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Running head: OCCUPATIONAL PROFILE

Occupational Profile and Intervention Plan


Edith Feld
Touro University Nevada

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Occupational Profile

Client Information
The client is an 82-year-old female at the Las Vegas Adult Day Care Center. She is
originally from New Mexico, but has been in Las Vegas for the last two years. Her husband
passed away five years ago. They were living in Arizona at the time, which is where they had
been residing for over 30 years. She has five children that she loves dearly. She has two
daughters, who are identical twins, and three sons. She currently lives with her eldest daughter
and her husband who are also her caregivers. The client stated how grateful she is for her
supportive family whom have been by her side each and every day.
Reason for Occupational Therapy Services
The client is seeking services due to her diagnosis of mild dementia, which was
determined two years ago. Her lapses of memory have interfered with her ability to perform
some of her regular occupations. Her medical history also includes hypertension, high
cholesterol, depression, osteoarthritis, and a herniated lumbar disc. Shortly after her husband
passed she was driving to the grocery store when she realized she was lost. She stated that she
had driven around for 30 minutes because she did not realize where she was, which was an
experience that scared her tremendously. Not long after she moved to Las Vegas to be with her
daughter. The client also has a history of falls. In 2011 and 2012 she fell out of her bed and was
hospitalized. She did not sustain any serious injuries from the falls, but they have contributed to
overall weakness within her trunk and have caused her to have a heavy lean towards her left side.
This lean requires her to have continued support from a chair or table top when she is sitting
down. According to her record she denies any falls, which is another concern on the families
part.

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Successful Occupations and Barriers


In regards to her occupations the client reported that she feels the most successful when
participating in activities with minimal assistance from her family or friends. Unfortunately, she
did not provide any more detail than that. She stated that she has a little trouble attending to
tasks when she tries them independently. Her cognitive impairment and lack of trunk stability
are the barriers that impede her from participating as much as she wants too in leisure activities,
as well as some self-care tasks. Even though she faces these barriers she said she is grateful for
the assistance she receives from those around her.
Environment and Contexts
She is currently surrounded by a supportive family and a small network of friends. She
described her daughter and son in law as angels on earth since they assist her every day. Her
daughter owns a two story home, but the client occupies the one bedroom on the main floor. She
stated that she has only seen the second level of the home maybe twice because she does not feel
comfortable going up the stairs. She does not go out into the community often unless they are
going out to dinner or the center, which is due to her history of falls. She attends the center three
to four times a week, which takes up a majority of her time.
Occupational History
The client grew up in Roswell, New Mexico where she graduated from high school.
After she graduated she became an assistant at a local financial office where she worked for
many years before moving to Arizona with her husband. Once they settled in their new home
she found a secretary position at a law firm. She performed this occupation until she stopped
working in the late nineties. Up until her husbands death they were both weekly volunteers at
their communitys local church.

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Values and Interests


The one thing the client values the most is family. She was unable to tell me where her
five children currently reside, besides the daughter she lives with, but she said they all visit her
when they can. She has eight grandchildren with whom she values spending her time with as
well. Another thing she values is her commitment to church, which she tries to attend every
Sunday. She stated how she couldnt think of many interests, but crafts and puzzles are activities
she has enjoyed since being at the center. The arts and crafts table at the center is her favorite. It
has an assortment of materials and projects to make, but she tends to stick to using paint on paper
because it is the easiest one to complete. She also loves puzzles, which she used to enjoy doing
with her husband. The client also loves to read the newspaper and magazines for entertainment.
Daily Life Roles
The client told me she does not have many roles besides jokingly saying she was a
burden to her daughter and son in law. Though she stopped working the client continues to
appreciate her current roles as a grandmother, daughter, mother in law, and friend. She
appreciates the support around her and values the relationship she has with those close to her.
She also mentioned that coming to the center was something she prioritized after moving to Las
Vegas because she has always had a social circle to interact with. Since she moved here only
two years ago it was imperative she made friends because she knew she would possibly drive
her daughter crazy if she was at the house all day.
Patterns of Engagement
Currently the client is modified independent in a majority of her activities of daily living
besides lower body dressing, grooming, bathing, and walking. It was noted in her file that she
was living independently for two years after her husband died, and it was not until late 2012 that

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she began to experience a functional decline. She is capable of completing upper body dressing
independently, but requires assistance to put on pants due to her poor postural stability.
According to her file she requires assistance for grooming because she has difficulty maintaining
a stable upright position to complete the tasks of brushing her hair and washing her face. She
requires a surface to lean on while seated, which affects her ability to utilize both of her upper
extremities to complete the tasks. Due to this challenge her daughter will do these tasks for her.
Her son in law recently purchased a tub transfer bench for bathing, which was noted in her file.
The client still requires assistance from her daughter, so she does not lean too far and fall. The
client also utilizes a four wheel walker when walking. The lean on her left side has not impacted
her ability to walk, but it is apparent that her impaired posture affects her ability to use the
walker safely, so she requires supervision. Her family is worried that her inability to stand
upright while using the walker will contribute to more serious falls, since she has fallen multiple
times within the last couple of years.
Clients Priorities and Desired Outcomes
Her main priority is to be able to participate in more activities within the center and in
some of her self-care activities. She believes that she can only engage in a few small games and
a physical activity class once in a while because she does not feel physically or cognitively
competent enough. She stated it sometimes becomes difficult to sit around during an art project
or puzzle because those activities are sometimes too mentally exhausting. Though faced with
these challenges, the client is thankful for being where she is today. She wants to participate in
more occupations, but appears tentative towards making changes because of the help she already
receives.

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Occupational Analysis

Context and Setting of Services


Though the client attends the center multiple times a week, she does not receive any
additional health care services during her time at the facility. There is a nurse that is on the floor
at all times to assist with medication administration, which is someone the client sees each time
she attends. She will approach the client with the medications she needs to take for the day.
There is also a medical doctor and occupational therapist that visit the clinic for a couple of
hours on Tuesdays, but there was no documentation for the client of any visits with either of
these medical professionals. The client engages in activities in the three rooms of the facility,
which is where occupational therapy services could be provided if needed.
Activity Performance
I had the opportunity to sit down with the client during an art activity. The client is one
of the few who has to sit in a chair with arm rests because of the lean to her left side. This was
my first time sitting down with her so I was unsure of how debilitating the impairment was. As
soon as she sat down I noticed her unstable posture. She leaned heavily on her left arm rest and
exhibited a slight posterior tilt. She appeared very uncomfortable, but it did not seem to bother
her in the least. Before we had sat down I noticed her approach the station and stare at the large
assortment of paints and brushes before taking a seat. She said that she gets overwhelmed with
all of the materials and just sticks with whatever is already on the table. I could tell this was
something that bothered her, but she didnt appear to want to ask for help or do anything about
the situation. When I asked if I could assist her with collecting any materials she politely told
me not to bother. She settled with using the only two colors on the table and began painting on a
pre-set piece of paper. A woman next to her was creating a flower vase out of recycled plastic

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and paper towels, which the client had told me was an activity that looked fun but she believed
was way too complicated for her to complete. She seemed upset at the fact that she didnt feel
competent enough to complete more exciting activities like she used too. I could see this was a
sign that her inability to fully participate in some of her favorite leisure activities due to her
cognitive impairment was negatively impacting her ability to continue.
Activity Performance Observations
The client appeared frustrated with the result of her art activity, but said it was nothing
new since she said she always gets confused with anything she tries to do. She said she usually
ends up watching some of the adults craft, but she tries participate as much as she can. She
stated this happens with puzzles too, which is frustrating because it is another one of her favorite
activities. This was concerning because I was made aware of how much she used to enjoy these
activities. Another concern was her unstable static sitting balance. This is something that could
significantly affect her ability to engage in her favorite leisure activities, as well as the self-care
activities she needs assistance with. It was evident that these issues could negatively impact her
ability to successfully engage in other activities within the center, as well as those at home.
Domains Impacted by Performance
Domains included in the Occupational Therapy Practice Framework such as her
instrumental and basic activities of daily living and performance skills would be the most
significantly impacted (American Occupational Therapy Association [AOTA], 2014). The
clients file indicated she needs assistance from a caregiver with managing finances, taking
medications, and utilizing transport services. She stated that she values her ability to participate
in her favorite leisure activities such as crafting, reading, and puzzles, but again those have
become increasingly difficult. Her file indicated that she was also unable to manage her bank

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account, so her daughter took over this responsibility. When I asked the client about this she
stated that her daughter does everything because she cannot handle a lot of responsible tasks.
Injuries she experienced from the multiple falls have also contributed to her decreased
functioning in some performance skills within her valued occupations, which have affected her
ability to stabilize her balance and align herself appropriately while seated (AOTA, 2014).
Though the client has a lot of support, it could be impacting her ability to function as
independently as possible and contributing to a faster decline in her engagement in her valued
occupations. Her daughter appears to have taken control of most of the clients occupations.
Problem List
Problem Statements
1) Client requires max V/C for completion during leisure activities 2 inability to sustain
attention for more than 5 minutes.
2) Poor static sitting balance results in need for chair arm rest supports 2 decreased trunk
stability.
3) Client is unable to demonstrate safe utilization of 4WW 2 history of falls.
4) Client is unable to manage personal finances due to inability to count money limits 2
impaired cognitive functioning.
5) Clients impaired problem-solving skills limits her ability to utilize public transportation
to attend adult day care center independently.
Justification of Problem Statements
The client faces daily challenges within her basic and independent activities of daily
living due to her diagnosis of mild dementia. This impairment has caused her difficulties in the
few occupations she still has the capability of performing. Due to the context of the facility it

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would be most feasible and appropriate to first address the impact the cognitive impairment is
having on her performance within common leisure activities. Engaging in valued activities, such
as puzzles and crafts, would allow her to implement techniques and strategies through
meaningful occupations with assistance from the occupational therapist and facility staff.
Another main concern in need of being addressed is the clients unstable sitting posture. It is
clear that this impairment is affecting her ability to perform activities safely, which can be
hazardous to her health and well-being. The third problem statement focuses on her inability to
stand up straight while using a four-wheel walker. The client is capable of walking
independently with the use of the walker, but her unstable posture has contributed to her
numerous falls. Weakness she experienced from the falls have caused her to rely heavily on
support around her, which accounts for the lean towards her left side. Another problem the client
faces is her inability to manage her personal finances. She did not state this as a need of focus
because she trusts her daughter to handle it, but did joke about feeling like she is now her
daughters child because she isnt allowed to purchase anything without permission. This is a
problem, but not something imperative to her immediate need of care. Lastly, the client is
unable to navigate independently around the community without supervision. Fortunately, she
still receives transportation from her family members, but at some points wishes she had the
freedom to come and go from the center as she pleases. She reported that the bus routes are
confusing and overwhelming, and she does not trust herself to get around town without incident.
Though she faces these challenges, she stated how blessed she was to be where she is today,
though she has hope to be a little more functional within the important aspects of her daily life.

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Intervention Plan and Outcomes

Long Term Goal


Client will complete 1 art activity of her choice 0 V/C 3/3 visits per week within 8
weeks.
Short Term Goal. Client will collect 4/4 materials for art activity 2 or fewer V/C
within 6 weeks.
Intervention. Since the client spends at least three days of the week at the center an
appropriate intervention would be to modify the environment in order for her be safe and as
functionally independent as possible. Ways to modify the environment would be to have clear
signs at the different stations of activities. The font on the sign would be large and bold so the
client can clearly see the station or room she is entering, such as the arts and crafts station. Large
labels can also be placed on the supplies, since this area is extremely busy because the tools and
materials are placed all over. If the items needed to construct a craft are placed neatly and near
each other in a designated location, it would simplify the process of collection of materials and
increase the clients motivation to complete the activity. This suggestion would eliminate the
confusion the client may experience when navigating around this station and other areas of the
facility. Another room that could be modified is the restroom since there are numerous stalls.
To keep things consistent the therapist can designate the first stall with a sign and instruct the
client to use that specific stall each time. This is also an intervention that could be implemented
within the home with proper client and caregiver education.
Intervention Approach. An appropriate intervention approach would be modify. This
approach is directed at modifying a clients current environment or activity demands in order to
decrease distracting sensory and physical stimuli to support performance within a natural setting.

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Fortunately, the clients impairment is not impacting her ability to get around the facility, but
limiting her confusion would allow her to be more functionally independent and increase her
ability to perform the activities she wants too.
Research. According to a textbook that focuses on occupational therapy within the
scope of mental health, A key approach to intervention with persons with dementia is to adapt
the environment (Schaber, 2011, p. 234). Due to the nature of this setting it would be
imperative that the client feel comfortable at the facility since she spends a majority of her time
there. Since the sessions would be conducted at the facility it would be appropriate to modify the
environment accordingly to maximize the clients needs and her functional capabilities.
Establishing consistent performance contexts and reinforcing well-developed habits and
routines can facilitate participation and ease the task of caregiving (Schaber, 2011, p. 235).
Outcomes. This form of intervention would influence continued participation in the
meaningful occupations within the clients life. By modifying the environment the client can
engage and navigate throughout her natural environment safely and effectively with less
confusion. If the client is limited by a cluttered and disorganized environment, it may negatively
impact her ability to move around comfortably, which would then effect their ability to
participate in the occupations she engages in, such as the activities she enjoys within the center.
Short Term Goal. Client will complete 1 arts and crafts activity 2 or fewer V/C within
6 weeks.
Intervention. The client will participate in the day care centers weekly class titled
Connections. This class is designated for individuals who have been diagnosed with
Alzheimers or dementia. Based on the clients diagnosis she would be eligible to participate in
this weekly course. This would allow her to engage in multi-sensory activities 60 minutes that

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are associated with a specific theme. For example, the theme of the class is communication.
Upon entering the session she would be introduced to theme-related dcor throughout the entire
classroom, such as an old-school telephone, pens and pads of paper, bottles for messages, and
other items that would allow the client to possibly recall a certain situation or memory associated
with the theme. Music that correlates to theme of communication is played, photos are looped
on a slideshow, and numerous activities are conducted. The client would partake in activities
about communication, such as writing out her own personal message in a bottle, match pictures
of face card emotions and relate them to a specific situation that made them experience that
emotion, and play a game of telephone, which would require her to translate a phrase to another
participant until everyone heard it. The client would have the occupational therapist and other
faculty in the room with her if assistance is required such as verbal cues for completion, but she
would be participating as independently as possible. All of the activities and other stimulating
amenities are meant to give the client the chance to reminisce on past memories, initiate
discussion with other participants, and provide her the opportunity to engage in fun activities,
which would all benefit her in more ways than one. The client would participate in the weekly
class to enhance her remaining cognitive abilities with the possibility of increasing her
motivation and ability to sustain her attention to participate more and complete the meaningful
occupations she has become withdrawn from.
Intervention Approach. The appropriate intervention approach for this treatment
activity would be promote. The class would provide the client with contextual and activity
experiences that would increase her functional performance through continuous engagement.
The multi-sensory environment would give her the opportunity to interact with other adults in a
variety of stimulating activities to promote sustained use of her cognitive abilities.

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Research. According to a study that focused on activity reminiscence therapy as brain


activating rehabilitation for elders with and without dementia, brain activity rehabilitation is
expected to activate the remaining cognitive ability and positively affect motivation to live
through enjoyable activities and playing a social role (Yamagami, Oosawa, Ito, & Yamaguchi,
2007, p. 69). A typical technique used in brain activating rehabilitation is known as activity
reminiscence therapy (ART), which has been found to be beneficial to individuals with cognitive
impairments. According to the researchers, ART can assist memory recall in demented persons
because old-style tools, such as a rice kettle, beanbags for juggling and old textbook, may
activate strong memories (Yamagami et al., 2007, p. 70). This technique is utilized within the
class each week to influence the use of the clients remaining cognitive skills to improve
attention and overall motivation for completion of activities.
Outcomes. An outcome intended to be achieved through this intervention would be
participation. The clients cognitive impairment has inhibited her from participating in desired
occupations such as engaging in leisure activities for fun. This class would give her the
opportunity to not only work on her ability to perform the activities within the class, but those
she chooses to engage in and complete for her own leisure enjoyment.
Long Term Goal
Client will sit in chair no arm rests for support (I) for 3 minutes within 8 weeks.
Short Term Goal. Client will read a magazine of her choice seated in chair no arm
rests Min (A) for 3 minutes within 6 weeks.
Intervention. An intervention idea that would be beneficial for this client would be
participating in the centers Seated Yoga class. This program allows participants to sit in a
chair and perform numerous movements with their arms and legs. This would allow the client to

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participate in a physical activity class at her own pace while working on specific
neuromusculoskeletal and movement-related functions. This would include things such as
muscle tone, power, and endurance, as well as her gait pattern needed to sustain a proper seated
position in order to complete everyday tasks and activities (AOTA, 2014). The class would start
off with simple breathing techniques to have the clients relax and focused. It would gradually
become more difficult as the client would be encouraged to begin arm and leg movements. The
client would have to attempt to concentrate on her posture and seated balance in order to safely
perform the movements. Due to her cognitive impairment this may be difficult, so the therapist
would be near to provide verbal and physical cues to promote continued engagement and
completion of all movements. In order for the client to complete important occupations such as
self-care tasks of grooming she needs a stable seated posture that allows her to utilize her upper
limbs to function to their maximum potential. Each individual activity would initiate static and
dynamic movements, as well as weight-shifting from the patient, which would allow her to
develop the proper trunk control and stability needed to sit and stand safely.
Intervention Approach. An appropriate intervention approach for this treatment
activity would be restore. The client has lost her trunk stability over time since she experienced
the falls, so it would be important to restore as much strength and balance as possible. Her
impairments have resulted in the loss of skills and abilities needed to support and balance herself
safely while seated, as well as when she is ambulating around her home and community
environment.
Research. According to an article focusing on interventions to help those with
Alzheimers and related dementias, the researchers reported that exercise-based interventions
that included two or more motor performance skills, such as balance, endurance, and

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strengthening, were the most effective in decreasing the number of people who fell and overall
number of falls sustained (Gillespie, Robertson, Gillespie, Lamb, Gates, Cumming, et al., 2009).
There are numerous exercise classes that the facility puts on throughout the week, which gives
the client and therapist the option to select the most appropriate one based on the clients current
capabilities. Researchers from the study also stressed the importance of group exercise
participation in classes, such as tai-chi and home-based exercise programs, along with the use of
multifactorial interventions that were also effective in reducing falls in those with Alzheimers
and related dementias (Gillespie et al., 2009). Engagement in an exercise class would increase
the clients capabilities, physically and cognitively, due to the variety of areas the program
facilitator targets while conducting the class, which would allow the client to participate to her
maximum potential.
Outcomes. The outcome of this intervention would be participation. The clients
decreased ability to hold herself up properly has contributed to her disengagement in many
occupations, such as self-care tasks and leisure activities. By implementing this treatment
intervention the client would be working on developing the trunk strength and stability needed to
sit and stand properly, which could translate over into her ability to participate in more
occupations safely and effectively.
Grade Up. Client will complete the class in a chair without arm supports to increase the
demands of the physical tasks she is performing, which would require her to utilize additional
core power and endurance to maintain herself upright safely.
Grade Down. Client will only perform upper body movements in order to decrease the
cognitive and physical demands of the task.

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Short Term Goal. Client will complete a 10 piece puzzle seated in a chair no arm rests
for 3 minutes 1 or fewer physical cues within 6 weeks.
Intervention. The client enjoys completing puzzles with larger pieces that do not
require an extended period of time to complete. This treatment activity would be an occupationas-a-means form of intervention incorporating focus on both physical and cognitive factors. It is
important that physical treatment interventions begin with focus more proximally, which in the
clients case would be her trunk strength and endurance. The motivation for completion would
in hopes come from engaging in a valued activity while working on weight shifting and dynamic
reaching, which will help her maintain a functional posture. The use of the chair with no arm
supports would require her to divide her focus between the game and her body position. Though
this could be challenging for the client due to her mild dementia, the incorporation of rest breaks,
along with verbal and physical cues from the therapist, would allow her to work at gradual pace
that is comfortable and beneficial to her.
Intervention Approach. The intervention approach restore would be the most
appropriate for this treatment activity. Due to the clients impaired ability to maintain a proper
posture while seated shows her need to restore the strength in her trunk and core that she lost
over the years.
Research. According to an article focusing on falls within the elderly population,
dementia is known to be an independent risk factor for falls because of its association with
impairments in an individuals gait, judgement, visual-spatial perception, and their ability to
recognize and avoid hazards (van Doorn et al., 2003). The client has a history of falls, which has
contributed to her impaired gait and inability to sit properly and utilize a four-wheel walker
safely and effectively. If not addressed within treatment researchers suspect that individuals,

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such as the client, with dementia, can expect more falls, more morbidity and mortality related to
falls, and higher costs of care in the future (van Doorn et al., 2003).
Outcomes. An outcome hoped to be achieved through this intervention would be
improvement in the clients quality of life. An individuals quality of life includes the interaction
of numerous factors, such as ones satisfaction with life, hope, self-concept, health and
functioning, and socioeconomic factors (AOTA, 2014). The clients decreased trunk stability,
along with effects of her mild cognitive impairment, have negatively impacted her ability to
functionally engage in occupations important to her thus affecting her quality of life. By using
this intervention technique the client would have the opportunity to work on her muscle power
and endurance needed to sustain a proper postural alignment for safe participation and
engagement in basic and instrumental activities of daily living.
Precautions and Contraindications
When participating in therapy there are a few precautions to consider for this client. The
clients main diagnosis is mild dementia. Some precautions that should be taken are her safety,
experience of fatigue, and the possibility of agitated behaviors. Though her condition is not
severe it would not be appropriate to push the client too much in therapy because it could
contribute to a decline in her functioning and overall well-being. Her physical impairment is
also significant and is something that should be monitored closely. The client should always be
supervised when in a chair without arm rests or while walking around the facility since she is
considered a fall risk.
Frequency and Duration of Intervention
The client will receive occupational therapy services for 30 minutes a day three times a
week at the Las Vegas Adult Day Care Center. Due to the nature of the setting the client will

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receive skilled services for up to eight weeks pending approval from her private medical
insurance. Since the center is considered a non-traditional setting it is possible that the client
could be eligible for services longer than eight weeks, as well as outpatient services within the
community.
Theoretical Framework
A theoretical framework that would be appropriate for this intervention plan is the
Person-Environment-Occupation Model (PEO). This model analyzes the transaction between
the person, environment, and the occupation being performed, meaning they should all be taken
into account during treatment (Turpin & Iwana, 2011). The therapist can use this model bearing
in mind the client with declining cognition, the supports within her environment, and the
occupation she is performing. This model allows one to understand an individuals occupational
performance when considering these individual factors all together. It would be imperative that
the client performs occupations of her choice within a supportive environment, and if the
occupations become challenging it would also be necessary to adapt these tasks accordingly in
order for her to maximize her functional performance. Overall, these three factors should all be
considered when determining the best performance outcome for the client. The aim of
occupational therapy is to facilitate occupational performance by intervening in any one or more
of these areas to enhance the congruence between person, environment, and occupation (Turpin
& Iwana, 2011, p. 106).
Training and Education
Proper education and training for the client and her caregivers is an extremely important
part of the intervention plan. Fortunately, the clients caregivers are heavily involved and
supportive. Though the clients caregivers are actively involved in the clients daily life it would

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be vital that they were made aware of disease progression and proper assistance methods in order
to enhance their understanding and performance as caregivers. According to Schaber (2011),
caregivers serve an important role in the intervention process for those with dementia because
they can assist in things such as identifying supports and barriers for occupational performance
and participation and adapt the clients home environment, which all can contribute to the
success or failure of treatment for the client. The caregivers should also receive information
about safety precautions needed to maximize function and the importance of monitoring the
clients condition, especially as her cognitive impairment begins to decline over time.
Response to Interventions
During the course of intervention it would be important for the therapist and staff
members to monitor the clients functional status each time she attends the center. This nontraditional setting has numerous attendees and a limited staff, so along with being monitored
through treatment it would also be crucial for the staff to note the clients status during the time
she is not seen by the occupational therapist. Unfortunately, her cognitive status will not
improve, so the therapist could use a tool such as the Mini Mental Status Exam to assess her
cognitive level as needed (Folstein, Folstein, & McHugh, 1975). In regards to her physical
impairment her ability to sit up without support would show improvement throughout the course
of treatment, but should be monitored in case she experiences a quick decline or loss of balance.
The interventions selected for this client may be supported by research, but not all ideas are
necessarily suitable or beneficial for her. It is important to continuously reassess her progression
in her goals each treatment session and adjust accordingly as needed.

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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
Folstein M, F., Folstein S, E., & McHugh P, R. (1975) Mini-mental state: A practical method for
grading the cognitive state of patients for the clinician. Journal of Psychiatric Research.
12, 189-198.
Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Lamb, S. E., Gates, S., Cumming, R. G., &
Rowe, B. H. (2009). Interventions for preventing falls in older people living in the
community. Cochrane Database of Systematic Reviews, 2009(2), CD007146. doi:
10.1002/14651858.CD007146.pub2
Schaber, P. (2011). Dementia. In C. Brown & V. C. Stoffel (Eds.), Occupational therapy in
mental health: A vision for participation. Philadelphia, PA: F.A. Davis Company.
Turpin, M., & Iwama, M. K. (2011). Using occupational therapy models in practice. Edinburgh:
Elsevier.
van Doorn, C., Gruber-Baldini, A., Zimmerman, S., Hebel, R., Port, C., Baumagarten, M.,
Magaziner, J. (2003). Dementia as a risk factor for falls and fall injuries among nursing
home residents. Journal of the American Geriatrics, Society, 51, 1213-1218. doi:
10.1046/j.1532-5415.2003.51404.x
Yamagami, T., Oosawa, M., Ito, S., & Yamaguchi, H. (2007). Effect of activity reminiscence
therapy as brainactivating rehabilitation for elderly people with and without
dementia. Psychogeriatrics, 7(2), 69-75. doi: 10.1111/j.1479-8301.2007.00189.x