Prescriptive Treatment Protocols Powered by the BCAT® Approach and Scientifically Validated by the BCAT® Research Center
These evidence-based protocols were created by the BCAT® Research Center as part of the Better Faster Outcomes Study (Mansbach, W.E., et al 2020). This study found that patients who participated in Working Memory Exercises (WME) were able to demonstrate improvements in both cognition and function.
Working Memory is the ability to mentally hold and manipulate information over a short period of time. You might think of it as a cognitive “workspace” in which we temporarily store information we hear, see, or feel (tactile) in order to do something with it. From a functional perspective, working memory is a foundational cognitive skill that allows one to successfully perform IADLs and ADLs. Reduced or impaired Working Memory means that one cannot efficiently make new memories and may be limited in performing daily life tasks. Improvement in working memory can improve cognition and in turn, functional performance. As noted in the study, a greater proportion of WME participants than controls progressed from dependent to independent on 5 ADLs: continence, dressing, feeding, functional transfers, and toileting. Functional improvements contribute to successful aging in place and promote higher levels of independence.
Each session in the protocol contains specific targeted exercises that address underlying impairments in key cognitive domains such as memory, attention, and executive function. When used as part of a cognitive rehabilitation program, these protocols will address underlying cognitive skills and provide evidence-based interventions that are predictive of improvements in ADL and IADL performance.
Mansbach, W. E., Mace, R. A., Tanner, M. A., Knoepfel, E., Maxwell, R., & Chew, F. (2020). Integrating working memory exercises with nursing home rehabilitation to achieve “better, faster” functional outcomes. Topics in Geriatric Rehabilitation, 36(1), 60-68. 10.1097/TGR.0000000000000256
Getting Started
- Administration of the BCAT® is essential to determine the appropriate protocol to select for treatment.
- The protocols include digital and workbook based cognitive exercises to provide comprehensive treatment options for clients across the cognitive continuum.
- For persons with scores aligning with MCI, mild dementia, and some moderate dementia, start with the prescribed exercises from The BCAT® Working Memory Exercise Book – Professional Edition.
- For persons with scores aligning with moderate and/or severe cognitive impairment (dementia), utilize the MemPics® Book Series and other key tools and resources to support your plan of care.
Tools
Online Resources that Support the Protocols
- The Digital Working Memory Exercise Platform.
- The ENRICH® Brain Health Program website offers brain health resources and a free Brain Exercise of the Week for ENRICH® members.
- Family Matters Interview Series is a free education series for older adults and families hosted on the BCAT® YouTube channel.
- The Columbia Behavior Scale for Dementia-8 (CBS-8®) is a free tool developed by the BCAT® Research Center to improve manage and treat the Behavioral and Psychological Symptoms of Dementia (BPSDs).
- The Great 8 Communication Tips offers best practices for communicating with persons living with dementia.
The Books that Support the Protocols
Best Practices
- Complete the supplemental exercises from the Digital Working Memory Exercise Platform and The BrainSharp™ Exercise Book to target key cognitive skill areas.
- At the end of each therapy session, the clinician should assign work from The BCAT® Working Memory Exercise Book – Home Edition to the resident to complete outside of therapy based on protocol guidance.
- The clinician should review the completed home exercises at the start of the next treatment session.
- Persons across the cognitive continuum should be considered candidates for a cognitive home exercise program. Leverage the BCAT® Discharge Planning Crosswalk on the BCAT® Crosswalk Tables page to determine appropriate home programming tools based on cognitive level.
- A sample cognitive home exercise packet is available to support an ongoing focus on brain health and to promote safe and sustainable transitions in care.