What job can I do with cognitive decline?

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation!

Published  

I am 60 yrs old and experiencing slower, longer cognitive abilities. I have ADD and on a stimulant med. Recently I started a new job, and was let go (it was a new startup line of business, lacked structure still, and I lacked a key skill so it was a poor fit overall), but it was apparent to me that I have become very visual, need clearly written notes for reference, and had some short term memory issues to retain certain info to complete a task.

Now I am unemployed, have bills fit for a nursing salary, but am fearful that my cognitive abilities make nursing perhaps too challenging. I've never worked in a hospital setting since my early nursing days, so I can't say I'd be competent to practice with any clinical intensity role. Mostly administrative. No UM experience. Considering job retraining/return to practice through DOL UI. Some of my concerns are shaken confidence, but I saw through this experience I do have STM and processing speed deficits, enough to make it clear that I struggled with some tasks I shouldn't. Is there a place for me in nursing still? Or do I reconcile that I just might have to work a different field? What is a good fit for nurses who are likely to continue cognitively declining?

Share this post

+ Add A Comment

13 Answers

Specializes in Tele, ICU, Staff Development.

I understand that you are currently facing challenges related to your cognitive abilities and are exploring your options in nursing or potentially considering other fields. It's commendable that you're actively seeking a path that aligns with your skills and career aspirations.

See your provider for treatment for STM (short-term memory loss) and cognitive decline, as well as for a diagnosis, which you may need to access resources.

Here are some things you may want to consider as you decide.

  • Reflect on your strengths and weaknesses, considering both your nursing experience and recent challenges. Identify the specific areas where you feel most confident and where you may struggle.
  • Connect with nursing professionals who have diverse roles and experiences. Seek advice from mentors or colleagues who may provide insights into alternative nursing roles or potential career paths.

Adaptation Strategies

Identify strategies to overcome cognitive challenges. You can use tools like visual aids, checklists, and quick notes on your phone.

  • Take pictures of things you may want to remember later, such as a recipe, a product you want to buy from the store, or a street sign.
  • Set alerts on your phone for specific times as an effective way to stay on track.
  • Search for memory aid apps.

Use organizational systems to support your workflow and memory, for example, color-coded notes. 

Try to keep everything in the same place and follow routines, such as a nightly routine that includes brushing your teeth, giving your dog her medication, turning off lights, and checking that the garage door is closed.

Routines at home and work help you stay organized and ensure you don't forget important tasks. 

Retraining

Explore the retraining and return-to-practice programs your local Department of Labor (DOL) or other educational institutions offer. These programs help individuals update their skills and knowledge and confidently re-enter the workforce.

Participating in one of these programs can help you further identify your strengths and limitations. Additionally, you can make valuable connections that could lead to employment opportunities.

Speak with healthcare career counselors or vocational guidance professionals who can provide personalized advice based on your situation, skills, and interests.

Non-clinical roles

Jobs that do not involve clinical intensity, stressful or fast-paced situations, and those that allow for a degree of autonomy without being overly demanding may be more appropriate.

Look into non-clinical roles within healthcare organizations or related industries. These roles may leverage your nursing background while focusing more on administrative, educational, or managerial responsibilities. Use indeed.com with the keywords "non-clinical."

Explore nursing roles less demanding in clinical intensity but still utilize your nursing knowledge. This could include roles in:

  • Case management, community health
  • Research or education

Consider roles involving patient teaching due to their repetitive nature, which may suit you.

  • Pre-op registration 
  • Diabetic clinics or cardiac rehab

Consider allied health roles. Explore allied health roles that may align with your background, such as

  • Healthcare administration
  • Medical billing and coding 
  • Healthcare consulting or wellness nurse

Support

Evaluate the work environment and culture. A supportive and understanding workplace may be more accommodating to your needs.

You have the right to keep your medical information confidential. However, if you disclose it, you can request accommodations, such as additional training time, written instructions, a modified break schedule, or visual schedulers.

Nurses with cognitive disabilities can be well-supported in the workplace with thoughtful and individualized accommodations.

Employers are responsible for providing these accommodations under ADA guidelines and fostering an inclusive work culture.

If you decide the challenges are too significant, exploring related fields or roles outside of nursing may be a valid option. Consulting with healthcare career professionals, mentors, or counselors can provide valuable guidance as you navigate this transition.

Best wishes,

Nurse Beth

Resources

Exceptional Nurse

Job Accommodation Network

National Organization of Nurses with Disabilities

Specializes in ICU/ER/Med-Surg/Case Management/Manageme.

So many of us can relate!  I'm soon to be 75.   It's painful the morning we wake up and realize we aren't as fast-moving or quick-thinking as we were a few years back. The first thing I want to say is to look hard and long at your personal stress level.  For me, as my stress increases, my ability to focus and recall decreases.  Yoga, meditation, going for walks (without the cell phone connected to ear) and simply enjoying the sights and sounds of nature do wonders for me.  Stay off the internet/computer.  Connect with others with similar interests - go out for coffee/lunch dates with friends, join work-out groups (gets the blood flowing to the brain!).  RELAX RELAX RELAX  I also like what someone mentioned...take a look at your current medications.  Sometimes they are the culprit.  Also your diet.  I'm very keto and have found since giving up carbs (10-20 gm/day) and especially sugar, I feel much, much better and I think my mental function is better.  Maybe?  LOL  

So now, going through all you're going through I know it's hard to lower those stress levels and RELAX.  But there are places for those of us no longer able to multi-tasks 15 different things.  I didn't enjoy my foray into home health, others love it.  It is a slower paced environment but allows you to use your education.  Lots of towns and cities have clinics for lower income senior citizens.  Check into that.  What about teaching in some of the CNA programs in your area?  Some agencies hire private duty nurses to provide companionship and safety for clients.  Less pay, but at least the bills are getting paid (stress reliever).  Above all, remember you are still a contributing member of society and the profession.  Your contributions won't be as "rapid" as that of the 40 year old, but they are still of value.

I know this is a long comment, but it's experience talking!  LOL

Specializes in ICU/ER/Med-Surg/Case Management/Manageme.
brandy1017 said:

Also, I would caution against any retraining that involves you taking out student loans as they are the worst debt out there with no bankruptcy options and you are so close to retirement.  You don't want to add student loan debt to your money problems and have to pay off student loans with your social security.  Over 100,000 seniors are having their social security garnished for deliquent student loans.  I wouldn't take the risk even if I was in good health!

That is an excellent point in terms of training involving any type of loan.  In my area, the various smaller suburb cities often have free courses in a huge variety of topics.  Even if a person isn't interested in a "career" in a particular topic, it's sometimes fun to just learn something new plus it keeps our minds working.  (Ex:  about a year ago, I went to two different all-day seminars led by CPA's having to do with starting small businesses and the tax laws).

I think you will find, what is going on with you is more common than you think.  I think some people just fake it better than others. Keeping up with new technology, fast pace, high stress, constant healthcare changes, and young nurses is exhausting.  This all has a negative impact on confidence, which in turn makes things seem worse than they are.  I applaud you for venturing out into a new business setting.  I like the suggestions given in the previous posts.  I agree with consulting a physician.  That being said, just because you are not as sharp as you used to be doesn't mean you don't have a lot to offer.  I would like to see more resources available for older nurses. Hang in there.  You are not alone.  God bless you for your years of service. There is no shame in slowing down and shifting to something less stressful, maybe with less hours. 

Specializes in NICU, PICU, Transport, L&D, Hospice.

I would recommend that you rethink your finances and budget as you look for employment.  Simplify.  

Good luck.  

Specializes in Critical Care.

See your Dr regarding your cognitive issues.  Perhaps you need to see a neurologist as well.  

 I just read a useful article about memory loss that also has a link to a free test you can take as well. https://washingtonpost.com/wellness/2024/03/03/mild-cognitive-impairment-dementia-treatment/ How to recognize mild cognitive impairment, and what to do about it - The Washington Post

Also, I would caution against any retraining that involves you taking out student loans as they are the worst debt out there with no bankruptcy options and you are so close to retirement.  You don't want to add student loan debt to your money problems and have to pay off student loans with your social security.  Over 100,000 seniors are having their social security garnished for deliquent student loans.  I wouldn't take the risk even if I was in good health!

I hope you get the right answers and wish you the best!

 

Specializes in Critical Care.
DallasRN said:

That is an excellent point in terms of training involving any type of loan.  In my area, the various smaller suburb cities often have free courses in a huge variety of topics.  Even if a person isn't interested in a "career" in a particular topic, it's sometimes fun to just learn something new plus it keeps our minds working.  (Ex:  about a year ago, I went to two different all-day seminars led by CPA's having to do with starting small businesses and the tax laws).

The public university near me allows seniors to audit classes for free but don't know how old you have to be if it's 60 or 65.  There is so much free info out there to avail oneself of both locally and on the internet.

Specializes in Psych, Addictions, SOL (Student of Life).

I would highly suggest asking your PCP for a referral to a Gerontology Specialist. There are medications that can slow declines in cognative ability. With regard to spending really look at all aspects and cut anything that is not necessary. Any month you have extra, sock it in the bank.

Peace and Namaste

Hppy

I agree with the one reply about checking the medications you are taking. I graduated as a RN in 2017 and have been a med surg nurse since. I will be 70 this year and have no issues. I am not on any medications. Was diagnosed with ADD years ago but refused the meds they wanted me to take. Routine and structure is best for people with add. I can't stand the stigma that because you're a certain age it automatically signals decline. Not so... Genetics and health status can affect anyone at any age. I see patients all the time a lot younger than me and look about 20 years older than me.

Specializes in Psych, Addictions, SOL (Student of Life).
paujos said:

 Was diagnosed with ADD years ago but refused the meds they wanted me to take. Routine and structure is best for people with add. 

ADD and ADHD are medical conditions that often not always require treatment. Just because you went successfully with no meds doesn't mean others don't need meds. I agree about the Stigma though many people mistake these as psychiatric disorders and do not seek treatment due to stigma. I am glad you had a good outcome. 

Hppy

Specializes in LTC, assisted living, med-surg, psych.

I hear you! I was diagnosed with mild cognitive impairment in February 2021. By that time I'd been "retired" for health reasons for over six years! The trouble with my STM loss and word-finding ability was it started around the time I was dx'd with bipolar 1 disorder, 8 years before, and I was showing signs years before that. 

Still, I can say that I've developed a self-deprecating sense of humor and learned how to turn my fumbles and bumbles into comedy routines performed in small venues, usually churches or Grange halls.

My advice to you is: find something closer to your heart and your peace. No more hospital nursing or LTC, both are crazy by nature and while some nurses thrive in this environment, many of us find it too stressful to the point of overwhelming us. (Which of course does nothing but damage to our minds and bodies.) I wish you all the best. Viva

I would just retire and go for SSD. At your age, they won't expect you to train for a new job/occupation. 

+ Add a Comment