When care teams are overloaded: where cognition fits in

This past week I’ve had two different opportunities to support conversations about how we actually manage the cogntive load of carers and just how much that load can impact our participants, in which we're all here to support.

Now I believe this to be true: understanding functional cognition doesn't just help your individual client in that moment, but it actually puts you in the best position to enhance your approach as an occupational therapist.

Example 1: SDA home with 10 participants - concierge style
The care staff need to be able to be able to provide some support to all participants. But there was just too much information, too much generalist information, not enough clarity on who needed what. The result? Overwhelm, confusion, and less capacity to provide high quality care.

Together we agreed on some simple, consistent systems:

• The first one was QR codes linking to transfer videos and guides for each participant, a quick reference point when they really needed it the most because they're not doing transfers all the time. We need to think about how can we provide them that information quickly and on hand for the purpose of high quality care

• Separate communication channels for separate clients so that staff only had to engage in the information that was relevant to them at that time. If they aren't servicing one of their clients for a whole day, why do they need to read that information on that client? It's just unnecessary information on already overwhelmed system. 

• We also agreed that the same system approach across the board for all participants. So this system was not just for this client but for the entirety of the SDA so that staff had that consistency and could really optimise their own function - and in turn optimising clients function.

So what's the shift - improved function was not only promoted for the client, because staff knew what they were doing and how they can provide high quality support, but carers  weren't as overwhelmed which means that, naturally, that the quality of care has increased. 

Example 2: Care team meeting with a client with ID
The challenge here was helping the team see why the supports I am recommending actually matter. In the carer training, I broke down the client's cognition and showed the staff of the foundations of their presentation that limited higher level thinking, which leads to emotional dysregulation, reduce planning, reduce problem solving, reduce decision making and how this actually impacts their daily routine.

Because the carers understood the why, they were able to actually understand the reasons for the external strategies that we were implementing, such as visual planners. 

Suddenly, it's not just occupational therapy is recommending a tool, is actually understanding the foundational needs of why we're recommending this tool and why carers need to review the guidelines recommended by the OT. It also enables carers to understand the foundations to take initiative, even environments that we don't directly assess, that we aren't there understanding the impacts.

When carers are supported to understand the cognitive “why,” they feel more confident, more capable, and less overloaded. And for our clients? That translates into more consistent, meaningful support across the board.

Until next time,
Imogen