include depression, anxiety disorders, and other mental illnesses.

Residents deserve the same dignity, privacy, safety, and participation in care as anyone else.

What Should I Assess?

Observe and report:

  • Changes in mobility, balance, or muscle control.
  • New swallowing or communication difficulties.
  • Seizure activity or changes in usual seizure patterns.
  • New confusion or changes in responsiveness.
  • Withdrawal, distress, or major behavioral changes.
  • Reduced ability to complete usual ADLs.
  • Statements indicating possible self-harm or suicide risk.

How Do I Provide Care?

  1. Learn how the resident prefers to communicate.
  2. Speak directly to the resident rather than assuming another person must answer.
  3. Use simple, clear instructions when helpful.
  4. Allow sufficient time for responses and movements.
  5. Offer choices and promote independence.
  6. Follow prescribed mobility, positioning, swallowing, and seizure precautions.
  7. Support meaningful activities appropriate to the person’s interests and capabilities.
  8. Protect privacy and respect informed decisions.
  9. Report changes from the resident’s usual baseline.

Safety & Precautions

  • Do not assume a resident lacks decision-making capacity based on a diagnosis.
  • Do not physically force movement or rush a resident with impaired coordination.
  • Follow the existing Seizure Response procedure during a seizure.
  • Do not restrain a seizing resident or put anything in their mouth.
  • Observe for signs of aspiration when swallowing difficulties are present.
  • Treat new severe confusion, stroke-like symptoms, or loss of responsiveness as potentially urgent.
  • Escalate self-harm or suicide concerns immediately according to facility procedures.

What Should I Report?

  • New seizures or changes in seizure activity.
  • Falls or unexpected changes in mobility.
  • New choking or swallowing difficulties.
  • Sudden confusion, weakness, or speech changes.
  • Severe emotional distress or self-harm concerns.
  • Changes affecting safety or daily functioning.

Sources

Flashcards

Does cerebral palsy automatically mean a resident has an intellectual disability?02-mechanisms / patient-care
Answer

No. Intellectual ability varies independently of movement difficulties.

What is epilepsy?01-foundations / patient-care
Answer

A neurological condition characterized by a tendency to have recurrent seizures.

What are common motor symptoms of Parkinson's disease?01-foundations / patient-care
Answer

Tremor, rigidity, slowed movement, and walking difficulties.

How should a CNA communicate with a resident with an intellectual disability?03-application / patient-care
Answer

Use clear communication, allow time, and adapt to the resident's needs.

What should a CNA do during a seizure?03-application / patient-care
Answer

Protect the resident from injury and follow the seizure response protocol.

Does a mental health diagnosis remove a resident's right to make choices?03-application / patient-care
Answer

No. Support consent, dignity, and individual decision-making.

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