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Functional Cognition Part 3: Preventions and Interventions in Rehabilitation

presented by Jennifer Bottomley, PT, MS, PhD

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Disclosure Statement:

Financial: Jennifer Bottomley receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.

Non-Financial: Jennifer Bottomley has no competing non-financial 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.

Accreditation Check:
Video Runtime: 80 Minutes; Learning Assessment Runtime: 60 Minutes

This course is part of our GCS Prep-Program. Learn more about the full prep-program here: MedBridge GCS Prep-Program.

This presentation will discuss important aspects of helping older adults stay in their home: cognition, home safety, screening, preventive interventions and resources. The participant will develop an understanding of the relationship between balance, cognition, aging, and the risk for falls. Selection of appropriate interdisciplinary assessment tools to screen for cognitive risk factors will be discussed. Intervention models to guide reduction of fall risks and safety related issues in the environment will be discussed. The impact of physical changes, fear of falling, and cognitive decline will be presented. At the completion of this educational session the participant will be able to select appropriate intervention approaches to address cognitive risk factors, reduce falls, assist the primary caregiver and enhance safe and independent community living.

Meet Your Instructor

Jennifer Bottomley, PT, MS, PhD

Jennifer M. Bottomley, PT, MS, PhD, embodies the characteristics of leadership, having worked on committees and task forces and behind the scenes to advance the goals and vision of the profession of physical therapy for 40 years. Bottomley is an independent geriatric rehabilitation program consultant, advisor, and educator. Previously, she held clinical roles at Sunspectrum…

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Chapters & Learning Objectives

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Download the learning objectives for Functional Cognition Part 3: Preventions and Interventions in Rehabilitation.

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1. Safety in the Home

Understanding the vital role that cognition and awareness plays in home safety is of utmost importance for the clinician treating the older adult. To facilitate independence in the home, screening tools that assess awareness and meta-cognitive abilities can help the therapist determine how the older adult is able to problem solve and make appropriate choices. Additionally, appreciating the role of executive functioning and its impact on balance and postural control is important, as older adults are often placed in situations that require the ability to dual task to solve routine daily activities.

2. Screening for Safety in the Home

When screening for safety and balance in the home after a fall occurs, asking the right questions has important value. Whether the fall was due to environmental demands, physiologic dysfunction, or even an over estimation of one’s abilities, all of these variables can and do create an unsafe situation for older adults that requires thoughtful inquiry by the treating therapist.

3. Prevention Interventions

The goal of keeping older adults safely in their home requires the treating therapist to adopt a preventative mindset. This approach requires the therapist to understand how cognition and the resulting behavior has influence on independence in the home, and how strategies to help mitigate fall risk can be employed. Using a cognitive-behavioral approach can be effective to help the older adult accomplish the required task using activity grading, practice, metacognitive training, and self-monitoring to influence success. Within this approach, the 6-level Allen Cognitive Battery can be employed to help the treating therapist understand functional milestones and social assistance needs. From this assessment, interventions can be selected that best enable independent living.

4. Modifying the Environment

The environment can either help or hinder the older adult at risk for falls. Understanding how modifying the environment and taking into account lighting, color/visual cues and patterns, and obstacles can greatly influence whether the older adult can manage independently at home.

5. Interventions in Rehabiliation

Intervention strategies to prevent falls and facilitate independence in the home require education, as well as treatment directed at preserving or restoring the movement system. Treatment for imbalance, weakness, sensory impairment, or loss of range of motion needs to be progressed in a graded fashion. Challenging the older adult in these areas can be interleaved with activities of daily living, giving the older adult the tools necessary to thrive in their home environment.

6. Resources

Identifying the appropriate agencies that provide information to foster health and wellness for the older adult living in their home can help the treating therapist advocate appropriately for their patient/client. Additionally, understanding that helping the older adult live safely in their home requires a team approach, and knowing when to refer to other providers is important if this goal can be realized. Reducing the risk of falling is an achievable goal, even in the midst of an aging system. The challenge for the treating clinician is keeping their patient/client engaged in lifelong physical activity and exercise, and taking to heart the mantras: “use it or lose it” and “use it to improve it."

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