Running head: OCCUPATIONAL PROFILE

Occupational Profile
Josee L. Lundquist
Touro University Nevada

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Occupational Profile

Client
Joe is a 63-year-old male admitted to the hospital on August 4th after falling in his house
and sustaining a right femoral neck fracture. On August 5th, Joe underwent a right posterolateral
hemiarthroplasty due to poor blood supply around the femoral head. Joe has previously
experienced two dislocations of his right hip within the last five years. Post-surgery, a hip
abduction brace was ordered by his orthopedic surgeon to prevent internal and external rotation,
and no flexion past 60 degrees to prevent post-surgery dislocation. He is currently prescribed
Ceftaroline to minimize the risk for infection, Ondansetron for nausea, and Aspirin for
inflammation and pain management. Joe is otherwise healthy, with no other significant health
concerns.
Joe was born and raised in Las Vegas, Nevada and is now retired after 36 years as a
technician for an air conditioning company. He lives with his wife of 28 years in a single story
rancher style home in Northern Las Vegas. They have two Maltese dogs which he enjoys
walking daily. Together they have two sons, one daughter, and five grandchildren who reside in
California and Arizona. After retirement, Joe has continued to maintain an active lifestyle
engaging in many activities during his free time. He enjoys golfing, going to trade shows,
working in his garage, walking the dogs, and visiting grandchildren to watch them play soccer
and baseball. His wife is not yet retired, leaving him in charge of the cooking and house
maintenance roles.
This is his third hip surgery and has expressed no concerns with returning home except
that he wants to return to driving as soon as possible. His wife expressed concern that he will be
home alone the majority of the time and doesn't want him to hurt his hip again. She explained

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that he does not know how to relax and let himself heal, fearing his safety when she is not home
to help and supervise.
His wife is very supportive but works full time at the Red Rock Casino. She is willing to
do whatever it takes to get him home as long as it is safe. His children are not able to help him
after discharge because they don't live in Las Vegas, and are not able to visit at this time. A friend
has offered to help him run errands and take him to appointments when his wife is at work. His
home is a single story home with an open floor plan minimizing some structural barriers, and
supporting his ability to engage in desired occupations.
Purpose of Services
Orders were given by Joes orthopedic surgeon to be seen by an occupational therapist
(OT) during admission at the acute hospital. Joe and his wife expressed their primary concerns
consist of self-care tasks, and driving. Specific tasks include transferring in and out of the
shower, bathing, toilet transfers, toilet hygiene, lower body dressing, and car transfers. These
tasks have all been identified as difficult due to his current hip precautions, frequent hip
dislocations, and decreased balance. Joe has verbalized comfort completing transfers from bed to
chair, and chair to standing but requires multiple verbal cues (VC) to follow precautions. Barriers
to Joes performance include his limited range of motion (ROM), decreased safety awareness,
decreased insight into the ability to perform tasks, and decreased balance.
Contexts and Environments
Consideration of ones contexts and environments are important to consider when
identifying what supports participation in engagement and what barriers may exist within the
contexts and environment. Joes personal and temporal contexts support his engagement in his
desired occupations. His personal context has many positive aspects including an active lifestyle
prior to hospitalization, and his socioeconomic status poses minimal barriers. Joes cultural

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context in addition to his physical and social environments poses many barriers to his
engagement in occupations. AOTA (2014) identifies relationships and expectations with
individuals in ones life as the foundation for the social environment. Within Joes social
environment, he has limited support. Although he is close to his family, his children and
grandchildren live out of town, and his wife works graveyard shifts full time. His wife is very
supportive but cannot take any more time off from work. His cultural context can be seen as a
positive factor as well as a barrier. As a man, he has remained very independent his entire life
and continues to have a willful mindset that he does not need help. This mindset may be linked to
his multiple dislocations post-operation. Joe explained that he feels fine after surgery and can
move his hip around fine. To address Joes belief, it is important to incorporate client and
caregiver education as well as develop techniques for Joe to continue his occupations of choice
safely. Currently, his physical environment within a hospital room has all the equipment required
for maintaining a safe environment. The toilet has a raised toilet seat, the chairs have arm rests,
and the hospital bed offers a firm surface with bed rails for bed mobility. Although Joe lives in a
single story home, the physical environment may put him in susceptible positions within the
kitchen, bathroom, living room, and bedroom that may lead to another hip dislocation if correct
techniques and equipment are not utilized.
Occupational History
As a retired technician from a local air conditioning company, Joe fills his day with home
maintenance, working in his shop, caring for his two dogs, attending trade shows, golfing weekly
with friends, and attending church with his wife. He begins the first part of each day making
breakfast and then working in his shop and doing yard work until his wife wakes up in the
afternoon. Every Thursday, he meets a group of friends for a round of golf and lunch at different
local golf courses. He said he used to walk the courses for exercise, but after his hip started

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bothering him, he relies on the golf cart to get through the course. On the weekends, he and his
wife travel all over Nevada, Utah, Arizona, and California attending different trade shows and
visiting his children and grandchildren. He also enjoys reading, walking his dogs and going to
Boulder City to look through the antique shops.
Priorities and Desired Outcomes
Joe is concerned with his ability to maintain an independent lifestyle caring for himself,
his dogs, and participating in leisure activities with friends and family. He is determined to return
to his prior level of functioning and immediately resume most of his occupations as soon as he is
home as he does not want to be stuck at home. His priorities for occupational therapy (OT)
while at the acute hospital are to be able to shower independently, go to the bathroom, and dress
himself so that his wife doesn't need to miss work. Joe also expressed his desire to learn how to
transfer safely in and out of their car to maintain his access to the community and then begin
driving.
Occupational Analysis
Joe was in his hospital room, seated in a chair with armrests, and with his hips flexed
more than 90 degrees. He was discussing discharge plans with his case manager and wife in
regards to what services he may need after returning home. During the intervention session, I
observed Joe donning gym shorts and hip abduction orthosis with the help of the therapist. He
required verbal cues to maintain his hip precautions seated in the chair, and moderate assistance
to manage clothing. He then required maximum assist to don his hip abduction orthosis to ensure
it was adjusted correctly, and met the requirements of his surgeon. Throughout the intervention,
he required constant verbal cues to follow hip precautions, sustain his balance, take rest breaks,
and maintain safety. Joe did not have any adaptive equipment (AE) in his room to assist with
these occupations. Joe was able to sit safely after hip orthosis was donned due to the 60-degree

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flexion limitation the brace placed on his hip joint. During the intervention, Joe displayed
urgency to complete the tasks, and continually verbalized his desire to go home.
The domains of the Occupation Therapy Practice Framework (OTPF) interact with each
other to affect an individual's occupational identity, well-being, and participation in life (AOTA,
2014). After careful observation of Joe completing a dressing activity and donning of orthosis,
the domains affecting Joe's successful occupational engagement include multiple client factors,
performance patterns, and his environment.
Client factors that are affecting his performance comprise of his belief that he can move
his hip without hesitation because he doesnt have pain, and his value of independence and not
wanting to rely on others. Joes joint mobility is limited to 60 degrees currently by the hip
abduction orthosis to protect his hip due to the decreased stability of the joint after surgery.
There are multiple performance patterns impacting his engagement in desired
occupations. Joe's habits and routines have remained the same for years, and even after his first
two hip surgeries, was unable to adapt to prevent additional injury. He completes the same
morning routine every day and has built in habits which may break his hip precautions, or result
in a fall. A habit identified is standing for meal preparation while watching television increasing
safety concerns. His roles can also impact his performance as he is the primary person who
completes home maintenance, chores, and preparation of meals. Education about techniques and
adaptations are required to ensure his safety while completing these roles.
His current environment in a hospital room is supportive of his occupations, however
when he returns home, his environment may impede his ability to perform his activities of daily
living (ADL) and instrumental activities of daily living (IADL). It is crucial that he is given
resources to obtain the durable medical equipment (DME), and AE needed to prevent another fall
or dislocation of his hip.
Problem List

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The following are the top five problem statements Joe and his wife would like to focus
occupational therapy sessions on with the occupational therapist.
1) Pt. is unable to complete LE dressing (I) 2 hip precautions.
2) Pt. requires Mod (A) to complete toileting on standard toilet 2 hip precautions.
3) Pt. is unable to complete ADLs standing at sink 2 to balance & standing
tolerance.
4) Pt. requires Max (A) to complete tub transfer 2 safety awareness, standing
balance & hip precautions.
5) Pt. is unable to complete car transfers 2 hip precautions & safety awareness.
Problem List Justification
Joe is currently concerned with being self-sufficient with self-care tasks while his wife is
at work as well as return to driving. His problem list is prioritized to initially address self-care
concerns, safety, and then to address his interests in driving. Self-care tasks are a priority because
his wife will be returning to work and will not be able to aid him. Addressing lower extremity
(LE) dressing initially will allow Joe to get ready for the day without his wife present. Toileting
is then addressed to decrease his risk for falls in the bathroom while he is home alone. Standing
to complete ADLs at the sink is third because of the activity tolerance required. Focusing on
other areas of occupation including LE dressing and toileting will increase his tolerance to stand
while maintaining balance. Tub transfers are prioritized towards the bottom of the list because
although the client cannot complete this occupation, a complete bath has not been cleared at this
time due to sutures, and the client should only participate in sponge baths while sitting. Finally,
car transfers are addressed in the end. Although driving is a crucial occupation to Joe, he cannot
drive until his orthopedic surgeon clears him for this activity, therefore, is prioritized at the end
of the list. Car transfers can be difficult and should only be addressed once Joe has full
understanding of his hip precautions. Addressing car transfers is important to allow his wife to
take him home, and provide access to the community.

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Client Centered Goals and Intervention Plan

Long Term Goal One
Pt. will complete LE dressing & donning of orthosis seated EOB MOD (I) c no VC
within 4 tx sessions.
Short Term Goal One. Pt. will complete LE dressing EOB MOD (I) c AE & 4 VC to
follow THP within 2 tx sessions.
Intervention. To address this goal, the intervention approach most appropriate is
modify. The intervention will use AE and compensatory techniques to change the demands of
the occupation and promote success with dressing (AOTA, 2014). Lower body dressing can be a
difficult task to complete without breaking an individuals hip precautions. This intervention will
begin with education about what Joes hip precautions are, and positions he needs to avoid.
Considering his history with multiple hip dislocations, it is important to discuss hip precautions
continually to increase awareness and prevent another injury. The therapist will then discuss AE
and compensatory techniques that may assist with the dressing task and problem solve with Joe
to determine the best solution for him. Possible AE that will be discussed include a reacher, sock
aid, dressing stick, long handled shoe horn, and leg lifter (Lawson & Murphy, 2013). Joe will
then participate in donning and doffing of his pants, socks, and shoes using the desired AE and
compensatory techniques of his personal preference. Lawson & Murphy (2013) discuss the
proper way to complete lower body dressing starting with the operated leg first. The therapist
will confer with Joe about clothing and shoe styles that may help increase the ease of dressing.
Collaboration between Joe and the therapist will be crucial to ensure Joe is using the equipment
correctly and maintaining hip precautions throughout the activity. After Joe has completed the
dressing activity, the therapist will discuss his thoughts about his performance, and whether there

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are other techniques or equipment that he would prefer to try the next time he gets dressed.
Remaining client-centered throughout this intervention is fundamental, to make certain the client
is using the clothing, techniques, and equipment preferred by the client even when the therapist
does not agree as long as it is safe. There are two desired outcomes for this intervention plan.
The first outcome is improvement to increase Joes occupational performance in lower body
dressing (AOTA, 2014). The second outcome is "prevention" to reduce the incidence of injury or
another hip dislocation while participating in the occupation of dressing (AOTA, 2014). The
ultimate goal for this intervention is to have Joe complete lower body dressing in a safe manner
with techniques and adaptations he is comfortable with.
Evidence Based. To improve the effectiveness of this intervention a study done by
Thomas, Pinkelman, and Gardine (2010) identified frequent themes that need to be addressed
during an intervention that utilizes AE to decrease noncompliance. The authors completed a
literature review and interviews with the study participants, where four common themes were
identified which have an influence on noncompliance of adaptive equipment. The themes
identified include; the clients involvement in the decision-making process, adequate instruction
from the occupational therapist, improvement of the clients medical condition, and consideration
of the environment to influence AE recommendations and the use of the AE (Thomas et al.,
2010). In consideration of this study, it is important to remain client-centered during
interventions that AE is utilized. To address the common reasons identified for noncompliance,
the occupational therapist provides education about the equipment, and then encourages Joe to
make a decision about which tools fit his needs best, and will be compatible to his environment
when he returns home. Through knowledge and practice with the AE, Joe's functional
performance can improve, and possibility of an injury can be decreased (Thomas et al., 2010).

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Grading up and Down. There are multiple ways in which this intervention can be graded
up and down. To grade the intervention down, loose pants that slip on can be worn, as well as
slip on shoes. Using loose fitting clothing and slip on shoes will require less manipulation with
AE. To grade the activity up, tighter fitting clothing, socks, and shoes that tie can be donned.
This will require Joe to demonstrate more precision and skill with AE, and will increase the
difficulty of the task.
Short Term Goal Two. Pt. will complete donning & doffing of hip abduction brace EOB
MOD (A) c 2 VC to follow THP within 3 tx sessions.
Intervention. An external hip abduction orthosis was ordered to provide extra protection
due to Joes history of hip dislocations, and instability of the joint post-surgery. This intervention
will use the prevent approach to decrease his risk of hip dislocation during recovery.
According to AOTA (2014), the "prevent" approach is used with individuals who may be at risk
for a problem with their occupational performance. The intervention will begin with an
introduction to what a hip abduction orthosis is, and why it will be beneficial for him. The
therapist will then demonstrate how to don and doff the orthosis, followed by Joe practicing and
demonstrating donning and doffing of the orthosis. Education will be provided to Joe and his
wife verbally and through handouts about proper care for the orthosis including cleaning
instructions, and how to adjust for comfort and functionality. The desired outcomes for this
intervention are prevention and quality of life (AOTA, 2014). After completion of this
intervention, Joe will be able to use his orthosis independently, ultimately preventing dislocation
of his hip as it heals. This intervention will also increase his quality of life allowing him to
participate in occupations of life safely as he progresses towards his goals.

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Evidence Based. McKee and Rivard (2004) reviewed three client stories to validate the
successfulness of orthosis on occupational performance. After reviewing these stories, the
authors identified six factors that need to be considered to ensure the orthosis increases a clients
occupational performance and helps them meet their goals. The factors include clientcenteredness, comfort, cosmesis, convenience, using a brace that follows a less is more design,
and follow-up. This study did not specifically address hip abduction braces, yet the orthosis
braces discussed addressed similar factors including relieving pain, stabilize or immobilize,
prevent or correct deformity, protects against injury, promote healing, and assist function
(McKee & Rivard, 2004). Considering the essential factors one must consider according to
McKee and Rivard (2004), Joe is included in the adjustment of the hip abduction brace and
educated about the importance of the brace. Educating and including Joe in the process of the
donning, doffing, and cleaning of the orthosis will allow him to identify techniques and strategies
that work best for him in collaboration with an occupational therapist and facilitate the ease of
use. Once Joe can independently and appropriately don the hip abduction orthosis, the brace will
support his performance in other ADLs and IADLs of choice.
Inclusion of Joes wife in this intervention is important according to Ulla-Maija &
Marinela (2012) who affirm the home environment is a major source of stress and relapse.
Although this article, focused on parents and the pediatric population, families should be
considered no matter the population, because of the impact a life changing event will have on the
entire family. Including Joes wife in education about the hip abduction orthosis will provide her
with knowledge and skills to help Joe and ultimately limit the stress a new device may have on
both of them. The authors explain that although the concept of family-centeredness is common, it
has a greater focus on the clients needs and not the family as a unit (Ulla-Maija & Marinela,

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2012). Including Joe's wife and considering her concerns along with Joe's will foster a more
holistic intervention approach.
Long Term Goal Two
Pt. will complete toileting c standard toilet & raised toilet seat (I) within 5 tx sessions
following THP.
Short Term Goal One. Pt. will complete toileting c BSC Min (A) & 2 VC to follow
THP within 2 tx sessions.
Intervention. This intervention should be approached as a "modify" intervention as the
activity demands of toileting is being modified for safety within the hospital room environment
(AOTA, 2014). This intervention will take place immediately after Joe's orthopedic surgeon has
cleared him for therapy, to start individualized therapy as early as possible. To begin the
intervention, the therapist will introduce Joe to a bedside commode (BSC) and explain the
benefits for safety and energy conservation. Before the toileting task is begun, THP will be
reviewed with Joe verbalizing the precautions he must follow. The BSC will be adjusted to the
appropriate height to ensure compliance with THP. The therapist will then discuss proper bed
mobility and bed to BSC transfer with a front wheel walker (FWW) to follow THP, and maintain
balance during ambulation. The therapist will then supervise Joe as he manages clothing with
desired technique, sits on BSC, stands, and transfers back to bed. Emphasis on using the BSC
should be stressed to maintain his safety until training on a standard toilet has been completed.
The outcomes for this intervention are "improvement" and "prevention" (AOTA, 2014). Joe has
limitations to his hip ROM that limit his ability to complete toileting. Utilizing a BSC will
improve his ability to complete toileting with increased performance skills (AOTA, 2014).

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Prevention of hip dislocation is also a desired outcome through education, safety, and
techniques using the BSC while maintaining THP.
Evidence Based. A randomized trial to assess the effects of an early, individualized,
postoperative occupational training program on the ability of hip fracture patients to perform
ADL and IAD was completed by Hagsten, Svensson, and Gardulf (2004, p.177). The authors
found early mobilization leads to a shorter stay in the hospital after surgery, and client-centered
interventions have a clinical effect on the early phase of the rehabilitation process. The study
specifically found skilled instruction by an OT will improve and increase the recovery process
with dressing, toileting, and bathing. Education and motivation are important throughout the
intervention to address fear and psychological factors (Hagsten et al., 2004). Decreased activity
tolerance and decreased balance may pose barriers for Joe to participate in toileting within the
bathroom. To address toileting and early mobilization, a BSC can be utilized to allow Joe to
participate in toileting, yet begin ambulating only short distances until his activity tolerance has
increased.
Short Term Goal Two. Pt. will complete toileting c standard toilet following THP c
supervision within 3 tx sessions.
Intervention. The appropriate approach for this intervention is Establish/Restore
because this intervention is intended to restore Joes ability to complete independent toileting on
a standard toilet (AOTA, 2014). As with all other interventions, Joe will verbalize his THP to
demonstrate understanding. The therapist will begin by discussing Joe's personal bathroom that
he will be using when he returns home and possible barriers that may be present. Questions the
therapist will include are in relation to space to ambulate with the use of his FWW, where the
toilet paper is located and the height of his toilet. His wife may need to help answer these

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questions and should be present for the intervention. After discussing his bathroom environment
at home, Joe will participate in functional mobility to the bathroom with a FWW. Joe will be
educated about how to sit properly and stand up from the toilet without breaking THP. Joe will
then learn about the different techniques for toileting hygiene, and allow Joe to decide which
technique is best for him. Proper toilet hygiene will be described and demonstrated as discussed
by Lawson & Murphy (2013). There are two techniques that can be used to perform wiping. The
first method is to have the client remain seated on the toilet and wipe between the legs. If the
patient prefers to stand, the client should wipe from behind with caution to avoid flexion and
rotation of the hip. To flush the toilet, the patient should turn and face the toilet when flushing to
avoid any excessive hip rotation (Lawson & Murphy, 2013). Clothing management will also be
included in the education, and educational handouts pertaining to toilet transfers and toilet
hygiene will be provided. After education has been completed, the therapist will have Joe,
verbally explain proper steps and techniques for toileting, as well as demonstrate preferred
techniques. The anticipated outcome of this intervention is improvement (AOTA, 2014). This
intervention will increase Joes occupational performance with the occupation of toileting on a
standard toilet.
Evidence Based. Jackson and Schkade (2001) conducted a study to determine the best
approach to intervention with individuals' post-hip fractures. The authors found that although all
patients benefited from occupational therapy, the individual that received intervention using an
Occupational Adaptation model has a more efficient outcome and saw greater patient satisfaction
(Jackson & Schkade, 2001). The Occupational Adaptation model suggests occupation is both a
means to adaptation and an ends for which functional adaptation is performed. If the client is
engaging in meaningful activities, they are more inclined to restore their functional adaptation

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process (Jackson & Schkade, 2001). When Joe returns home, he is determined to complete his
ADLs and IADLs independently to avoid his wife missing more work. This intervention
approach is beneficial to the desired outcome of independent toileting, which will be "efficient,
effective, and satisfying" (Jackson & Schkade, 2001, p. 537). Hagsten et al. (2004) also
explained that individualized patient-chosen tasks increase functional performance more than
tasks from a biomechanical approach. The client-centered approach also considers psychological
support for individuals who have recently sustained a hip fracture and may feel their
independent life has ended (Hagsten et al., 2004). As a very independent man, Joe may
experience fear and anxiety with a feeling of loss in independence. Focusing on the tasks and
occupations of interest will provide the skills needed to return to the occupations as well as
provide assurance that he is capable of doing so.
Precautions and Contraindications
Currently, he has posterolateral hip precautions to prevent dislocation of his right hip.
These precautions include no hip adduction, no hip flexion past 90 degrees, and no internal
rotation (Lawson & Murphy, 2013). Joe is also at risk for falls due to decreased balance and
activity tolerance. These precautions should be considered during all ADL and IADL
interventions to ensure safety. There are no contraindications for toileting and dressing, although
pain should be assessed throughout the intervention to prevent any further discomfort or injury.
Frequency and Duration
Joe will receive OT daily at the acute hospital until discharge. The intervention sessions
will range from 30 to 45 minutes depending on his activity tolerance and medical management
schedule. With a focus on medical management, the therapist will need to schedule intervention
sessions in respect to other professionals schedules, and be prepared for interruptions. An acute
hospital is very fast paced, and the patients are discharged quickly, requiring a flexible schedule.

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OT interventions will address basic ADLs, activity tolerance, safety, and caregiver education to
ensure a safe, successful and smooth transition home and to prevent readmission to the hospital.
Primary Framework
The primary framework used for this intervention plan was the Ecology of Human
Performance model (EHP). Krohn & Pendleton (2013) explains the EHP model considers the
interaction between the person, environment, and activity demands of the occupation when
determining an individual's occupational performance (p.39). The model considers that these
three factors have an influence on each other and are of an equal amount of importance. This
model guided my interventions taking into consideration the assumption of the EHP that, "rather
than exclusively using interventions that change a person, it is often more efficient and effective
to change the environment or find a person-environment match" (Brown, 2014, p. 499).
The EHP has five intervention strategies including; establish/restore, adapt/modify, alter,
prevent, and create (Krohn & Pendleton, 2013, p.39). Using these intervention strategies to guide
the intervention can help provide a client-centered approach to addressing all areas of
occupation.
Client and Caregiver Training
Education will be provided continually to the client and caregiver while services are being
delivered. Lawson & Murphy (2013) explain the caregiver should be present for OT intervention
sessions, to allow them to ask questions and provide appropriate recommendations and
instructions about precautions and techniques. Although Joe's wife works full time and will not
be home the majority of the time, it is important she knows the precautions and
recommendations to reiterate them to Joe when possible. The education will be provided verbally
throughout treatment sessions, and printed literature will be provided to take home upon
discharge. Education will include but is not limited to hip precautions, AE, ADL and IADL
compensatory techniques, and home safety to decrease the risk of another fall. The therapist will

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have Joe and his wife verbally explain the education provided and demonstrate appropriate
occupations with AE and techniques.
Response to Interventions
Response to interventions should be formally and informally assessed. Throughout the
occupational therapy interventions, the therapist should discuss verbally and use observation
skills to evaluate if the intervention is generating effective results with occupational
performance. Communication with other facility employees involved in Joe's care can also be
useful to determine his response to the occupational therapy interventions. To assess Joe's
progress formally, the Functional Independence Measure (FIM) can be utilized to document
improvement with ADLs and IADLs. Edwards, Baptiste, Stratford, and Law (2007) completed a
study to determine if the Canadian Occupational Performance Measure (COPM) was an
appropriate outcome measure for elderly patients after a hip fracture. The authors concluded that
the assessment was useful to measure a patient's perception of their occupational performance,
and satisfaction with their performance (Edwards et al., 2007). Considering the clinical utility of
these two measures, collectively using the FIM and COPM should be utilized during the initial
evaluation and at discharge to determine his response to the interventions provided, and make
appropriate recommendations.

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References
American Occupational Therapy Association [AOTA]. (2014). Occupational therapy practice
framework: Domain and process (3rd ed.). American Journal of Occupational
Therapy, 68(Suppl. 1), S1-S48. http://dx .doi .org/10 .5014/ajot .2014 .
682006
Brown, C. (2014). Ecological models in occupational therapy. In B.A.B. Schell, G. Gillen,
&M.E. Scaffa (Eds). Willard and Spackmans occupational therapy (12th ed.,
pp.494-

504). Philadelphia: Lippincott Williams & Wilkins.

Edwards, M., Baptiste, S., Stratford, P.W. & Law, M. (2007). Recovery after hip fracture: What
can we learn from the Canadian Occupational Performance Measure? American
Journal

of Occupational Therapy, 61, 335-344.

Hagsten, B., Svensson, O., & Gardulf, A. (2004). Early individualized postoperative
occupational therapy training in 100 patients improves ADL after hip fracture.
Acta
Orthopaedica Scandinavica,75(2), 177-183.
Jackson, J., & Schkade, J.K. (2001). Occupational adaptation model versus biomechanicalrehabilitation model in the treatment of patients with hip fractures. American Journal of
occupational Therapy, 55, 531-537.
Krohn, W.S., & Pendleton, H.M. (2013). Application of the occupational therapy practice
framework to physical dysfunction. Pedrettis Occupational Therapy: Practice
skills for
physical dysfunction (7th ed., pp. 28-54). St. Louis. MO:Elsevier Mosby.
Lawson, S., & Murphy, L. (2013). Hip fractures and lower extremity joint replacement.
Pedrettis Occupational Therapy: Practice skills for physical dysfunction. (7th ed., pp.
1071-1089). St. Louis. MO:Elsevier Mosby.

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McKee, P., Rivard, A. (2004). Orthoses as enablers of occupation: Client-centered splinting for
better outcomes. The Canadian Journal of Occupational Therapy, 71, 5,306-314.
Thomas W., Pinkelman L., & Gardine, C. (2010). The reasons for noncompliance with adaptive
equipment in patients returning home after a total hip replacement. Physical &
Occupational Therapy in Geriatrics, 28(2), 170-180. doi:
10.3109/02703181003698593
Ulla-Maija, S., & Marinela, R. (2012). Family-centered occupational therapy; is it really
applied?. Gymnasium: Scientific Journal of Education, Sports & Health, 13(1),
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