Functional Cognition: Managing Difficult Cases 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 healthcare management and driving. This course addresses special topics in cognition, including altered mental status, delirium, driving, medication management, and establishing competency and decision-making capacity. Each area will be discussed, providing an acute care–focused description of functional implications, evaluation, and intervention using a performance-based lens. The learner will be able to apply practical strategies immediately after this course.
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. Altered Mental Status
Altered mental status (AMS) is generally the symptom, not the final diagnosis. Many clinical features of the causes of AMS are similar and are frequently superimposed on preexisting diagnoses. The primary etiologies for altered mental status and common presenting symptomology and intervention strategies will be discussed.
2. Delirium
Delirium is a sudden and acute change in mental status. It presents with psychomotor activity impairment and cognitive or perceptual changes. Three types of delirium will be discussed, along with differential diagnoses and intervention strategies.
3. Driving and Medication Management
Driving and medication management are two common issues that have the possibility of causing significant harm to the patient if deficits are not identified before discharge. The three levels of driving behaviors and cognitive skills involved in medication management will be discussed along with rapid clinical evaluations to determine the need for follow-up assessments once the patient is discharged.
4. Establishing Competency
Therapists can contribute to interdisciplinary discussions regarding competency and decision-making capacity by providing insight into the observed functional cognition, performance deficits, and thought processes that impact decision-making. It is helpful to clearly understand the issues involved in determining competency for a vulnerable patient.
