Discharge planning in mental health: the relevance of cognition to community living.

OBJECTIVE

The purpose of this study was to investigate the relationship between cognitive disability and performance of daily living skills and stability of cognitive level after discharge in a sample of adult psychiatric inpatients (N = 40).

METHOD

The Allen Cognitive Level Test-90 (ACL-90) was administered at time of discharge (Time I) and at 21 days to 28 days after discharge (Time II). The self-report version of the revised Routine Task Inventory (RTI-2) was also administered at Time II.

RESULTS

No significant correlation was found between the ACL-90 at Time I and the RTI-2 scores; however, significant correlations were found between the ACL-90 scores at both times and between the ACL-90 score at Time II and the RTI-2 scores.

CONCLUSION

The findings suggest that cognitive level remains relatively stable over a 1-month period in the postacute stage of a psychiatric illness. Cognitive level and performance of daily living skills are related, but the relationship is sensitive to time. Implications for occupational therapy assessment include recognizing the temporal constraints of functional assessments and refining instruments to be more sensitive to performance of familiar tasks, taking into consideration client adaptation to exigencies.