Assessment of Cognitive Function Flashcards
Why do we consider cognitive function?
- Diagnosis
- Prognosis
- Treatment
Why do we consider cognitive function in diagnosis?
- Have they sustained a brain injury?
- Do they have a neurological condition?
- Are they in PTA?
What is post traumatic amnesia?
Period of recovery following traumatic brain injury.
Disorientation
Unable to locate themselves in time and place
Antero-grade amnesia
Inability to remember new events/experiences occurred after brain injury
Why do we consider cognitive function in diagnosis/prognosis?
- Delivery of medical treatment
- Make a diagnosis
- Are there questions about capacity
- Do the cognitive impairments pose risk to the patient or others
- Plan care
- Concerns about driving
- Concerns about employment
- Impact on home life
- Will the patients cognition improve?
Why do we consider cognitive function in treatment?
-Medical treatment informed by an appreciation of cognition.
-Conversations informed by an awareness of their cognition.
-What abilities remain intact – could these be used to compensate for cognitive difficulties?
-Would the patient benefit from rehabilitation?
-Is family intervention required?
Does the patient need OT input for ADLs? -Does this need to be neuro-specific?
-Does the patient need supervision/care requirement?
-Would they benefit from follow up? Psychiatry, Neuropsychology, Social Work, OT, Neurology?
What is the purpose of bedside assessment?
To raise the possibility of cognitive impairments which may need further assessment/onward referral and may impact treatment/consent.
How is a bedside assessment carried out?
- Observation
- Clinical Interview (patient & relative)
- Screening Assessments
How is memory assessed in clinical interview?
New learning in daily life e.g. Where they are, reason for admission, conversations, T.V programmes, personal history.
What is assessed during clinical interview?
- Memory
- Language
- Processing speed
- Attention/Concentration
- executive functioning
- Personality
- Insight
- Visual spatial
How is language assessed in clinical interview?
Word finding, errors (semantic/phonetic), poor understanding, inappropriate answers, reading/writing errors
How is processing speed assessed in clinical interview?
Slowed down, not following conversation, long response times
How is attention/concentration assessed in clinical interview?
Difficulties focusing, losing track in conversation, reading
How is executive functioning assessed in clinical interview?
Stuck on ideas/tasks, difficulty making decisions
