Services Paper

Week Four – The Cognitive Issue Assignment

The cognitive issue revolves primarily around the simple use of a piece of paper and pencil in a task to assess (in this instance) an elderly person’s range of abilities. These would include their span of attention, retention of information, their ability to solve problems, language skills, and their intellectual functioning. The main objective is the process of determining a patient’s abilities (their cognitive strengths and weaknesses) via the qualitative and quantitative approaches. The qualitative would be the approach to one’s tasks and their observed behavior, whereas the quantitative would involve the measures of standardized and scaled methods. Interpretation of their test scores would be on the basis of the client’s educational level or occupation along with pre-morbid estimates on their functioning level (intellectual level).

The cognitive assessment area consists of five parts:

Intellectual and Executive Functioning, Attention – Concentration,

Working Memory, Speed of Processing, Learning Memory Short-term –

Long-Term, Auditory – Visual, Recall – Recognition

Self-Reported Cognition – Emotional Functioning.


  • While it is a known fact that doctors have attained a poor record in their predictions of patients’ cognitive functions rooted in a non-cognitive and routine evaluation alone. There is no doubt the cognitive assessment is a valuable clinical skill, as it makes possible the diagnosis of the various disorders impairing one’s thinking. It also permits a more accurate estimate of the function’s ability. Cognition also can be a part of the predictability of hospital admissions in which mortality is involved. Clearly, these benefits lend themselves toward a practical value while the cognitive assessment may also be some type of skill to be employed in the Directly Observed Procedural Skills (DOPS) outline for the on-going evaluation as they trained geriatricians and neurologists.
  • Obtain the necessary information for this project, the County of Du Page, Illinois, Health Care Department was contacted. The response from them was that they do not have any type of services pertaining to psychosocial, cognitive, or emotional services available, and they had no idea where one could call and have their inquiries answered. Referring to our instructor’s assistance, a nursing and assisted living facility was contacted right here in town, went over to their facility, and obtained the following information required from that source.
  • They call their facilities part of the Lifespace community that consists of 12-multi-state system and community-based senior living. They have facilities in Florida, Iowa, Illinois, Kansas, Minnesota, Nebraska, and Pennsylvania catering specifically to those individuals with cognitive issues. Lifespace is deeply committed to sharing an integrated plan, a commitment of experiencing service to senior adults in their plan of wellness for them in addition to an array of options for the continuation of care for them. Lifespace has been in this area since 1973 and underwent change in 2011 when Lifespace Communities, Inc., bought the community and renamed it Oak Trace. Presently, they are part of the multi-state system serving more than 5,000 people.
  • Lifespace is a not-for-profit community backed by a financially strong and stable organization. They have received a well-deserved “A” rating from Fitch, S & P, and Moody’s financial ratings group. As an example, the following information relates to figures reflecting the industry’s ratings:
  • 1,861 Continuing Care Retirement Communities (CCRC’s) in the United States
  • Out of the 1,861 CCRC’s, 363 are rated by Fitch, S&P, Moody’s
  • The 363 CCRC’s consist of 58 systems (multi-sited such as Lifespace Communities)
  • Out of the 58 systems, only one has attained the coveted “A+” rating, while three
  • others earned an “A” rating
  • Lifespace Communities was one of the three CCRC multi-site systems to received an “A”
  • (Jeffrey Girardi, research specialist, Ziegler Capital Markets/Senior Living Finance,
  • Columbia, MD).
  • The services that this community offers to the area are a multitude of those connected with the intellect, social, physical, emotional, vocational, and spiritual. With the intellectual part, the facility works to expand the patient’s mind as the patients provide mentally and stimulating challenges for them. On the social end, they help their patient to interact and be harmonious as they grow with their circle of friends. The physical dimension helps the patient to improve their balance, strength, endurance, and mobility. With the emotional approach, they work on helping the patient to build a more optimistic attitude, as they assist the patient in managing his or her reactions to the rollercoaster of life (with its usual ups-and-downs). Along with the vocational tactic, they are there with their patient to help them in sharing, serving, and even leading, as their talents are put to use. Finally, the spiritual slant gives the patient an opportunity to connect with their heart, between themselves and their Supreme Being/Universe/Cosmic Force. It is in this aspect that the CCRC hope their patient finds a sense of peace and harmony.
  • Lifespace/Oak Trace has a program called PEP (People Energized through Purpose) and appears to be an ideal opportunity to fit in with their six dimensions of wellness that also offers their residents. It provides many activities to keep them occupied or enjoying a bit of leisure time that might include one of their choruses, gardening, woodworking, among a few of them as they steer their residents on a course of benefiting from both programs.
  • Oak Trace has many opportunities for their residents to pursue those classes and programs they previously did not find time for and to enjoy rich associations and connections with other residents in their area. The residents will find their lives have fewer limits placed on them and open to more freedoms and fulfillments. The facility strives to emphasize adult daily living with simplicity as a normal freedom from the usual heavy logistics of living each day under what might be experienced in another facility. That does not exist here.
  • Oak Trace has catered living services along with skilled nursing and memory care. They work diligently to provide an adult senior living lifestyle that goes on 24-hours a day from their RN’s, LPN’s, and CNA’s. Their range of care covers internal medicine, gerontology, dentistry, optometry, podiatry, and neurology specialists. They have advanced pain management and a physiatrist (that is a physician specializing in rehabilitation) who oversees individualized care as plans are prepared for each patient as they are helped to successfully become part of daily living. Palliative care and hospice services, comprehensive as well as restorative physical therapy, and of course social services as they endeavor to be of support to not only the residents but also the family members.