Running head: OCCUPATIONAL PROFILE

Occupational Profile and Intervention Plan

Edith Feld
Touro University Nevada

OCCUPATIONAL PROFILE

2
Occupational Profile

Client Information
The client is a 90-year-old female patient at HealthSouth Desert Canyon. She is
originally from Hollywood, but has been in Las Vegas for the last 40 years. Her husband passed
away over ten years ago from pneumonia. She has two daughters whom she tries to see as often
as she can. She emphasized how grateful she was that her daughters live in town because she
loves to see them and her grandchildren frequently. The client also has had a caregiver for the
last 22 years. The caregiver originally came into the clients home to care for her late husband
but once he passed the client insisted that she stay with her for assistance. She visits the house
every day, except Sundays, from 11 in the morning until seven at night.
Reason for Occupational Therapy Services
The client is seeking services due to weakness and balance deficits from a fall she
sustained a week prior. She has a history of falls, which have caused her to become weaker over
time. Unfortunately, she is unable to provide herself a proper base of support before performing
functional mobility. The client is very worried that she will have to become too dependent on
medical equipment such as using a wheelchair. She stated that she is embarrassed to be seen
with a wheelchair because it doesnt make her look like a lady. She uses a four wheeled walker
in her home and in the community. She is mainly concerned with not performing important
things in her home and going out in the community as much because of her risk of falls. When
asked about any barriers inhibiting her from engaging in occupations she said her balance
deficits and shortness of breath have been difficult things to deal with. She was also diagnosed
with scoliosis within the last three years, and she is devastated by her poor posture. She believes
her scoliosis diagnosis is one of the reasons for her poor balance. She is able to participate in

OCCUPATIONAL PROFILE

activities, but will attempt to rush through them so she is not working as long. The client is also
very hard of hearing. When it comes to her hearing the client stated that she has been resistant
towards getting hearing aids, but is tired of having her friends and family raise their voice to
have a normal conversation with her.
Successful Occupations and Barriers
In regards to her occupations the client says she feels most successful in cooking,
grooming, and socializing. Cooking is something her and her husband used to love doing
together and it is a very important occupation to her. She considered herself the main cook of
the house throughout her marriage. Her caregiver told me that cooking has become more
difficult for the client in the recent years because of weakness, so she will cook for the client or
they will try to go out to eat. The client also loves to get dressed up and do her make up. When
it comes to barriers the client stated her decreased balance, general weakness, and hearing are
what inhibit her from participating in the things she loves. The clients countertops and kitchen
table are too high to work on even if she were seated in a chair when preparing meals, and
ambulating continuously only exacerbates her shortness of breath. Though she reported these
barriers she said she is blessed to be in the condition she is because not many can say they still
live on their own and do what she does at her age.
Environment and Contexts
She is currently surrounded by a supportive family and strong social network of friends.
She describes her caregiver as a blessing in her life. One of the clients favorite activities is
going out and seeing friends at their weekly card nights or at a restaurant. Her supportive family
and friends attempt to choose quieter areas to socialize in so the client isnt straining her ears to
engage in conversations, but that isnt always the easiest task to accomplish. She says her home

OCCUPATIONAL PROFILE

is very accommodating because it is only one level. She stated she lives in a popular senior
citizen area, so it is very peaceful and quiet.
Occupational History
The client grew up in California to a wealthy family, but began working as soon as she
could. Her first job was a cashier at a local mart down the street from her home. She graduated
from high school and began taking college courses soon after. Right before she entered college
she had met her husband at the restaurant he owned. Since her husband was a rich business man
she found herself married a few years later and never had to work. She is grateful that she was
able to live a lavish lifestyle and stay home with their children, but she always participated in
working with her husband to keep busy once they got older. When her children were old enough
they all moved to Las Vegas for her husbands work. He built a total of three hotels on the strip,
which the client became responsible for when he fell ill about 30 years later.
Values and Interests
The client made sure to reiterate that she values her independence though she said she is
very fortunate for the constant help she receives. She said she was always an independent, but
the falls have made her become more dependent on help. Her family is something she values
dearly. The client loved to dance and paint portraits when she was younger, but dancing is
something she gave up ten years ago. She loves to go to Color Me Mine with her
granddaughters. Since her husband was in the casino business the client was also always
attracted to card games and machines. Her weekly game nights with her girlfriends is something
she tries not to miss. Her favorite game to play with them is Rummikub because it works her
brain and keeps her smarter than her friends.

OCCUPATIONAL PROFILE

Daily Life Roles

She continued to tell me she has achieved many things in her life so she appreciates her
free time to perform her current roles as a grandmother, mother, and friend. One of her only
wishes as an older adult was making sure her children stayed close so she could see them as
often as she could. Since her ability to walk has decreased over the past years her daughters
have prioritized visiting their mom with their entire families. When her family is not around she
gets together with friends. She joked about not having many roles, but says she enjoys a simple
life.
Patterns of Engagement
Currently the client is modified independent in a majority of her activities of daily living
besides lower body dressing and functional mobility. She is able to perform her grooming
routine and feeding routine without assistance, but it does take her more time to complete these
tasks. She blames her old age on the reason why it takes her so long to do her occupations,
which she said is frustrating. She requires some assistance from her caregiver when standing up
from the toilet and transferring into the tub. The client stated that she only takes baths at home.
The client mentioned that though she prefers not to take showers it has become increasingly
more difficult to get in and out of the tub even with help. As she described the way she gets in
and out of the tub I became concerned because she sits on the floor of it. She also does not own
any durable medical equipment for her bathroom. She does not have to clean her home because
she has a cleaning service come twice a week. Her cleaning lady has also began to assist with
laundry due to the clients inability to reach into her top load washer and bend over to retrieve
the clothes from the dryer. This was the result of one of her falls five years ago. She also does
not make her bed anymore because she is not strong enough to pull the sheets up. The client

OCCUPATIONAL PROFILE

described her patterns of engagement in occupations as declining, especially over the last seven
years. She said she can only handle around 10 minutes of activity at the most before needing a
rest break. The client is appreciative of the help, but doesnt like constant assistance. The client
expressed that she is generally disappointed because she is unable to do some things she used to
be able to do easily.
Clients Priorities and Desired Outcomes
Her main priority is to improve her balance, so she can be more independent. She is
comfortable with utilizing a walker, but doesnt want to have to resort to using a wheelchair once
she is discharged. The client is eager to return back to her normal life. She is very happy at
home and feels fortunate to have a very supportive network of family and friends. She wants to
participate in as many occupations as she can, but understands that she needs to work on her
balance and safety in order to be more functionally independent.
Occupational Analysis
Context and Setting of Services
During her time as a patient at HealthSouth the client received occupational therapy
services every day during her stay. HealthSouth customizes clients schedules in accordance to
the services allowed by insurance companies, and this client was allowed up to three hours of
therapy a day. Occupational therapy services work in conjunction with physical therapy as well
as other services provided within this facility. Therapy can be conducted in the therapy gym, a
clients bedroom, or anywhere an individual can be functional.
Activity Performance
Before heading down to the therapy gym with the client I had the opportunity to go to her
room and observe her utilizing a front wheel walker to go from her bed to the bathroom. I

OCCUPATIONAL PROFILE

wanted to observe her perform functional mobility because of her history of falls. This was a red
flag in my mind that safety education and balance activities were going to have to be addressed
within treatment after reviewing her chart and documentation.
Activity Performance Observations
The client appeared to demonstrate impulsive tendencies when transferring from different
surfaces, especially when moving from sit to stand. I was quite concerned with her disregard
towards stabilizing herself before beginning to walk. The occupational therapist had to
repeatedly provide verbal cues to emphasize the importance of balance while standing. The
therapist also provided minimal assistance when she was standing up to ensure the client did not
lose her balance. She did not stumble or fall, but it was something that caught my eye
immediately as she began to walk. It was apparent that this was a topic of concern. It was also
clear that this issue could possibly impact her ability to successfully engage in activities.
Domains Impacted by Performance
Domains included in the Occupational Therapy Practice Framework such as her activities
of daily living and performance patterns in her regular routines would be the most significantly
impacted (American Occupational Therapy Association [AOTA], 2014). I believe this is
because of her passion to be active and independent. The clients inability to ambulate through
her home or community safely has caused her to fall and sustain injuries. The injuries brought
on weakness and decreased strength, which have required her to need more assistance with her
daily tasks. The client does not take the time to adjust her body positioning when standing,
which is unsafe. She told me she sometimes believes she is still as strong as she used to be when
she was 40. Meaningful occupations for the client such as dressing, cooking, and functional
mobility can become increasingly difficult due to her lack of awareness of stability and fatigue.

OCCUPATIONAL PROFILE

As mentioned earlier she lives at home and is at greatest risk on Sundays when her caregiver has
the day off or when family is unable to visit. Her routine of spending her days at home or out
with friends and family could also be greatly impacted. Fortunately, she has not experienced a
fall that resulted in any serious complications. Weakness has caused her to have a decreased
activity tolerance, which could affect the number of activities she participates in independently.
Problem List
Problem Statements
1) Decreased standing balance results in need for caregiver assistance in ADLs such as
grooming & bathing.
2) Client requires Mod (A) in functional mobility in bathroom due to strength & lack of
DME & A/E.
3) Client unable to perform activity for more than 10 min due to SOB.
4) Client requires Mod (A) in LE dressing due to UE & LE weakness & activity
tolerance.
5) Client unable to communicate with individuals in crowds due to in hearing capabilities.
Justification of Problem Statements
The client is a high functioning individual. She is cognitively aware of her surroundings,
needs, and responsibilities as an older adult, but has areas of concern. The multiple falls have
contributed to her decline in independently completing some of her activities of daily living,
regard to safety precautions, and inability to measure her performance limit. Due to the nature of
the rehabilitation setting and the amount of time the client would be staying at the facility it was
crucial that the problem statements were prioritized in the importance of addressing the clients
need for safety risk education and balance training first. The second problem statement is in

OCCUPATIONAL PROFILE

regards to deficits she experienced in specific activities of daily living. The client is striving to
be more independent, but due to a decrease in her upper and lower extremity strength she is only
able to complete about half of the activity such as dressing and bathing. Within the context of
the rehabilitation hospital it would be possible to focus on increasing endurance and strength
capabilities along with educating on safety awareness. The client experiences shortness of breath
while performing activities, which has contributed to her decreased activity tolerance and is the
reason for the third problem statement. Another problem is her ability to perform lower
extremity dressing. Since the client is older a decline in her muscle mass and functions along
with decrease in the integrity of the skeletal system is quite common. When asked if she utilized
any adaptive equipment she reported no. She receives assistance from her caregiver, but this
occupation will exhaust the client a majority of the time. Lastly, even though her hearing loss
has impacted her ability to engage in social experiences within certain settings it is not an area
that is of extreme importance for her. The client also did not state that her hearing was one of
her main concerns and understood that it was not necessarily an area the facility addressed in
therapy. It does frustrate her, but her want to improve her ability to stand safely and perform
occupations exceeds the hearing problem. She knows that she can go to a quieter place in the
community at any time. She realized that that is not the case when it comes to her safety, and
more falls could result in serious injury if these areas of concern are not addressed.
Intervention Plan and Outcomes
Long Term Goal
Client will perform 5/5 grooming activities standing at sink Mod (I) no rest breaks by
6/8/2015.

OCCUPATIONAL PROFILE

10

Short Term Goal. Client will complete a 4 step activity standing at table Min (A) 2
or fewer rest breaks within 3 tx. sessions.
Intervention. Client will participate in an activity that focuses on lower extremity
weight bearing while standing. This would incorporate her favorite game Rummikub, which she
enjoys because it works her brain. By standing at the table top the client will play this tile based
game with another client or therapist. Her occupational therapist would be standing next to her
for balance assistance. This activity would work on upper extremity range of motion such as
reaching outside of her base of support when collecting tiles. This would promote the act of
leaning from side to side during a weight bearing activity while adjusting her balance. Since the
client is unaware of a safe base of support due to her impulsive tendencies when adjusting her
balance this activity would primarily help her recognize her postural muscles and help her better
control her trunk while standing at the table. This activity would also focus on muscle endurance
and power within her lower extremities while maintaining the standing position. She would have
a wheelchair behind her for when she needs to take a rest break. Vestibular functions are another
key factor when performing this activity because the client will be continuously assessing her
position and balance against gravity while playing the game (AOTA, 2014). The client loves
competitive activities, so this would also be incorporating an activity she finds very enjoyable.
Intervention Approach. Utilizing the intervention approach restore would be the most
appropriate for this treatment activity. Due to the clients impaired ability to maintain a proper
base of support while standing shows her need to restore the strength in her lower extremities
and trunk that she lost over the years.
Research. According to a study titled, Reducing Risk of Falling in Older People
Discharged From Hospital: A Randomized Controlled Trial Comparing Seated Exercises,

OCCUPATIONAL PROFILE

11

Weight-Bearing Exercises, and Social Visits weight bearing exercise has been found to provide
additional improvements in leaning balance and result in a decreased amount of musculoskeletal
adverse events (Vogler, Sherrington, Ogle, & Lord, 2009). The client is considered an older
adult so a decrease in muscle strength and power is common. The study conducted found that
weight bearing exercises can improve an individuals postural sway and reaction time when
performing activities while standing, which would ultimately improve an individuals balance
(Vogler et al., 2009).
Outcomes. An outcome that would be expected to be achieved would be participation.
This client does have the ability to perform functional and community mobility to a certain
extent, so by focusing on her standing balance particularly she can increase her confidence and
strength when ambulating. Though she has faced numerous falls that have resulted in weakness
and diminished strength and endurance the goal is to give the client the opportunity to work on
components of her deficits in order to promote her ability to participate in more occupations and
increase her independence.
Short Term Goal. Client will perform 2 grooming activities standing at sink Min (A)
2 or fewer rest breaks within 4 tx. sessions.
Intervention. In order to incorporate resistance within physical activity the client will
cook a simple pasta dish while wearing ankle weights, which would be an occupation-as-ameans form of intervention. This meaningful activity requires the client to utilize many body
functions and skills to complete it safely and correctly. The client will be working on muscle
endurance and power with the ankle weights on when standing. Consistently shifting her weight
with the additional weight would contribute to her standing balance abilities. Ingredients and
tools will be in close proximity, so she will have to walk with a front wheel walker with the

OCCUPATIONAL PROFILE

12

weights on when retrieving items. The therapist will also have the wheelchair behind her at all
times for needed rest breaks. An important body function that will be monitored would be her
respiratory functions due to her shortness of breath when engaged in activity. Along with body
functions the client will need to incorporate various skills such as choosing appropriate
ingredients for the recipe, sequencing the correct steps in an effective pattern according to the
recipe, and pacing in order to maintain a consistent rate throughout the entire cooking task
(AOTA, 2014). The ankle cuff weights in this activity would be two pounds each. This activity
would work on the clients upper extremity strength, standing balance, and weight shifting with
resistance, which would be important when performing grooming activities at the sink. She
would be required to move her legs when shifting her weight and when moving to different areas
of the kitchen such as the stove. The additional weight would contribute to lower extremity
strengthening by adding resistance, which is an important technique utilized within treatment
when working on an individuals static standing balance.
Intervention Approach. An intervention approach for this activity would be restore.
This particular clients impairments have resulted in loss of skills and abilities needed to support
and balance herself safely while standing. The activity of cooking can influence the ability for
her to restore poor body functions and performance skills that were impaired due to the fall.
Research. According to a study aimed at understanding the role of occupational therapy
in fall prevention for older adults, people of all ages, including those in their nineties, can make
great gains in muscle power and balance (Peterson & Clemson, 2008, p. CE-6). They also
reported the benefit of incorporating strength training in treatment, which requires overloading
muscles. To do this ankle cuff weights or a Theraband can be included within the activity for
added resistance. Researchers also noted that balance training only occurs when clients

OCCUPATIONAL PROFILE

13

challenge their postural control during a task or activity, which would come from her standing
with additional weight while completing the activity or walking around the kitchen (Peterson &
Clemson, 2008).
Outcomes. An outcome hoped to be achieved through this intervention would be role
competence. Cooking has always been a huge part of the clients life for many years. Though
she has her caregiver to assist her she hopes to gain back the one of the main roles she had when
she was married. The caregiver is not at the house every single day and the client hopes to be
able to feel confident enough to stand in the kitchen by herself to prepare meals using the
microwave, stovetop, and oven.
Grade Up. Client will wear five pound ankle weights on each ankle to increase the
resistance on her lower extremities while shifting her weight when standing and walking.
Grade Down. The therapist will provide the setup of ingredients and tools needed to
reduce the amount of walking the client would be doing around the kitchen with a front wheeled
walker.
Long Term Goal
Client will complete transfer w/c shower Min (A) using DME & AE by 6/8/15.
Short Term Goal. Client will display proper use of A/E & DME Mod (A) in a dry
environment within 4 tx. sessions.
Intervention. An intervention idea that would be beneficial for this client would be the
introduction and education of adaptive equipment and durable medical equipment. This client is
unaware of the danger her current method of transferring into and out of the tub is to her
musculoskeletal functions such as muscle mass and strength capabilities. Her current method
has become increasingly more difficult due to her diminished upper and lower extremity

OCCUPATIONAL PROFILE

14

functions, and can be considered unsafe. Her behavior is in need of change in order to sustain
her current level of functioning for as long as possible. By implementing the use of a tub
transfer bench the client would increase her ability to get into the tub shower in her home safely
and decrease her risk of injury. She would not sit on the tub floor using this equipment. The
adaptive equipment such as a leg lifter and long handled sponge would assist her lower
extremities in and out of the tub she has at home, and help her complete the activity of bathing
her lower extremities while seated. She wasnt able to bathe while sitting down in the tub, but
the long handle sponge would enhance her ability to perform this function without having her
bend over while seated on the beach. A dressing stick and reacher could also be incorporated
within this intervention because these tools could be used to assist the client with setting up her
bathing environment by collecting all materials needed. Education on the equipment could also
translate over to other occupations the client needs assistance in such as lower body dressing.
Utilizing adaptive equipment and durable medical equipment not only increases the clients
physical safety, but brings awareness to the client about their level of impairments and better
ways to approach performing occupations, which would be extremely beneficial for this
particular client. Educating the client in the importance of this equipment in her every day
routine will significantly impact her performance as well as increase her safety awareness.
Intervention Approach. An appropriate intervention approach for this intervention
would be maintain. In this case the client is almost ninety years old, so she is not going to be
increasing her muscles mass too much. Fortunately, she is able to perform many of her
occupations, so it would be extremely appropriate for her to maintain her current level of
functioning with the use of equipment, such as a reacher, dressing stick, and long handled
sponge. Performance could potentially decrease in occupations if current abilities arent

OCCUPATIONAL PROFILE

15

maintained, which may contribute to a poor quality of life (AOTA, 2014). Without using
equipment the client is potentially putting herself at risk for serious injury.
Research. According to an article addressing the topic of preventing falls using a home
intervention team, interventions should be targeted towards not only environmental risk factors
and physical activity but also associated behavior that requires change (Nikolaus & Bach, 2003).
This must be identified and modified through the use of adaptive equipment aids and home
modifications. Researchers found that teaching the use of technical mobility aids and equipment
when necessary is effective for those with a high risk of repeated falls (Nikolaus & Bach, 2003).
Though this clients treatment will not be taking place within their home the importance of
educating them on the use of adaptive equipment and durable medical equipment is crucial as
part of intervention for overall safety, and will contribute to an increase in her independence.
Outcomes. This form of intervention would influence prevention of unsafe risk factors
or injuries within the clients occupations. By implementing the use of adaptive equipment and
durable medical equipment the client may significantly decrease the possibility of facing serious
injuries if used correctly. With the use of equipment the client would increase her independence
and function within her occupations such as dressing and bathing.
Short Term Goal. Client will complete transfer w/c shower Mod (A) using TTB by
6/3/2015.
Intervention. The client will paint a design of her choice on a medium sized canvas
while seated in the therapy gym. This will involve wearing two pound wrist weights on each
arm to increase resistance and improve upper extremity strength while moving the brush over the
canvas in various formations. The client will have to also continuously apply paint to the brush
from the color tray. Each of these movements will require the client to reach outside of her base

OCCUPATIONAL PROFILE

16

and that will also force her to activate her trunk muscles used for support. This activity will
allow the client to engage in an activity that she has always enjoyed while working on her upper
extremity strength and flexibility. Her postural control will be challenged since she is
performing an activity while seated in a chair. Her increase in strength and flexibility may
translate over to her ability to transfer herself along the tub transfer bench and utilize adaptive
equipment more efficiently.
Intervention Approach. The approach for this intervention would be maintain. As
stated previously the clients upper body strength is not as impaired. Maintaining the strength in
her upper extremities will allow her to participate in activities of daily living that she has had
increasing trouble with. Her upper body and core strength will be targeted while seated during
the activity, which will improve her ability to transfer onto and off as well as sit safely on a tub
transfer bench in the tub shower setting.
Research. A study titled Positive Effects of Physical training in Activity of Daily
Living Dependent Older Adults found that an upper body physical fitness exercise program
showed improvements in arm strength and shoulder flexibility. Researchers also discovered that
the upper body training translated to improvements during an individuals occupational
performance of activities of daily living (Venturelli, Lanza, Muti, & Schena, 2008). As an
individual ages their independence level may reduce when performing activities of daily living,
leading to an increasing need to receive caregiver assistance. This is the case especially when
clients are older. According to researchers, physical training for the upper part of the body,
such as using light dumbbells, has been shown to positively impact ones strength and flexibility
in healthy older people (Venturelli et al., 2008, p. 192).

OCCUPATIONAL PROFILE

17

Outcomes. The outcome of this intervention would be participation. Painting is a

desired occupation that the client has engaged in for many years. By participating in this
intervention the client will be working on her upper extremity strength, which will translate over
into her ability to participate in her occupations safely and effectively.
Precautions and Contraindications
When participating in therapy there are a few precautions to consider for this client.
Though it was not directly addressed in the intervention plan the client experiences shortness of
breath during increased activity. It was noted that it is not severe or a reason to not participate in
therapy, but is something that should be monitored throughout treatment. Another precaution to
be aware of is safety. The clients goal is to be as independent as possible, but she is at risk for
falls. This is a main focus in intervention, so it should not be taken lightly. For example, she
may be improving her physical strength and endurance while participating in treatment, but
should still be closely attended too when engaging in any type of activity.
Frequency and Duration of Intervention
The client will participate in acute rehabilitation therapy for 60 minutes once a day at
HealthSouth Desert Canyon six times a week for seven days. At that point in time the client had
already been there for two days, but was unaware of a possible discharge date. She was
informed that she would be staying for at least another seven days. She stated that if made
possible by her insurance company she would hope to receive outpatient services for continued
treatment.
Theoretical Framework
A theoretical framework that would be appropriate for this intervention plan is the
Person-Environment-Occupation-Performance Model (PEOP). This model analyzes an

OCCUPATIONAL PROFILE

18

individuals occupational performance within their natural environment. It breaks down specific
components of a persons occupational performance, which is influenced by intrinsic and
extrinsic factors. This model has substantial detail about both internal and external factors to
support occupational therapists to analyze the interests, skills and capacities of the person, the
demands of the environment and how they interact to facilitate or inhibit occupational
performance and participation (Turpin & Iwama, 2011, p. 94). For this client she was internally
motivated to complete as many of her occupations as independently as possible. Unfortunately,
many extrinsic factors such as lack of durable medical equipment to perform safe transfers and
decrease in physical strength have inhibited her from engaging in certain activities of daily living
safely and effectively. This model identifies the individual factors effecting optimal
occupational performance and assisted in guiding the type of intervention activities used in
treatment. Overall, this model helped prioritize the most crucial aspects that need to be
addressed in treatment, which assisted in formulating the goals that were designed to help the
client get back to being safe and functional within her home and community.
Training and Education
Education and training for the client and her caregiver is extremely vital in the
intervention plan. Fortunately, the clients caregiver comes and visits her every day and check
on her condition. Though the clients caregiver was a registered nurse for many years, she is
around 65 years old and expressed her recent increase in fatigue when assisting the client. The
caregiver should receive training and education about safety benefits and the importance of
monitoring the condition of durable medical equipment and adaptive equipment. The caregiver
had said she was unfamiliar with current products out for use, so this would be an important
thing to incorporate when training. This would be addressed throughout the clients stay to make

OCCUPATIONAL PROFILE

19

sure the client and caregiver understood proper use. The caregiver would still be of assistance,
but she would be working along with the client versus doing things for her.
Response to Interventions
During the implementation of intervention it would be crucial for the therapist to monitor
the clients improvements or decline in function during each treatment session. As the client
progresses through the intervention plan the therapist will monitor her recall of knowledge and
abilities by assessing development and performance daily. When it comes to the clients balance
abilities the therapist will have to note if there is an increase in time maintaining balance or
decrease in the amount of rest breaks the client utilizes during the activity. Improvement in
physical strength and flexibility can be assessed by the amount of weight used on the wrists and
ankles during activities. Education on the use of equipment during transfers and occupations
should be assessed by the clients ability to recall proper safety precautions and demonstration of
appropriate technique. Though interventions may be supported by research not all ideas are
necessarily suitable or beneficial for every single client, so it is important to monitor and
continuously reassess this clients progression in her goals every treatment session.

OCCUPATIONAL PROFILE

20
References

American Occupational Therapy Association (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
Nikolaus, T., & Bach, M. (2003). Preventing falls in communitydwelling frail older people
using a home intervention team (HIT): results from the randomized FallsHIT
trial. Journal of the American Geriatrics Society, 51(3), 300-305.
Peterson, L., & Clemson, L. (2008). Understanding the role of occupational therapy in fall
prevention for community dwelling older adults. OT Practice, 13(3).
Turpin, M., & Iwama, M. K. (2011). Using occupational therapy models in practice. Edinburgh:
Elsevier.
Venturelli, M., Laza, M., Muti, E., & Schena, F. (2010). Positive effects of physical training in
activity of living-dependent older adults. Experimental Aging Research, 36(2), 190-205.
doi: 10.1080/03610731003613771
Vogler, C. M., Sherrington, C., Ogle, S. J., & Lord, S. R. (2009). Reducing risk of falling in
older people discharged from hospital: a randomized controlled trial comparing seated
exercises, weight-bearing exercises, and social visits. Archives of physical medicine and
rehabilitation, 90(8), 1317-1324.