Honking gets your attention. It gets you engaged. It wakes up your mind to the present moment of what’s happening. Getting a task done doesn’t always mean that there was higher cognitive engagement in the task.
Working in a SNF presents a unique opportunity to challenge patients with not only a therapeutic physical task, but also a honk-of-a-cognitive task.* Lets take for example the task of getting to the bathroom, completing 15 repetitions of an arm exercise, or putting on a pair of socks... For some people, each of the these tasks may be a habit and would require little critical thinking or problem solving. In other words, the patient could do this half asleep but still get the task done.
Now change it up a bit. Instead, you challenge the same patient to work on standing activity tolerance (which can be used during cooking tasks, showering, grooming or laundry) while having the patient prepare a bowl of instant oatmeal, complete a puzzle, or play Kings Corner. Any of these activities not only address a physical goal, but also engage the cognitive skills of a patient which can be overlooked during therapy at a SNF.
(Note: It is in part of the service-oriented nature of a SNF that facilities the lack of necessity to cognitively engage in challenging activity. Consider it... at the SNF meals are prepared, medications are administered, laundry and cleaning is completed for the patient and these are reasons why the patient is there. Yet for true independence, these same patients must be challenged on a daily basis in order to maintain their higher level thinking skills and abilities in order to return to these very same tasks, routines, and occupations.)
Become aware of how you are currently engaging patients in cognitively stimulating activity (given that this is therapeutically appropriate and realistic) and what opportunities your current work environment may provide for a more engaging therapy experience.
Let’s aim to help keep our patients not just awake, but truly engaged...
*A future post will highlight specific ideas to increase cognitive engagement in SNF OT.