What is cognition?
Cognition is a term that refers to our memory and thinking skills. Our bodies are bombarded with sensory information coming from our environment, which we register through our five senses (touch, taste, vision, smell and hearing). Our brains are constantly hard at work making sense of this information and deciding how we should respond to it, often also drawing upon memories from previous similar situations to aid us in these decisions. Our brains are in control of all our functions, from movement to talking, and regulating our emotions and behaviours.
How damage can occur
It’s easy to ‘take for granted’ our cognitive processes because most of this work happens automatically in the background as we go about our daily lives. Usually well protected by the surrounding skull, it’s easy to forget that our brains are actually very fragile organs, susceptible to damage in a number of ways; such as head trauma, infection, stroke (when the blood supply to the brain is interrupted due to blockage of a blood vessel or a haemorrhage), tumour, and degenerative diseases such as Alzheimer’s and dementia. Additional conditions including MS, Parkinson’s Disease, MND and FND can also result in cognitive changes which may present as feelings of distraction or disorganization, finding it difficult to plan and accomplish tasks or significant levels of fatigue causing ‘brain fog’ which may further limit levels of independence.
How an Occupational Therapist can help
Injury to the brain and the subsequent impact on cognition can present challenges to our ability to carry out our usual routines. As occupational therapists, our role is to help identify ways of overcoming these challenges to enable people to continue living full lives. Occupational therapists will often start with an assessment to identify a person’s areas of cognitive strength and limitation, and how this is impacting on their ability to engage in their normal everyday activities and roles. With constant advancements in knowledge about ‘neuroplasticity’ (the brain’s ability to ‘rewire’ itself), there’s never been a better time to be working with people in this area.
When assessing whether someone may be experiencing changes to their cognition, occupational therapists may consider the following patterns of behaviour:
- High levels of confusion
- Poor motor coordination
- Poor planning and sequencing of a task (i.e. making a hot drink in the kitchen)
- Reduced short-term or long-term memory
- Impaired judgement or impulsivity
- High-level distraction / reduced ability to maintain attention on one task
Following assessment, occupational therapists may employ a range of treatment approaches depending on the individual, including structured rehabilitation modules targeting improvement of specific cognitive skills, use of adaptive strategies or aids to help compensate for cognitive losses and importantly ‘real-life practice’ to ensure any improvements to cognitive function or adaptive strategies are generalised into the context of daily functioning. Occupational therapists can also assist with implementing fatigue management strategies to assist with high-level fatigue and subsequent barriers to achieving activities of daily living. We also understand that neuroplasticity requires a whole lifestyle approach, with factors such as stress, exercise and nutrition contributing to outcomes, and often work alongside our exercise physiology colleagues to help maximise gains.
With an overall aim of helping people to gradually re-engage in their preferred activities and life roles, this is one of the many rewarding aspects of our jobs as occupational therapists!