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Diagnosis: Dementia Patients, Primary Progressive Aphasia Patients, Traumatic Brain Injury Survivors, Stroke Survivors, Multiple Sclerosis, and other individuals who have a cognitive impairment (Sohlberg & Mateer, 2001). It was noted that this long-term treatment plan is based on a Dementia patient.
What is Dementia?
A neurodegenerative diagnoses specifically involving memory loss in addition to decrease in other cognitive areas. Please click on link to review the Dementia document (Turner, 2015).
Definition of Dementia.pdfGoal: By 1/4/2023, the client will recall 5 family members names using compensatory strategies in 4 out of 5 opportunities, across 2 out of 3 sessions.
Memory Book.pdf
Steps
Client brings photos of friends, family, and other photos regarding main life events to the session.
Allow family members to also be involved in making the memory book by providing more information about the client if the client cannot recall.
Go through the checklist in the activity packet (e.g., name, birthday, details of family members, etc).
Ask client comprehensive questions regarding the pictures when creating the memory book.
Provide 5-10 minute breaks after every three trials of questions.
Homework: Have family members continue to ask the client questions about the book at home.
Next session: Continue to work on the memory book by using steps 1-5.
(Turner, 2015)
Prompting Levels (If Needed)
Provide verbal prompts (e.g., choice of 3)
If this prompt is too challenging, simplify the prompt.
Provide a verbal prompt (e.g., choice of 2) and visual stimulus (e.g., showing two pictures and having the client choose).
Session
Based on the diagnosis, it is important to keep in mind the functional needs of each individual in order to provide effective treatment with the appropriate intensity, duration, and interval determined with the collaboration of the interdisciplinary team (MacLennan & MCD, 2012). For example, an individual with a cognitive-communication impairment may need to see a speech-language pathologist for 30 minutes a day for three days a week.
Importance of Implementation
When creating a memory book, the client and the family will be involved by bringing important pictures of family members during each of the sessions. In the process, the goal of each session includes working on memory retrieval and recognition of the names of important people in the client's family. Word retrieval interventions are a spaced-retrieval approach that targets an individuals memory skills (Volkmer, 2020). Personally, one of the highlights in life is having a loved-one with dementia recall names (e.g., A grandpa recalling the son and granddaughter's name). While working in each session, it is vital that the client takes breaks in order to decrease any fatigue. Also, verbal prompting is recommended to provide the support needed for the client (e.g., Is the picture of Norma, Victoria, or Laura?).
Evidence-Based Research
An individuals ability to process information involves their cognitive abilities to provide executive functioning, memory, abstract reasoning, and attention (Rogers & Panegyres, 2007). When using cognitive skills, an individual provides the ability to use the working memory and attention to comprehend questions asked by the clinician and answer with an appropriate response. Individuals' with a cognitive-communication impairment are characterized to suffer from fatigue when becoming frustrated in not being able to communicate their wants and needs (Rogers & Panegyres, 2007). According Hopper (2005), written and graphic cues in the intervention provides the dementia patient the ability to attempt to recall certain familiar people and objects. Memory tasks are highly recommended as a spaced-retrieval training intervention to support individuals with short-term and long-term memory skills (Hopper et. al., 2013).
Data tracking system: SOAP notes provide thorough documentation of clients information regarding the session (Podder, Lew, & Ghassemzadeh, 2021).
SOAP Notes Template:
SOAP NotesReferences
Hopper, T., Bourgeois, M., Pimentel, J., Qualls, C. D., Hickey, E., Frymark, T., & Schooling, T. (2013). An evidence-based systematic review on cognitive interventions for individuals with dementia
Hopper, T. (2005). Assessment and treatment of cognitive-communication disorders in individuals with dementia. The ASHA Leader, 10(15), 10-11.
MacLennan, D. L., & MCD, L. M. P. (2012). Cognitive-communication rehabilitation for combat-related mild traumatic brain injury. Journal of rehabilitation research and development, 49(7), XI.
Podder, V., Lew, V., & Ghassemzadeh, S. (2021). SOAP notes. In StatPearls [Internet]. StatPearls Publishing.
Results for soap notes. TPT. (n.d.). Retrieved December 18, 2022, from https://www.teacherspayteachers.com/Browse/Search:soap%20notes
Rogers, J. M., & Panegyres, P. K. (2007). Cognitive impairment in multiple sclerosis: evidence-based analysis and recommendations. Journal of Clinical Neuroscience, 14(10), 919-927.
Sohlberg, M. K. M., & Mateer, C. A. (2001). Cognitive rehabilitation: An integrative neuropsychological approach. Guilford Press.
Turner, T.BCS-S, M. S. C. C. C.-S. L. P. (2015). Slp starter kit for Snf and Ltc settings: An all-inclusive resource for speech-language pathologists in the skilled nursing facility and long-term care settings. Swallowing and Neurological Rehabilitation, LLC.
Volkmer, A., Rogalski, E., Henry, M., Taylor-Rubin, C., Ruggero, L., Khayum, R., ... & Rohrer, J. D. (2020). Speech and language therapy approaches to managing primary progressive aphasia. Practical neurology, 20(2), 154-161.
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