Date of Award

2022

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Kelly Dornbier

Abstract

Title: Functional Cognition in Long-Term Care: Implementing Allen’s Cognitive Level Screen

Purpose: It is motivating to many individuals to remain as independent as possible for as long as possible. As we age, there is a shift to balancing needed support while maintaining independence. According to Allen (1991), cognition is the number one factor affecting an individual’s ability to live independently. Within long-term care, specifically assisted living facilities, cognitive screening processes are in place to measure one’s cognition, however, often the tools in place do not measure functional cognition (Stewart, O’Riley, Edelstein, & Gould, 2012). The purpose of this scholarly project is to provide staff within long-term care the education and resources to improve the screening process to measure functional cognition and determine supports to ensure both safety and independence of residents within the facility.

Method: In addition to completing a needs assessment with stakeholders at a local long-term care facility, an extensive review of the literature was conducted to gather the most up-to-date information on widely used cognitive screening tools used within long-term care facilities and the effect of cognition on one’s health, well-being, and quality of life. Several occupational therapy models were considered through the development of this product including the Person- Environment-Occupation (PEO) model, Environment-Health-Occupation-Well-Being (E-HOW) model, and the Cognitive Disabilities Model. Based on the needs identified, an educational inservice was created and delivered to staff on the Allen’s Cognitive Level Screen and associated cognitive levels.

Summary: An educational training was developed using the PEO, E-HOW, and Cognitive Disabilities models to understand the new screening tool and structure the in-service. The training session was designed to fill the gap between cognitive screening tools used in long-term care facilities and those that are evidence-based. Training materials created include: an instructor’s guide for an in-service training addressing the need for a new assessment, as well as a detailed description of the Allen’s Cognitive Disabilities Model, cognitive levels, and the screening tool; “Quick Guide” handouts on the cognitive levels and screen implementation; and a handout of useful community resources for residents.

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