Where There Is No SLP - Cognition Strategies (third in a series)

What can you do, if your home health patient doesn't have speech therapy - but isn't thinking well? Problems with thinking (cognition) skills can make a patient less independent, and even jeopardize her/his safety. Human cognition is a complex hierarchy of skills that we depend upon for living in the modern complex world. Preventing long - term effects of challenges to a patient's cognitive status is a worthy goal of home health intervention. Where there is no SLP, what can you do help the patient to function best to meet her/his cognitive needs? Remember that hearing impairment in adults is a major risk factor for development of cognitive impairment. Suggest the patient get a hearing screening, either through self - assessment or behavioral testing.

Effective communication with your patient during the visit will make thinking through your activities easier. For example, speak clearly with the patient, maintaining consistent eye contact. Regularly ask the patient to "teach back" what you have demonstrated or explained. Use the "WRAP" strategy (write down; repeat/routine; associations; picturing) to help the patient retain your information. Supply WRITTEN illustrations of home exercises when possible. If the patient does not easily initiate an action (e.g., picking up a utensil or taking a step), give a timing cue by modeling what you wish her/him to do.