Disturbed Thought Process Care Plan

Disturbed thought process care plan is designed to deal with patients suffering from problems with thinking processes. In order to understand the condition better, it is necessary to read the disturbed thought process definition.

Disturbed process of thinking is described as a state, which prevents an individual from proper thinking activities, from normal perception of reality, making logical decisions while solving problems, as well as from developing proper coping strategies.

A person suffering from a disorder has serious problems with normal daily functioning due to altered perception of reality. Possible reasons of disturbed though processes can be personality disorder or depression.

In order to restore proper thinking and orientation in reality, disturbed thought process care plan is an important tool in nursing practice. Such condition among elderly is mostly connected to aging and is tightly related to such factors as dementia, depression, side effects of taking medicine, etc. However, depression is one of the most common reasons of disturbed though processes development.

Factors Related to Disturbed Thought Processes

Following are the factors that are related to disturbed thinking:

Physiological Factors:

  • Age
  • Infectious diseases
  • Head injuries
  • Poor nutrition
  • Hypoxia

Biochemical Factors

  • Substance abuse (drugs, alcohol)
  • Medications intake

Psychological Factors

  • Depression
  • Fear and anxiety
  • Disorders caused by grief
  • Mental problems

Maturational Factors

  • Self-isolation
  • Depression caused by aging

Situational Factors

  • Experience of physical abuse or childhood trauma

Characteristics and Symptoms of Disturbed Thought Processes

Disturbed thought process care plan defines the following symptoms of the disease:

Primary Symptoms:

  • Improper interpretation of reality

Secondary Symptoms:

  • Disorientation
  • Cognitive disorders
  • Improper or ritualistic behavior
  • Obsession
  • Fears and phobias
  • Delusions and hallucinations
  • Suspiciousness
  • Impulsive reactions

Expected Outcomes of Nursing Care Plan for Disturbed Thought Process

The goals of treatment of patients suffering the condition include the following:

  1. Patient restores the ability to percept reality;
  2. Patient restores the ability to communicate with others;
  3. Patient receives and ability to clearly realize and analyze the behaviors of other people;
  4. Patient expresses improper behaviors seldom;
  5. Patient takes active parts in social life, as well as in unit activities;
  6. Patient learns to develop and use coping strategies to overcome episodes of delusions.


Assessment is an important step in writing disturbed thought process nursing care plan. Considering that disturbed thought process related to bipolar disorder is a difficult condition, it has to be assessed in the following way:

  • It is necessary to determine whether patient takes drugs or alcohol;

Rationale: Drugs and alcohol may negatively influence functioning of a brain and have different side effects, which, in their turn, may badly influence the reality perception abilities of a patient.

  • Identification of the present factors. They may include brain damage, malnutrition, mental illnesses, different brain syndromes, including strokes, Alzheimer, etc., infections, etc.

Rationale: Such assessment is important to identify contributing factors.

  • Access patient's ability to make decisions, solve problems, determine level of attentiveness and concentration;

Rationale: It helps identify how prepared the patient is to take part in treatment process and react to it.

  • It is necessary to run and study the laboratory tests results.

Rationale: Such approach also helps identify contributing factors.

  • Assessment of nutrition status of a patient.

Rationale: Helps identify contributing factors.

  • Evaluation of mental status of a patient depending on his age.

Rationale: It helps in identifying the degree to which the patient is affected.

  • Organize an interview with the caregivers to identify the severity of the problem, its duration, patient's actual status, and other related information.

Rationale: Such assessment helps in creating basis for comparison.

  • Perform regular check-ups of patients.

Rationale: It helps identify to what extent the condition has progressed or reduced, which helps modify the treatment plan timely. 

Nursing Interventions

Following are the nursing interventions useful in the process of patient's treatment:

  • Addressing and treatment of underlying problems (anorexia, sleep disorders, injuries of brain, etc.).

Rationale: Treatment of underlying problems very often leads to improvement of thinking processes among patients.

  • Ask a patient to write the same text from time to time.

Rationale: It helps determine the status of patient's functioning.

  • Make sure all necessary supportive elements are available for patients (side rails, padding, etc.), especially the elderly ones.

Rationale: Safety of the patients is a priority in medical facilities.

  • Create a schedule for physical activities and rest.

Rationale: Such intervention helps improve physical condition of patients and reduce level of fatigue.

  • Create a relaxing and safe environment for patients and avoid aggressive or anxious behavior.

Rationale: If the patient is scared, he/she may respond with aggressiveness.

  • Avoid persistence persuasion and present reality briefly to the patients. It is important to avoid evasive remarks.

Rationale: Patients suffering delusions can have a strong reaction on insincerity. Moreover, they may react to evasive remarks with mistrust.

  • It is important to remain logical and sequential in setting goals and expectations.

Rationale: Clear treatment structure improves treatment process by making it more effective.

  • Avoid forcing patients to do something (take part in activities, communicate).

Rationale: Sensitive patients may perceive it as a danger sign and rebel or get scared.

  • It is necessary to ensure that healthcare specialists avoid aggressive behaviors, negative comments and confrontations.

Rationale: Such behaviors can lead to aggressive responses.

  • Determine specific problem of a patient that is not resolved in his past or present and help the patient find a proper solution.

Rationale: Improvement of health condition of a patient is impossible without overcoming basic problem. If the problem is not resolved, even visible improvement will be temporary.

  • It is necessary to create positive environment to encourage a patient to eat properly. It foresees giving enough time for a patient for taking his/her meal, providing specific, diet and considering patient's preferences.

Rationale: It will help improve patient's general well-being.

  • Try to get clarifications from the patients to better understand their altered thinking. Such approach foresees setting supportive questions, such as, for example, "Please explain you point", "Why do you mean?", etc.

Rationale: Such intervention helps understand how the patient perceived reality and makes him/her think over about their understanding of the surrounding, which, eventually, may lead to realization of wrong thinking.

  • Make patient communicate with other individuals. It can be reached by involving a patient in face-to-face interactions at first, then inviting him/her to work in small groups and then in the bigger ones.

Rationale: Such approach will teach the patient that communication with other individuals can be safe.

  • Teach the patient to use special techniques to block negative thoughts in case they start prevailing.

Rationale: Such intervention includes distracting patient from negative thinking but giving him/herself a loud command, for example, shouting: "Stop!"

  • Help patient identify by him/herself the need for further treatment.

Rationale: It will help trace the level of progress and understand how good the patient responds to treatment.

  • It is important to identify the problems a patient experiences as a result of aging and help find problem to solve them (if possible).

Rationale: Such approach will encourage patients to apply problem-solving skills instead of giving up.

  • Develop a proper treatment plan, if the problems identified require much time for solving.

Rationale: Long-lasting problems does not always require hospitalization. As a result, proper plan will help in creating conditions for improvement at home by considering such issues as accommodation, supportive elements, transportation, assistance of care givers, etc.