Functional Cognition: Higher-Level Mental Functions in Acute Care

presented by Judy Hamby, OTD, MHS, OTR/L, BCPR

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Disclosure Statement:

Financial: Judy Hamby is an employee at Wellstar Health System. She is a continuing education presenter at AOTA and is also an author at AOTA Press. She receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.

Nonfinancial: Judy Hamby has no competing nonfinancial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

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Video Runtime: 43 Minutes; Learning Assessment Time: 53 Minutes

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, OTD, MHS, OTR/L, BCPR

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 such as discharge…

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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.

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.

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