Functional Cognition: Higher-Level Mental Functions in Acute Care
Presented by Judy Hamby
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Occupational therapy (OT) practitioners can contribute to a thorough assessment of cognition in acute care by determining cognitive deficits, how they could impact functional performance, and strategies to mitigate the ramifications. Deficits in functional cognition can impede a safe and complete return to the community, including returning to work and driving or living independently. This course continues the discussion, progressing from lower-level to higher-level mental functions. These include problem-solving, awareness, safety judgment, and executive function. Each area will be discussed in a scaffolded manner, providing an acute care–focused description of functional implications, evaluation, intervention, and documentation strategies using a performance-based lens. Standardized and nonstandardized assessment strategies will be discussed.
Meet your instructor
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Judy Hamby
With more than 33 years of experience, Judy Hamby has worked with adults across the continuum of care, dedicating nearly 23 years to full-time service in acute care. She is a recognized expert in the field, having authored multiple chapters in the Occupational Therapy in Acute Care textbook (editions 1–3), covering topics…
Chapters & learning objectives
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1. Problem-Solving and Awareness
This chapter will discuss problem-solving and awareness, which are closely linked because they both involve metacognitive abilities. Determining the degree of a patient’s self-awareness is essential to determining the patient’s level of insight and ability to modify task performance based on their situation, which in turn may provide insights into discharge recommendations.
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2. Safety Judgment
Safety judgment is the critical piece that binds all recommendations together. Decision-making capacity and competency are closely linked with safety judgment. Whether a patient can make safe decisions will determine the eventual discharge recommendations.
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3. Executive Function
Executive function pulls all the other cognitive skills together and is the integrative cognitive process determining goal-directed and purposeful behavior. A patient’s ability to perform complex tasks (such as medication and financial management), perform work-related tasks, cook, drive, and learn new tasks (such as applying hip precautions to ADLs) will be impacted if deficits in this area are present.
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4. Evaluation
Performance-based, standardized assessments are considered the best practice for evaluating functional cognition. Standardized and nonstandardized evaluation strategies that are easily implemented in the fast-paced acute care setting will be presented.