Running head: OCCUPATIONAL PROFILE

Occupational Profile
Samantha Burneo
Touro University Nevada

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Occupational Profile

Client Information
The client is an 89-year-old female from Las Vegas, Nevada. She was originally from
Israel, but moved to the United States when she was 22 years old. She was admitted into hospice
due to rapid weight loss and a decline in her caloric intake. She has currently been experiencing
abdominal pain and spotting when she goes to the restroom, which has led the nurse and
physician to believe she may have cancer. She currently lives in an assisted living facility where
she spends the majority of her time in her room. The clients room contains that Star of David
due to her belief in the religion of Judaism. The client values her family and she has pictures and
memory books all over her room of them. She has both a son and a daughter who are fraternal
twins that visit her regularly as well as three grandchildren. Her son and daughter are both 63
years old. Her son is a lawyer who is thinking about retiring while her daughter spends her time
volunteering at a local hospital. They all live in Las Vegas as well. Before she moved into the
assisted living facility, her daughter would come over to the clients home and take care of
anything her mother needed. Once her mother needed assistance with her activities of daily
living (ADLs), the daughter came to an agreement with her brother to find a home for her mother
that would suit her needs. This assisted living facility provides breakfast, lunch, and dinner in the
dining hall. There is also a snack room that allows the residents to grab food whenever they
please. There is a bus that takes the residents into the community and an area outside that allows
the residents to walk, sit, and enjoy the fresh air. Unfortunately the client is unable to have pets
in the assisted living facility and her daughter had to take her two cats in. The client misses her
pets dearly.
Occupational History and Patterns of Engagement

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The client was married for 64 years before her husband passed away five years ago from
lung cancer. She adored her husband and loved spending time watching movies with him. She
was the homemaker of the home and a mother to her two children. She cooked, cleaned, and did
all the laundry in her home. She also took care of her two cats by cleaning their litter box,
grooming, and feeding them. Her husband took care of anything that needed to be fixed around
the home including mowing the lawn and taking care of the garden. Her husband also took care
of all the finances. Her husband worked as a lawyer and worked long hours. She was a school
teacher for 40 years, but retired when she was 65 years old in order to travel with her husband.
Once her husband passed away, she had a difficult time trying to take care of all the extra tasks.
She had to learn how to pay all the bills and had to hire a gardener to take care of all the yard
work. It was a tough transition for her to get use to only making food for herself. It took her a
long time to accept that her husband was gone and the client stopped doing many things that she
once enjoyed. For example, she use to enjoy reading a book while her husband read the morning
paper, going on walks outside, and playing card games at night.
Daily Life Roles
On a daily basis, the client wakes up and either goes down to grab breakfast or has her
breakfast brought to her room depending on how she is feeling. The client is unable to walk by
herself and must be taken to breakfast in her wheelchair. Before she heads to breakfast she has to
take her regimen of medication in order to manage her pain. She does this with the help of a
nurse because she has difficulty remembering when and what medications to take. She does not
eat much of her breakfast, but does like try to eat as much as she can because if she does not eat
she will get nauseous from her medication. After she eats breakfast, she will attempt to brush her
teeth, hair, and wash her face. She is unable to shower by herself and waits for a nurse to come

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once a week to help her shower. Most of the morning she will watch television in her room until
her son or daughter comes to visit her. This is the clients favorite part of the day. Her children
enjoy coming to visit their mom and watching television with her. They like to take her outside
when the weather is nice so that she can get some fresh air, but that has become increasingly
difficult secondary to the increase in pain levels that the client is experiencing. They also like to
spend lunch with their mom. Sometimes they eat in the assisted living facility with her or bring
her some of her favorite food, spaghetti and meatballs or matzah soup. Once her family leaves
from visiting she ends up taking a nap. Once she wakes up from her nap she eats her dinner,
takes her medication, and gets ready for bed. She attempts to independently brush her teeth and
get into her pajamas, but usually requires some assistance because of her decrease in endurance.
Clients Priorities and Desired Outcomes
The clients priorities are to be able to spend the last couple months of her life doing
things that she finds meaningful and spending time with her family. She misses all the things that
she use to do with her husband and would like to resume some of the activities such as reading
books and playing card games. She wants to focus on managing her pain and increasing her
activity tolerance to allow her to participate in meaningful occupations. She already knows that
her health is not going to improve, but she is concerned and depressed that she will spend the last
couple weeks of her life only lying in bed and having people take care of her. She also would like
to spend time with animals if she could because of her love for cats.
Occupational Analysis
Context and Setting of Services

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The client was in her room in the assisted living facility when the nurse came to visit her.
She was lying in bed watching television. It was around eight in the morning and she was still in
her pajamas. She also had not eaten breakfast yet. Since the client gets nauseas when she takes
her medication without eating, it was determined that the most appropriate step would be to grab
the client breakfast and help her eat. Breakfast was eaten while the client sat up in her bed and
used a side tray.
Activity Performance
Overall the occupation of eating went well with the client. She was motivated to eat
because she did not want to feel nauseas and needed to take her medication in order to reduce her
pain. The client ate apple sauce, scrambled eggs, and toast. The client was able to feed herself
with minimum assistance. The nurse had to help her with several bites because it took her a
longer time to finish eating secondary to her pain and decrease in her endurance. It was easier for
the client to scoop out the apple sauce with a spoon than to use the fork to eat her eggs. She often
dropped the eggs as she picked them up off the plate secondary to her decrease in endurance and
decline in upper extremity strength. On multiple occasions the client had to take a break in the
middle of eating secondary to her increase in fatigue. A concern of mine for this client was the
inability for the client to finish her meal secondary to the amount of time it took her. She often
became frustrated with her inability to consistently feed herself in a timely manner and was
exhausted by the end of eating.
Occupational Therapy Practice Framework Domains
There were several client factors that were addressed during eating that the client
participated in. Under global mental functions, the client had to use the category of energy and

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drive. This consists of ones energy level, motivation, appetite, craving, and impulse control
(American Occupational Therapy Association [AOTA], 2014). The client had a decline in her
energy level that forced her to spend extra time eating because she needed to take breaks. Also
due to the clients decline in appetite, it was difficult for the client to be able to finish her entire
breakfast. Under muscle functions, the client had to use the category of muscle endurance to
finish the task of eating her breakfast (AOTA, 2014). Since the client has not been moving
around a lot, she has had a significant decline in her muscle endurance making it difficult to use
the fork continuously to bring the eggs to her mouth. This also caused her to drop her eggs
multiple times while trying to pick the eggs up off of her plate.
There were a couple areas of performance skills that had to be utilized for the client to
accomplish the occupation of feeding and eating. Under the category of motor skills, the client
had a difficult time manipulating the utensils in her hand in order to obtain her food. Another
motor skill that was troublesome for the client was endures (AOTA, 2014). Again, the client had
to have several breaks throughout the activity because she would become tired quite frequently.
The context addressed in the activity of eating was personal (AOTA, 2014). The client is
89 years old and she knows she has deficits in her ability to feed herself and eat. She is
incredibly frustrated with the fact that her body no longer functions as it once had. She wishes
she could eat in a timely manner without any deficits as she once did, but she is up for trying
new strategies that will allow her to live a meaningful life in her last few weeks.
Problem Statements
1. The client eats with minimum assistance with the help of a caregiver secondary to her
decreased endurance.

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2. The client is unable to independently go out to the courtyard secondary to an increase in

her pain levels.
3. The client requires supervision from the nurse while taking her medications secondary to
a decrease in her short-term memory.
4. The client takes a shower with maximum assistance with the help of a nurse secondary to
a decrease in overall body strength.
5. The client grooms her hair with minimum assistance with the help of a nurse secondary
to a decrease in her grip strength.
There are numerous problems that need to be addressed for this client. The clients
inability to finish eating secondary to a decrease in endurance is her number one problem
because if she does not eat enough she will become nauseas from her medication. The reason
that the client is obtaining hospice services is due to her decline in caloric intake and her
rapid weight loss. Therefore, it is imperative to help her improve her endurance by using
energy conservation techniques to give the client the ability to eat enough food to inhibit her
from getting nauseas from her medication. The second problem is that the client is unable to
go to the courtyard and go outside secondary to her increase in pain. Allowing the client to
adequately manage her pain will allow her to participate in more meaningful occupations.
The client does not want to be stuck in her bed all the time, but due to her pain she would
rather not move. The third problem is that the client requires supervision to take her
medication secondary to her decline in short-term memory. Since she has to wait for the
nurse to remind her when to take her medication, sometimes the client is not given her
medication at the appropriate time allowing her pain to catch up to her. This forces the client
to stay put in her bed. The fourth problem is that the client takes a shower with maximum
assistance secondary to the decrease in her overall body strength. Since the client is in
hospice, improving her strength is not something that will be focused on. Rather,

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recommending that the client provides input on ways that she prefers her shower and when
she prefers to take it can make this occupation a more enjoyable process. The fifth problem is
that the client grooms her hair with minimum assistance secondary to her decrease in grip
strength. Again, in the hospice setting improving the grip strength of the client is not feasible,
but using adaptive equipment may help the client participate in this occupation with more
independence.
Intervention Plan and Outcomes
Long-term Goal
The client will be able to eat spaghetti and meatballs with modified independence
using adaptive equipment and energy conservation techniques with her family in two weeks.
Short-term Goal. The client will be able to eat scrambled eggs with supervision using a
universal cuff in one week.
Intervention. The intervention will take place at the breakfast table in the dining hall.
The client will first be educated on the use of a universal cuff. She will be educated that it
will conserve her energy because she will no longer have to grip the fork with as much
strength. This has been an issue for the client because of her decrease in endurance. This
decrease in endurance has been causing the client to drop her eggs when trying to eat
breakfast. After teaching the client the importance of using a universal cuff, the client will be
taught how to use the universal cuff and eat her eggs with it. The client will take five bites
using a fork with the universal cuff and then she will take a break for one minute. During this
intervention the client will be encouraged to take smaller bites in order to use less energy.
The intervention will end once the client finishes her eggs or no longer wants to eat.

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Intervention Approach. The intervention approach that will be used is modify. By using
the universal cuff, the client will modify the way she normally eats food in order to conserve
her energy.
Outcomes. The outcomes for this intervention will be improvement in occupational
performance and quality of life. Since the client has difficulty eating secondary to her
decrease in endurance, teaching the client how to use the universal cuff will allow her to
conserve more energy while eating. This will increase the clients occupational performance
in eating by allowing her to eat her food without continuing to drop pieces. It will also allow
the client to become more independent in eating. This intervention will help increase the
clients quality of life by allowing her to be less frustrated with the occupation of eating
because she will be able to pick up food without the assistance of a caregiver.
Research. According to the article Factors Affecting Older Adults Use of Adaptive
Equipment: Review of the Literature adaptive equipment is any tool that maximizes an
individuals independence in an occupation. These occupations can include activities of daily
living such as eating, bathing, dressing, grooming, toileting, and mobility (Kraskowky &
Finlayson, 2001). Foti and Koketsu (2013) stated that there are specific adaptive equipment
that can be used when eating. For an individual that has trouble with their grasp, using a
universal cuff is beneficial. In regards to the client, this research helps determine the impact
that using adaptive equipment can have on increasing independence in eating. The universal
cuff will decrease the amount of endurance the client will need to expend while eating
because she will not have to use as much strength to grip the fork. The client also tends to
drop food while eating because it is difficult for her to grasp the fork secondary to her
decrease in endurance. This forces a caregiver to step in and help the client get the food to

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her mouth. Since the client is in hospice remediating her endurance will not be appropriate
therefore using adaptive equipment is the best strategy to increase her independence.
Short-term Goal. The client will be able to eat a bowl of matzah soup with modified
independence using energy conservation techniques in one week.
Intervention. The client will participate in animal assisted therapy using a comb to brush
a cat. This will be an intervention as a means that will translate to the occupation of eating.
During this intervention the client will brush the cat five times and then take a minute rest to
work on conserving her energy. She will repeat this process five times. The intervention will
take place in the clients wheelchair in order to get her out of her bed. Using the comb will
help the client practice a similar movement that would be needed to be able to scoop up soup
with a spoon. This will help the client work on maintaining her endurance of that specific
motion that is necessary to eat. The client will be educated on the importance of participating
in the activity and then taking a break in order to conserve her energy. This intervention will
also be motivating for the client to complete because she adores cats. She dearly misses her
cats and wishes she could spend time with them. Having the client participate in this
meaningful occupation will help the client engage in an occupation that brings her joy in her
life.
Grade Up. The client will brush the cat 5 times, but will only receive a 30 second break.
This will give the client less time to recover and have her use more energy if she is up for it.
Grade Down. The client will remain in her bed when brushing the cat in order to
conserve more energy. By transferring the client into her wheelchair it may cause an even

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greater decrease in her energy level, which may not allow the client to fully participate in the
intervention.
Intervention Approach. The intervention approach that will be used is modify. By using
energy conservation techniques, it will allow the client to use less endurance to participate in
the intervention longer.
Outcomes. The outcomes for this intervention will be improvement in occupational
performance and an increase in participation. The client will be able to improve her
occupational performance in brushing a cat because she will conserve more energy which
will then translate to her ability to improve her occupational performance in eating. This will
also improve her participation in interacting with cats which is an occupation that she has
missed participating in.
Research. According to the article Evaluation of a Pet-Assisted Living Intervention for
Improving Functional Status in Assisted Living Residents with Mild to Moderate Cognitive
Impairment: A Pilot Study the authors found that animal assisted therapy decreased
depression and increased participation in physical activity for residents in an assisted living
facility with dementia (Friedmann, Ggalik, Thomas, Hall, Chung, & McCune, 2015). The
study took place over a three month period with 40 participants who resided in an assisted
living facility and had mild to moderate cognitive deficits from dementia. Participants were
randomized to determine who received the Pet Assisted Living (PAL) intervention and who
was placed into the control group. The PAL intervention consisted of 60-90 minute sessions
twice a week for 12 weeks using a therapy dog. During the intervention the residents would
participate in activities such as feeding the dog, brushing the dogs teeth, brushing the dog,
and playing catch with the dog (Friedmann et al., 2015). This research article shows the

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benefits of using animal assisted therapy. There are a wide variety of skills that can be
practiced using animal assisted therapy that can benefit the client. This study used brushing
the dog as an activity to increase physical activity for these residents. The client adores cats
and by using animal assisted therapy it will motivate her to engage in practicing energy
conservation techniques that can be translated to her eating. It will also help decrease her
depression that she contains about spending the remaining weeks of her life just lying in bed
doing nothing.
Long-term Goal
The client will play a card game in the courtyard with her children with minimum assistance
in a wheelchair in two weeks.
Short-term Goal. The client will independently write out a pain log to determine when
her pain is the highest and lowest in the day in one week.
Intervention. The client will participate in this intervention in her wheelchair in order to
get out of her bed. The log will have every hour of the day from 8 a.m. to 8 p.m. The client
will write down at each hour what her pain level is on a scale of 1-10 and the activities that
she is participating in during that time. This will help the client realize what time of the day
she has the least amount of pain and the highest amount of pain. By determining this, the
client will be able to let her children and grandchildren know the best time to visit her in
order for her to participate in occupations with them such as going out to the courtyard. Also
by knowing this, the client will know when is the best time for her to participate in other
meaningful occupations such as reading a leisure book or looking through her memory books
that she has in her room.

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Intervention Approach. The intervention approach will be modify. By participating in

this intervention the client will be able to modify her schedule to allow her to participate
more fully in meaningful occupations.
Outcomes. The outcome will be an increase in participation and an increase in quality of
life. By determining when the client has the least amount of pain she will be able to
participate in activities that she was no longer able to participate in secondary to her pain
level. This intervention will also help increase the clients quality of life because it will allow
her to participate in meaningful occupations that she no longer thought she could do.
Research. The article Development and Implementation of a Pain Education Program
found that individuals suffering from cancer and their family caregivers benefit from an
education program for relief of their pain (Ferrell, Rhiner, & Ferrell, 1993). This study used
teaching materials consisting of verbal instruction by a nurse, a written patient education
booklet, two audiocassette tapes, and written instructions for 19 interventions across five
areas of nondrug techniques including heat, cold, massage, relaxation, and imagery (Ferrell,
Rhiner, & Ferrell, 1993). The study consisted of 40 individuals diagnosed with cancer with
the average age being 66 years old. In order to track the participants pain, each participant
had to fill out a pain log. This pain log consisted of what time the individual had pain, what
activity they were participating in, how the pain persisted after one hour, and how distressing
the pain was on a scale of 1-10 (Ferrell, Rhiner, & Ferrell, 1993). This study coincides with
the intervention that the client will participate in because she too will be completing a pain
log. This log will be slightly different than from the study excluding how the pain persisted
after an hour. Just like in the study, this will be a good way to track the clients pain in order
to determine when she has the highest and lowest pain. This will help the client determine

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appropriate times that her children can visit in order for her to engage in activities with them
as fully as possible.
Short-term Goal. The client will take her pain medication with modified independence
when the alarm goes off in one week.
Intervention. The intervention will consist of helping the client set an alarm on her pill
medication box that will remind her that it is time to take her pain medication. The
intervention will take place in the clients room while she sits in her wheelchair in order to
get her out of bed. The alarm will be set once in the morning and once in the afternoon. The
client will be educated on learning on how to set the timer, practicing opening the pill box,
and taking the medication in the container each time the alarm goes off. The client will also
be educated on placing the pill box back to the designated spot on the night stand next to her
bed to allow easy access for her. Since the client forgets when she specifically needs to take
her medication, the alarm is a perfect way to help remind her when it is the appropriate time.
Intervention Approach. The intervention approach will be modify. The alarm on the pill
box will be a modification for the clients decline in her short-term memory.
Outcomes. The outcome will be an increase in participation. By helping the client take
her medicine at the appropriate time she will be able to maintain her pain level allowing her
to participate and engage in meaningful occupations.
Research. The article Can Adherence to Topical Glaucoma Medication be Improved by
Using an Audible Alarm? determined that using an alarm improved the adherence of
medication in individuals with glaucoma. The study consisted of 34 participants. The first
three months of the intervention the alarm did not go off on the electronic monitoring device

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and in the next three month span the alarm was turned on (Holl & Kthy, 2008). This study
is relevant to the intervention that the client will be participating in because she will be using
a pill box with an alarm on it. The client has had a decline in her short-term memory causing
her to need assistance taking her medication because she often forgets when to take it. By
using the alarm it will improve the clients adherence to taking her medication allowing her
to be more independent in this aspect. This will allow the client to stay on top of her pain and
better manage it, allowing her to participate in more meaningful occupations.
Precautions and Contraindications
While working in hospice, there are multiple precautions and contraindications that need
to be addressed. A precaution to be aware of is fatigue. The client is in the dying process and
realizing when she needs to rest is imperative. It is not a priority in hospice to push the client
to make gains. According to the National Hospice and Palliative Care Organization (2013),
hospice is focused on caring not curing. Instead, focusing on engaging the client in
meaningful occupations at the optimal functional level is preferred in hospice. By pushing
the client too far you may cause more harm than good and increase her pain level. Another
precaution is medication. The client may be put on medication that causes her to be
disoriented or sleepy. It is important to determine the side effects of the particular
medications that the client is on and try to schedule treatment sessions when the side effects
are minimal. A contraindication is pain. The National Hospice and Palliative Care
Organization (2013) also states that pain management is an area that is focused on in hospice.
If the client is in a great deal of pain you do not want to continue therapy.
Frequency and Duration

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The client will participate in skilled occupational therapy services two times a week for
two weeks. Each treatment session will occur no longer than one hour long. The client may
not be able to finish treatment sessions due to fatigue. Treatment sessions will be scheduled
around the client.
Model
An appropriate frame of reference to use for this client is the Model of Human
Occupation (MOHO). MOHO focuses on being client centered and holistic. MOHO consists
of three subsystems which include volition, habituation, and performance capacity (Schultzkrohn & Pendleton, 2013). These three subsystems interrelate to determine an individuals
occupational performance. Volition is the clients values, interests, and personal causation.
Habituation looks at the roles and habits of the client. Performance capacity looks at the
clients previous performance in occupations and how they use to be performed (Schultzkrohn & Pendleton, 2013). In regards to the setting of hospice, their main focus is on being
client centered and holistic. They focus on doing what the client wants and needs in order to
make the client as comfortable as possible in the end stages of their life. For this client, using
MOHO allows interventions to be geared toward occupations that are important to her based
on her occupational profile. By determining that the client values her family and is interested
in cats, interventions were created to allow the client to engage in those meaningful
occupations. By engaging the client in meaningful occupations, it will improve the clients
overall quality of life in the final stages of her life.
Client Training and Education

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There are multiple areas that the client needs to be trained and educated on. First, the
client needs to be educated on the importance of using energy conservation techniques while
participating in meaningful occupations. By using energy conservation techniques, it will
allow the client to be less fatigued and engage in occupations longer. Second, the client needs
to be educated on the appropriate times that she needs to take her medication and the dosage
that is required. This allows the client to become more independent in managing her
medication. Lastly, the client needs to be educated on using the pill box alarm system. She
needs to understand how to set the alarm and when she needs to set the alarm each day. By
teaching the client all of these important components, it will allow her to better achieve her
goals and participate fully in meaningful occupations. In regards to the clients children,
providing them with education on the dying process and coping strategies is important. This
will help them learn how to move on with their life once their mother passes away.
Clients Response
In order to determine if the client is making progress, multiple assessments will be used
in order to measure her outcomes in regards to pain, quality of life, and fatigue level. First,
the clients quality of life will be assessed using the Assessment of Quality of Life (AQoL)
8D version. This version of the assessment takes about five minutes to administer and
consists of the eight domains of independent living, happiness, mental health, coping,
relationships, self-worth, pain, and senses (Assessment of Quality of Life, 2014). This
assessment uses a semantic differential response method to answer the questions. The AQoL
assessment tool is perfect for the client because it does not take much of the clients time to
fill out which is important to consider because she fatigues easily. This assessment tool is
also a good fit for the client because it hits on important domains. For example, relationships

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and pain are a concern for the client and being able to assess how those affect her quality of
life determines whether or not the interventions are having a positive impact. This assessment
tool will be given before treatment begins and two weeks later.
In order to assess pain, the visual rating scale will be used on the client. The client will be
asked to express her pain on a scale of 1-10. According to Flaherty (2012), using tools and
questions that are easy to understand are the most effective for older adults. The visual rating
scale is an assessment tool that is mentioned in the article to be used with older adults
because it is easy for older adults to understand. This will determine how much of the
intervention the client is going to be able to participate in. It will also determine if the clients
pain medication is the appropriate dosage and if she is taking it at the appropriate times.
In order to measure the clients fatigue level the Fatigue Symptom Inventory will be used.
According to Jacobsen (2004), the Fatigue Symptom Inventory has been used to find out the
fatigue level of clients who have cancer. This assessment uses 14 different Likert scales to
determine a clients fatigue level and how fatigue effects certain aspects of your life. Two of
the interventions are geared toward using compensatory strategies to help the client
overcome her endurance deficits that cause her to be fatigued. This assessment will help
determine if the client is able to participate more fully in her meaningful occupations using
the compensatory strategies.

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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),
S1S48.http://dx.doi.org/10.5014/ajot.2014.682006
Assessment of Quality of Life. (2014). AQoL-8D. Retrieved from
http://www.aqol.com.au/index.php/aqolquestionnaires?id=58
Ferrell, B. R., Rhiner, M., & Ferrell, B. A. (1993). Development and implementation of a pain
education program. Cancer, 72(11 Suppl), 3426-3432.
Flaherty, E. (2012). Pain assessment for older adults. Try This: Best Practices in Nursing Care in
Older Adults, (7). Retrieved from
http://consultgerirn.org/uploads/File/trythis/try_this_7.pdf
Foti, F., & Koketsu, J. S. (2013). Activities of daily living. In H. M. Pendleton & W. SchultzKrohn (Eds.), Pedrettis occupational therapy: Practice skills for physical dysfunction.
(7th ed.). St. Louis, MO: Mosby, Inc.
Friedmann, E., Galik, E., Thomas, S. A., Hall, P. S., Chung, S. Y., & McCune, S. (2015).
Evaluation of a pet-assisted living intervention for improving functional status in assisted
living residents with mild to moderate cognitive impairment: A pilot study. American
Journal Of Alzheimer's Disease & Other Dementias, 30(3), 276-289.
doi:10.1177/1533317514545477
Holl, G., & Kthy, P. (2008). Can adherence to topical glaucoma medication be improved by
using an audible alarm?. Pharmaceutical Medicine - New Zealand, 22(3), 175-179.

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Jacobsen, P.B. (2004). Assessment of fatigue in cancer patients. Journal of the National Cancer
Institute Monographs, 32, 93-97. doi: 10.1093/jncimonographs/lgh010
Kraskowsky, L., & Finlayson, M. (2001). Factors affecting older adults' use of adaptive
equipment: review of the literature. American Journal Of Occupational Therapy, 55(3),
303-310.
National Hospice and Palliative Care Organization. (2013). NHPCOs facts and figures.
Retrieved from
http://www.nhpco.org/sites/default/files/public/Statistics_Research/2013_Facts_Figures.p
df
Schultz-Krohn, W.., & Pendleton, H.M. (2013). Application of the occupational therapy practice
framework to physical dysfunction. In H. M. Pendleton & W. Schultz-Krohn (Eds.),
Pedrettis occupational therapy: Practice skills for physical dysfunction. (7th ed.). St.
Louis, MO: Mosby, Inc.