The Memory Unit OT

Last week in Stories, I asked you to share the one thing you struggle with the most when it comes to memory care. On Thursday afternoon, I went answered those questions on Stories. In case you missed it, here’s the recap!

Communicating memory care needs to the Interdisciplinary Team. When I’m communicating with the interdisciplinary team, I find that approaching the conversation with objective measures works best. So I’ll present any testing that I’ve performed, what that testing indicates, and then the strategies that I’ve trialed that have proven to be the most successful. It’s very important to be objective in your daily treatment documentation here. This will show the IDT that you’re not just basing these recommendations on a hunch or hypothesis, but rather you’ve tested these strategies and have clear evidence to support their effectiveness.

How to plan effective interventions (when working in an independent living facility). We can’t appropriately plan interventions if we don’t fully understand why we are treating our patients. Intervention planning always starts with a solid evaluation. Once we determine what the deficits are, we have to ask ourselves “Why does this matter?”. When it come to an independent living facility, it’s important to remember that these folks don’t have the same supports as individuals living in long-term care placement. So interventions should focus on how to best support all areas of daily living.

Interventions to provide in the home health setting besides caregiver education. The same rules apply here. Know why you’re treating this individual, and then address that deficit with a functional task. Modify the environment. Take a walk around the yard. Wash the dishes. Make the bed. Play a board game at the dining room table. Perform activities that are cognitively stimulating and that address the physical and cognitive areas that exhibit the most deficit.

Knowing where to start! Such an important thing to recognize. As always, start with a solid evaluation. Do the Occupational Profile (check out my free modified version here). Observe your patient and note any area where you see a deficit. Then, once you’ve determined the deficits, ask yourself why that matters. What will happen to their life and their functional routine if you don’t address that deficit?

Anxiety and depression in my loved one. So I interpreted this question in 2 ways: either you’re referring to the individual living with dementia, or you’re referring to the loved one of an individual living with dementia. If you’re noticing anxiety and depression in someone with dementia, it is important to speak with a doctor about this right away. If you’re trying to support families who have anxiety and depression, check out yesterday’s Friday Favorites for my top 5 caregiver resources.

Judging/cringing at the way other therapy members communicate with patients. Honestly, same. The reality is, we can’t change anyone’s behavior. We can only educate and advocate. The more you use appropriate strategies, the better outcomes you’ll see in your residents. I can promise you that. Hard evidence tends to convince. Keep doing what you’re doing, and keep being honest with yourself and others.

How to handle cognitive interventions when the facility only allows speech therapy to do this. I can’t tell you how frustrated this makes me. Cognitive intervention is well within our scope of practice, and the facilities we work in/for should understand and support this. If you’re in this situation: advocate advocate advocate. Then, incorporate a cognitive challenge into your treatments. As an examples, let’s say you’re assisting with ADL. Don’t give any verbal direction. Challenge your patient to sequence through the steps themselves.

How to facilitate carryover when the caregivers are not able to follow an HEP. The answer depends on why the carryover isn’t happening. If the caregiver is physically unable to follow the HEP (either due to their own physical deficit or cognitive deficit), we probably need to come up with a new HEP. If the caregiver just flat out refuses, then collaborate with them. Ask them what they find to be the most challenging. What do they need supports with? Then educate on why these recommendations will help to ease their burden of care. Collaboration vs. dictation tends to be more effective.

I really loved getting interactive with you over on Instagram. Stay tuned for more Q&As! We can always always learn from each other.