Download OT`s Role in Functional Cognition Rehabilitation

April 22, 2016
OT’s Role in Functional Cognition Rehabilitation
By: Julie Thornton, OTD, ORT/L
Marisa Velez-Spina, OTR/L
Clinical Mentors
A cornerstone of Occupational Therapy is the belief that cognition plays an inextricable part in daily
occupations and life roles. Our clients require cognitive abilities and skills in order to successfully engage
in simple to complex daily tasks such as: bathing, dressing, managing medications, budgeting funds, time
management, organization, engaging in leisure pursuits, shopping, and driving ; to name but a few.
Occupational therapy practitioners address cognition in a functional context as it pertains to initiation,
sequencing, planning, processing, problem-solving, and safety awareness. Occupational Therapy plays an
important role as a member of the interdisciplinary team by performing comprehensive assessments and
data collection, determining how cognitive deficits impact function and safety, assessing the patient’s
preserved strengths, and designing a customized plan of care driven by standardized assessments and
evidenced based practice.
Examples of OT Cognitive Based Assessments
Mild Dementia
Moderate Dementia
Severe Dementia
Allen Diagnostic Module Canvas
Placemat
Allen Diagnostic Module Canvas
Placemat
Allen Diagnostic Module Canvas
Placemat
Routine Task Inventory
Routine Task Inventory
Routine Task Inventory
Montreal Cognitive Assessment
Montreal Cognitive Assessment
Edinburgh Feeding Evaluation in
Dementia
Brief Cognitive Assessment Tool (BCAT)
Brief Cognitive Assessment Tool (BCAT)
Brief Cognitive Impairment Scale
Trail Making Test
Trail Making Test
Non Verbal Pain Scale
Clock Drawing Test
Clock Drawing Test
Global deterioration Scale
Spaced Retrieval Trial
Spaced Retrieval Trial
Spaced Retrieval Trial
Vision Screen
Assess remaining Abilities
Vision Screen
Assess remaining Abilities
Vision Screen
Assess remaining Abilities
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Examples of OT Cognitive Based Interventions
Mild Dementia
• Assist with establishment of external memory aids such as calendars/notebooks to track medications,
activities, appointments, new routines, time, family visits, etc.
• Topographical orientation training of new environment(s) to safely navigate and successfully locate
personal items ( labeling drawers /doors, etc.)
• Compensatory training in technology use (cell phone, Ipads, desktop computers, talking watches,
programmable phones)
• Environmental modification for visual spatial organization and simplification, grouping of like items to
improve visual attention, spacing (efficiency)
• Use of spaced retrieval / errorless learning for new learning using procedural memory training
• Simplification of tasks/task segmentation to facilitate functional sequencing
Moderate Dementia
• Use of spaced retrieval / errorless learning for new learning using procedural memory training
• Development of memory aids to increase recall, simple and direct communication prompts
• Provide orientation to environment : navigation, positioning of ADL items
• Provide sequencing with visual aids using color contrasts, enlarged items
Severe Dementia
• Maximize participation in preferred daily tasks: self feeding, mobility, leisure pursuits.
• Provide staff education on maintenance of ADLs, psychosocial engagement and functional mobility
• Maximize positioning for proper respiration, digestion, environmental interaction, skin integrity
• Provide caregiver education/strategies for client engagement in daily tasks utilizing preserved areas of
strength.
• Provide caregiver education/strategies for communication/comprehension to promote engagement
and minimize maladaptive behaviors.
Occupational Therapy’s expertise in understanding human performance and its inherent need for
successful interaction with the environment helps to capitalize on the client’s preserved cognitive,
physical, and psychosocial skills. This abilities focused model affords our clients the opportunities for
meaningful and purposeful engagement in activities of daily living.
OT’s Role – Functional Cognitive Rehab | 04.22.16
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