08/10/2025
Something that has surprised me about operating a practice that primary works with individuals with cognitive impairment and neurodegenerative conditions are how many times the following occur:
🥸 client tells me that their therapist said they weren’t a strong rehab candidate because of “poor carryover”.
😩 I have read discharge notes stating that “the patient was discharge due to non-compliance secondary to cognitive impairment” or “poor candidate for skilled rehabilitation secondary to noncompliance associated with cognitive decline”.
🫢 Caregivers have said, “it seems like they didn’t understand or take into account that he had dementia”.
These things shouldn’t be happening. It’s the responsibility of every therapist, regardless of setting, to understand how to adapt and support individuals who need assistance (or ensure you have a network of people you can refer to!)
One thing not noted here is environment! If you have someone with memory impairment or attention difficulties secondary to any kind of thinking impairment - ensure you are modifying your environment as best you can! Take them from that big open room with many patients and distractions and close their environment so they can focus. This will reduce extraneous cognitive load, reduce anxiety and overstimulation, and better allow them to focus on their exercises.
