As part of the Neuro Aspects course I'm taking in OT school, I participated in a clinical simulation encounter during which I administered a cognitive screening to a person with a recent history of stroke. Cognition can be thought of as someone's ability to comprehend and evaluate information/stimuli from the environment around them and then apply that information to complete tasks. An occupational therapist can work with people with cognitive disorders and help them complete ADLs (activities of daily living) such as grooming and self-care and iADLs (instrumental activities of daily living) like paying bills or doing laundry. Clients can benefit from occupational therapy services in many ways, some being: helping them complete tasks through verbal cues, making modifications to their home to promote accessibility, and educating family members or caregivers on their condition.
On the SLUMS (St. Louis University Mental Status) test my client scored a 21. Since my client had obtained her bachelor's degree, this means her score indicated a mild cognitive disorder. Some challenges she may face related to this cognitive impairment would be issues managing the household, such as difficulty keeping up with finances. In a community/social setting the client may have difficulties when it comes to conversation, she may repeat the same questions or possibly not remember new names or details of stories. As for a hospital setting, due to her cognitive impairment, she may have issues comprehending conversations with the doctors, understanding why she is taking new medications, and following orders from the healthcare team. When I explained what occupational therapy is to the client I started by asking her what one of her favorite activities is and she answered that she loved to garden. I used this hobby to explain to her that as an OT, I could help her strategize ways to keep herself gardening even after her stroke. Due to the nature of her diagnosis and the confusion and stress that occurs after an event such as this, I kept my elevator speech to a minimum and just explained to her that occupational therapy is all about helping her continue to take part in her daily roles.
During this encounter, I feel as if I did a good job making sure the client felt comfortable during the administration of the SLUMS exam and was able to make her feel at ease when answering questions. Looking back, I would change how nervous I was going into the simulation. As soon as I was about to walk in the door I got hit with a big rush of nerves and I was scared I was going to completely blank when it came to administering the test. Fortunately, once I started talking all the nerves disappeared and I had a great time getting to chat with the client and was able to get through the test efficiently. My main takeaway from this simulation is that I need to be more confident in my own abilities and worry less about myself, and more about how I can make the client feel comfortable, open, and eager to share his/her experiences with me in order to best treat their needs. Going forward, I will use the knowledge I gained from this experience as a means to continue to improve upon my therapeutic use of self and as a 'building block' for working with clients who have cognitive disorders.
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