Functional Occupational Therapy Assessments for Cognition in Acute Care

Functional Occupational Therapy Assessments for Cognition in Acute Care

When people are in acute care due to a neurological condition, occupational therapists (OTs) can assess cognitive function to detect any impairments or limitations that could impact functional outcomes in the future. This information is essential when making placement and discharge decisions as well as providing client/caregiver training sessions.

OTs employ a range of assessment methods to gather data related to cognitive impairments. These include standardized performance-based tests (PBTs) and impairment or body functions measures such as the Abbreviated Motor Performance Scale (AMPS).

Some PBTs are better suited for measuring functional cognition than others, so it’s essential to determine when they should be utilized. Some assessments require less specialized equipment and can be administered quickly and efficiently when time is of the essence; on the other hand, other assessments may require more specialized tools that may prove difficult to administer or interpret during crunch times.

Valid assessments that provide comprehensive cognitive information are the most reliable. For instance, the MMSE provides both executive and manual function assessments; similarly, the AMPS measures motor and processing skills as well as several other areas.

As more attention is being paid to the connection between cognitive impairments and functional ability in acute care settings, occupational therapists (OTs) must be knowledgeable of the most accurate ways of assessing patients with cognitive deficits – particularly those suffering from TBI.

Contrary to popular belief, it can be challenging for therapists to select the appropriate assessment type for a patient’s functional needs. This is especially true in acute care settings where resources and time may be scarce.

No universal agreement exists on the best assessment type to use when diagnosing cognitive dysfunction. There needs to be an international initiative that promotes the use of standardized tests as a reliable method.

It is unknown whether therapists around the world make similar assessment choices as those in their home regions, and whether this decision-making is influenced by factors such as experience or education. This study seeks to uncover which tools therapists are employing and why.

Participants were a multidisciplinary group of OTs from three nations who specialize in working with people living with FND in acute and community settings: England (n=7), Scotland (n=3) and the USA (n=2). All had at least 10 years postgraduate experience within their field and worked across various clinical settings.

They were asked to discuss their current practice and express their opinions on the most suitable assessment tools for assessing functional cognition. Furthermore, they were requested to suggest specific physical therapy interventions they believed would be most beneficial in treating patients with FND.

The primary recommendations were that occupational therapists should prioritize improving cognitive function rather than treating the underlying impairments of their client’s condition. Doing this will help patients develop internal locus of control and take responsibility for their own rehabilitation. The therapist should support self-management skills, encouraging them to set goals and plan ahead. Interactive workbooks or therapy journals could be beneficial tools in this endeavor.

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