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
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
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.
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.
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.
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.
