A Problem Solving Intervention for Post-ICU Cognitive Impairment in Older Adults

The Post‐Intensive Care Unit Problem Solving (PIC‐UPS) is an adaptation of a problem solving strategy developed and tested in diverse patient populations. Its effectiveness has been demonstrated in children with movement disorders or learning difficulties as well as adults with cognitive problems following acute stroke. Participants will be randomized onto usual care and intervention groups. The usual care group will complete study surveys after enrollment and 10 weeks after enrollment. The intervention group will receive the following: In the (PIC‐UPS) program, participants will be engaged for 10 sessions, learning how to do skills they select as treatment goals. The first session consists of an assessment, and selecting the goals to meet during the 10 sessions. In the next sessions, conducted at the participant's home, participants practice the skills selected as treatment goals, and assisted by the study team, use strategies to help better learn and perform those skills. Some examples of tasks that others have addressed in these sessions are gardening, yoga breathing, handwriting, managing family finances, medication management, or initiating an exercise regimen. Participants will be encouraged to select tasks most relevant and problematic to their unique situation. In addition to attending the sessions, the participants will be asked to rate the sessions and asked about how useful they were in helping to achieve goals. This involves the completion of some written questionnaires and will take about a half hour. Sample Assessment and Treatment Schedule Session Description 1. Assessment session approximately one and a half hours long. Combination of questionnaires and goal setting interview. Baseline testing of 3 goals. 2. Treatment session + 2 surveys, approximately one hour long. 3. Treatment session 3, approximately one hour long. 4. Treatment session 4, approximately one hour long. 5. Treatment session 5, approximately one hour long. 6. Treatment session 6, approximately one hour long. 7. Treatment session 7, approximately one hour long. 8. Treatment session 8, approximately one hour long. 9. Treatment session 9, approximately one hour long. 10. Treatment session 10, followed by first post‐intervention assessments, approximately 2 hours long.