The Memory Unit OT

When talking with other OT practitioners, it seems like the biggest and most common struggle people have when it comes to treating individuals with neurocognitive impairment is knowing where to start. And this makes complete sense. In school, we’re given maybe a few opportunities to learn the very basics of what dementia is; but unless you’re lucky enough to work with a CI on clinical who treats individuals with dementia frequently, we never learn how to actually treat people with dementia.

Good dementia care always starts with good data collection.

So when it comes to treatment planning I’m always going to recommend starting with a solid, thorough evaluation that includes the Occupational Profile. If evaluations skills are tricky, I’ve got lots of evaluation tools and resources for you. I also have a Modified Occupational Profile available if you’re working with someone who has a limited ability to sit and answer all of the questions within the traditional Profile.

Once you know who your patient is, what they have difficulty with, and why that matters, then you’re ready to start treatment planning.

This is crucial. You absolutely cannot provide quality, client-centered treatments if you don’t fully understand what the patient’s goals are and why they are unable to perform those tasks and activities right now.

Once you have your skilled evaluation complete, the treatment planning should flow right from there. There are lots of things to ask yourself, but it really boils down to 3 basic questions: What is my patient having difficulty with? Why does this matter? What activity can I use to address this?

Here’s a practical example.

I’ve just evaluated Helen who lives at home with her daughter (who is her primary care partner). Up until the last 2 weeks, Helen was able to transfer off of every surface in the house independently. Now, Helen is no longer able to transfer off of soft surfaces like the couch. She has fallen several times while attempting transfers independently and her daughter now has to remain close by at all times incase Helen needs to get up.

Let’s answer those 3 questions:

What is she having difficulty with? transfers

Why does this matter? she is falling, she has lost some of her independence, she can no longer engage in her environment in the meaningful way she could before, her daughter now has to assist which puts a greater strain on her ability to engage in her own routine

What activities can I use to address this? we can practice standing activities (like washing dishes or making the bed) to increase standing tolerance and lower extremity strength, we can dance to Helen’s favorite music, we can water the gardens in the yard to work on dynamic standing and ambulation, we can practice frequent walks around the house while always taking a rest on the couch to engage Helen in repetitive transfers

See how that works? It just takes a bit of critical thinking and activity analysis to come up with a strong intervention plan once you know what you’re working towards.

I’ve got a free printable for you that includes more questions to consider when treatment planning. And if coming up with treatment ideas is still tricky, I’ve got plenty of resources here too.

Happy Treating!!