Title: Assessing Functional Cognition in Patient with Mild Stroke: Feasibility in Acute Care 

Author:
Judy Hamby, OTD, MHS, OTR/L, BCPR
Catherine Verrier Piersol, PhD, OTR/L, FAOTA

JACOT Volume 4, Issue 2

Abstract

Clients who have sustained a mild stroke often have unrecognized deficits in executive function. In the acute care setting, occupational therapists typically evaluate cognitive function using naturalistic observations of basic activities of daily living rather than standardized evaluation. When using an informal assessment approach, deficits in executive function may not be evident if higher-level cognitive processes are not required. Thus, patients with a mild stroke may be discharged home with executive function deficits that place them at risk for financial, emotional, and social instability. This study evaluated the feasibility of implementing a performance-based cognitive test protocol within the acute care setting of a large suburban hospital using a one-group pretest-posttest design. Trained acute care occupational therapists implemented the six-week protocol with patients diagnosed with a mild stroke. The therapists perceived that a performance-based functional cognition test in the acute care setting was beneficial for their patients, did not take excessive time and could be utilized routinely. Time constraints and patient conditions such as patient cognitive or medical status, aphasia, co-morbidities, or patient refusal to participate were the most common barriers reported. Still, therapists felt they could incorporate the protocol into their workflow. The implementation process of this protocol can be replicated to successfully introduce additional performance-based tests in the acute care setting.