Date of Award


Document Type

Scholarly Project

Degree Name

Master of Occupational Therapy (MOT)


Occupational Therapy

First Advisor

Kelly Dornbier


Reference Tool, Training Program, Comorbidities, Cognitive Disfunction, Allen's Cognitive Disabilities Model (ACDM), Person, Environment, Occupation Model (PEO)


Purpose: The purpose of this product was to create a quick reference guide with a corresponding in-service training to be used by the treatment team within the physical rehabilitative settings in order to address comorbid cognitive diagnoses in a consistent manner.

  • 10-30% of all new hospital admissions have been estimated to experience delirium, or a disruption in the person's cognitive abilities (Ahmed, Leurent, & Sampson, 2014)
  • Individuals diagnosed with mild cognitive impairment had a 17-39% increase in the rate of hospitalizations (Callahan et al., 2015)
  • 20-60% of clients who receive anesthesia for surgery experience delirium or some residual cognitive deficit that may last days to years (Bekkers & Weeks, 2003)
  • In some cases of polypharmacy, a person’s ability to engage in and perform desired occupations is hindered due to a decline in their cognition (Thelen et al., 2014)

Methods: A literature review was conducted using various databases including PubMed, CINAHL Complete, Academic Search Complete, Google Scholar, and the American Journal of Occupational Therapy. Based on the available evidence, it is apparent that there are significant inconsistencies in the way members of the interdisciplinary rehabilitation teams view and address cognitive co-morbidities. The Allen’s Cognitive Disabilities Model (ACDM) and the Person, Environment, Occupation (PEO) Model were chosen to guide the creation of Allen’s Cognitive Levels Quick Reference Guide: Self-Cares, Transfers and Therapeutic Exercise. Both the ACDM and PEO were used in order to highlight the transactive nature of a person’s cognitive abilities, their environment, and the occupations they engage in.

Product: The researchers created an in-service training and quick reference guide based on the primary principles and concepts of the ACDM and PEO Model. The quick reference guide provides rehabilitation professionals with a tool to address behavioral deficits related to comorbid cognitive impairments in a hierarchical fashion. The in-service training was subsequently created to educate the treatment team on the use of the tool and the models incorporated within it.

Conclusion: The Allen’s Cognitive Levels Quick Reference Guide provides rehabilitation professionals with a user-friendly tool for addressing client challenges due to comorbid cognitive impairments.