Occupational Therapists often take the lead in functional cognitive assessment of a person with dementia. In the absence of a neuropsychologist, it can be difficult to outline each specific component of cognitive deficit. To help, here are five things to remember when assessing cognition.


1)      Keep it functional

As an OT, your role is to look at how a person’s cognition affects their safety and independence. Try to use as many functional assessments as possible to gather your information. It’s not necessary to use the psychological term for every error made during the assessment.

2)      Don’t rely on numbers

Cognitive screening tests are great tools for narrowing down the areas of cognition that need to be assessed in a functional way. But don’t rely on the numbers to make a final call. Remember, a person’s performance on a task is individual to the person’s experience. When actually completing the task, the person may perform better or worse than predicted on paper.

3)      Break it down

Cognitive difficulties can range from being subtle to overwhelming. This can sometimes makes it hard to pinpoint what to document. When analysing where the deficit lies, break it down. Doing so will help to document the areas of concern and target your intervention. And remember, keep it functional!

 4)      Generalise your analysis

Once you have analysed the cognitive deficits, identify what other tasks or situations may affect the person and what others can do to help. For example, if a person has problems remembering appointments, they also may have difficulty remembering to take medications, or remembering conversations, exercises or what service they’re meant to contact for particular issues. Make it clear to others that it is important to write down simple, clear information after any discussion with the individual.

5)      Trust your assessment

Writing the results of a functional cognitive assessment isn’t as clear-cut as writing a number at the end of the screening tool. But trust your ability to analyse the person’s performance in the context of their life. Don’t feel like you have to provide numbers.