When a patient cannot provide informed consent due to cognitive or communication issues, it is necessary to protect their rights and interests while providing appropriate care. Here are some general guidelines for handling such situations:   ᐅ Identify the Issue: The first step is identifying the nature and extent of the patient's cognitive or communication impairment. You may need to consult with family members or other caregivers or assess the patient's decision-making capacity. ᐅ Identify a Surrogate Decision-Maker: If the patient is unable to provide informed consent, the next step is to identify a surrogate decision-maker who can make decisions on behalf of the patient. This may be a family member, caregiver, or legal guardian, depending on the circumstances. ᐅ Obtain Consent: Once a surrogate decision-maker has been identified, it is essential to obtain their consent to proceed with the proposed treatment or procedure. The surrogate decision-maker should be fully informed about the nature and purpose of the treatment and any potential risks or benefits. ᐅ Document the Process: It is important to document the process of obtaining surrogate consent, including the steps taken to identify the surrogate decision-maker, the information provided to the surrogate decision-maker, and their decision to consent or decline the proposed treatment or procedure. ᐅ Seek Guidance and Support: Finally, it may be helpful to seek guidance and support from other healthcare professionals, such as social workers or ethicists, to ensure that the rights and interests of the patient are fully protected. When a patient is unable to provide informed consent due to cognitive or communication issues, it is vital to take a thoughtful and thorough approach to decision-making that prioritizes the patient's well-being and respects their autonomy to the greatest extent possible, given their limitations.