Running head: OCCUPATIONAL PROFILE

Occupational Profile and Intervention Plan

Davis Legaspi-David
Touro University Nevada

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Occupational Profile

Client, Interests and Values

Anthony Smith is a 32-year old man who sustained a complete C6 tetraplegia injury due
to a motor vehicle accident. Anthony is originally from Dallas, Texas however moved to Las
Vegas, Nevada fourteen years ago to pursue a career in construction. With that said, Anthony has
been working in the same construction company full-time since he moved to Las Vegas.
Throughout those years working in construction, Anthony has developed a sense of pride of
being a handy man and a close bond with his fellow co-workers. Anthony has been
incarcerated in the past due to undisclosed reasons, however his family has stated that, he has
now cleaned up his act entirely. Anthony has gotten married twice in his life, the first time was
when he was 21-years old to his high school girlfriend and the second time when he was 29years old. Anthonys first marriage only lasted for 2 years due to his wife passing away because
of brain cancer. Six years later Anthony got remarried, however the same motor vehicle accident
that he had sustained after a family trip to the lake, had also caused him to lose his second wife.
Therefore, Anthonys main social support consists of his two children, a daughter who is 2-years
old and a stepdaughter who is 6-years old. In addition to the social support he receives from his
children, Anthony has both of his parents, his brother and sister-in-law, who all live in Las Vegas
as well. After being discharged, Anthonys family plans for him and his daughter to move into
his brother and sister-in-laws two-story home where he will receive all of his caregiving needs.
For this reason, this is why Anthony has expressed why he values the importance of family
above all things, because they have always supported him throughout all of his life events. Prior
to Anthonys accident, the physical activities that he was interested in was the restoration of his
classic Ford Mustang vehicle, riding his dirt bike and playing with his two daughters. Aside from

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those physical activities, he admires the art of tattoos and watching World War II documentaries
and movies.
Services Seeking and Concerns
Upon Anthonys arrival to Progressive Hospital, his vital signs were medically stable,
however it can instantly change due to his autonomic dysreflexia. He had also arrived with a
halo to stabilize the fractured site where rods and screws had been placed surgically in order to
realign his cervical vertebrae. As a result, the client is to follow strict spinal cord precautions.
Secondary to Anthonys vertebra issue, his record states that he is to remain with a ventilator
until further notice due to previous respiratory failures. Clients pulmonary issue has caused him
to have shortness of breath, which has limited his activity tolerance dramatically. In addition, he
displays spasticity in both upper extremities and occasional muscle spasms. Due to prolonged
bed rest, Anthony displays significant muscle weakness and atrophy throughout his body as well.
Consequently, Anthonys muscle weakness has caused him to be unable to perform his activities
of daily living (ADLs) independently. Since the Anthonys arrival to the facility, he has
remained in his bed (clients body position is regularly shifted to another side in order to avoid
bed sores) and has only been Hoyer lifted out onto a wheelchair once in order to be custom fitted
for one. Anthony currently utilizes a folly catheter and Depend underwear to take care of his
toileting issues. Furthermore, Anthonys constant bed rest has caused edema to develop in his
lower legs; client is now obligatory to wear compression stockings for the mean time. Anthonys
condition further declined as a result of complications with sepsis, which required him to be
rushed into the emergency room. As for the Anthonys emotional health, due to the tragic loss of
his second wife and his current condition, Anthonys emotional state has declined, which has
caused him to be depressed for the majority of the day. An occupational therapist (OT) has

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visited him to conduct an initial evaluation. During the initial evaluation, Anthony reported that
he is concerned about his physical strength and if he will regain his independence in order to be
able to take care of his two daughters. Areas that Anthony reported having difficulty with were
his inability to remain sitting up because of poor core strength and limited control of his upper
extremities.
Areas of Occupation
As mentioned earlier, Anthony is currently unable to perform any of his basic ADLs
independently, therefore that is the area of occupation that his intervention is focused on (with
his current condition he is unable to engage in instrumental activities of daily living (IADLs),
work, play and leisure occupations). Particularly, Anthony needs total assistance with bathing,
personal hygiene and grooming, toileting and toilet hygiene, and dressing. As for feeding,
Anthony requires max assist. He is able to use a fork to poke his food, however needs hand over
hand to help bring the food to his mouth. Besides working on his ADLs, the other type of
occupation that he engages in is social participation. This is the area of occupation that Anthony
feels the most success in. Although he is still having difficulty speaking because of the
tracheostomy, he is still able to communicate with head gestures and facial expressions.
Therefore, whenever his family or friends comes to visit his depression is temporarily decreased
because he gets to have a little bit of normalcy back in his life. As for Anthonys sleeping
situation, he has a room to himself and since he spends the majority of his time on bed rest, he
often reports feeling well rested.
Contexts and Environments
Prior to Anthonys spinal cord injury (SCI), he lived in a two-story house with his family.
However due to his inability to no longer use his legs, continuing to live at that same home will

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be difficult for him to manage and parent his daughters. Therefore, arrangements have already
been made for him and his daughters to move into his brothers home for the mean time.
Anthonys brother lives in a one-story home in which Anthony and his daughters will stay in the
master bedroom. Having the master bedroom is beneficial for Anthony because it will have
enough space for him and his daughters to sleep in and for him to maneuver in his wheelchair. In
addition, the master bedroom has an attached bathroom that has a tub shower. The tub shower
will be perfect for a tub shower bench. Furthermore, it is also very convenient for Anthony to
enter and exit his brothers home since there are no steps that lead up to the entrance door.
Anthony moving into his brothers home will be a good transition for him, because having a full
house surrounded by his love ones will help ease his depression and help with his
responsibilities. With that said, there are some aspects to Anthonys brother home that can
potentially impact his engagement with his occupations. Specifically, Anthonys brother has a
steep long driveway; therefore, it might be physically exhausting for Anthony to functionally
move independently when on his wheelchair. Another possible barrier within Anthonys
brothers home are the narrow hallways and the positioning of the furniture. The client will most
likely have a tendency in bumping into thing, which will frustrate him.
Occupational History
Anthony has been working in the same construction job in Las Vegas ever since he
moved here after graduating from high school in Dallas, Texas. Anthony considers himself lucky
to still have his job even after he was briefly incarcerated due to undisclosed reasons. He was a
part of the demolition team at his job, which involved driving bulldozers and using jackhammers.
Anthony takes pride in the experience he has gained from working in construction because he is
able to be a handy man and help friends and family members fix home improvement issues.

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However, Anthonys main priority is being a good husband to his wife (when she was alive) and
a loving father to his two young daughters. Anthonys fatherly duties consist of helping to dress
his kids, dropping his youngest daughter at her daycare and taking the oldest daughter to school.
When he has time for himself, Anthony will either work on his classic car or ride his dirt bike,
which is a hobby that he has been doing since he was 17. Anthony comes from a very supportive
family and he surrounds himself with close friends from his construction job.
Daily Roles, Priorities & Desires
In a typical weekday for Anthony, he engages in different life roles depending on the
time of day. One of his main roles besides being a husband is being a father; however, being a
father for Anthony encompasses multiple sub-roles. Specifically, after Anthony wakes up and
gets himself ready for work, he is a personal stylist for his daughters, while his wife prepares
everyones breakfast and lunch. Particularly, Anthony picks out his daughters outfits and makes
sure that they are properly groomed either for school or daycare. Afterwards, he switches from
being his daughters stylist to their personal chauffeur by transporting them to either to their
school or daycare. From nine to three oclock, Anthony plays the role of a construction
crewmember and a fellow friend to his co-workers. Anthony enjoys his time at work because this
is usually the only time out of his busy scheduled that he gets to be around other men and talk
about common interest (unlike when he is at home). When Anthony arrives home he is once
again a husband and father. During this late period of the day he is a teacher by helping his other
daughter with her homework and a romantic partner to his wife. With all that said, Anthonys
main priority is to be discharged home as soon as possible so that he can return to being a father
for his daughter, especially now since he is a widower. He desires to be able to provide, protect
and care for them again. As for returning back to his construction job, Anthony is not concern

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with that as of now since his insurance company is taking care of all the financial issues. In
addition, he has been thinking about other professions that would be easier for him to do because
of his disability. However, he does miss bonding with his co-workers and hopes to be able to see
them soon. Ultimately, Anthonys desired outcome is to be modified independent in all areas of
ADLs and IADLs so that he can have a sense of normalcy again.
Patterns of Engagement
Anthony was relatively in good physical shape. He was young and being in construction
for so many years, allowed him to develop a strong body. He had a good balance of working and
his social life as well. Therefore, Anthony did not struggle in with his ADLs, IADLs, work,
leisure and social participation. However, a lot of his ability to engage in his occupation changed
after his accident. Anthony is still able to participate in social interaction but it is limited to only
making head gestures and facial expressions. As for his other occupations such as ADLs and
IADLs, he requires total assistance to accomplish them. Obviously, he is not able to engage in
work and in his leisure activities.
Occupational Analysis
Context and Setting
Anthony was transferred to Progressive Hospital due to the growing complications that
were unmanageable in his primary acute care facility. Progressive Hospital is a relatively small
long-term acute care facility that is able to house 34 clients (two beds for each room and one
bathroom with a shower tub). Interestingly, the hospital was designed to look like a bed and
breakfast lodging. This is beneficial for the clients because instead of the typical cold and sterile
hospital ambience, Progressive Hospital provides their clients a sense of home comfort. The
majority of the clients that come here are ventilator dependent and on bed rest. Fortunately,

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clients do receive therapy services such as OT, physical therapy and respiratory therapy. Therapy
services can either be conducted in the clients room or in the rehabilitation room. In Anthonys
case, OT services were provided in his room. Lucky for Anthony and the OT, he was not
currently sharing his room with anyone. Therefore, there was plenty of space for the Hoyer lift to
be utilized easily. Upon arriving to Anthonys room (where there are vital sign monitors and an
IV bag on a pole) the OT and I were greeted with a well sunlit room decorated with photos, get
well cards, flowers and Anthony watching television, while on a semi-reclined bed.
Activity and Client Performance
During the most recent intervention session with Anthony that was observed on the
fourth week of fieldwork, Anthony reported having back pains and feeling light headed.
However, within that intervention session he had made significant improvements in his upper
extremity strength and range of motion relative to the first week. A lot of the improvement had to
do with the therapeutic activity that the OT had been working on him with, which involved
weights and a neuromuscular electrical stimulation (NMES) unit. Specifically, the intervention
session began by taking and recording Anthonys vital signs and then, while still at a supine
position on a semi-reclined bed, NMES electrode pads were placed on his right triceps. On his
left forearm, two-pound weights were strapped on. Simultaneously, while performing two sets of
ten repetitions of arm flexion and shoulder abduction exercises on his left arm, the NMES unit
was set to level five and produced muscle contractions of his right triceps. During the NMES
stimulation, the OT is also applying a neuromuscular reeducation technique to increase blood
flow circulation, stabilize blood pressure, and oscillation of the triceps. The clients vitals were
monitored throughout the intervention as well. At the end of the intervention session, the OT
discussed with Anthony her plans for their next intervention session.

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Key Observations
Anthony was scheduled to have a full 45-minute with the OT, however due to a sudden
increase in the clients blood pressure and a feeling of light headedness, the OT decided to
abruptly stop the entire intervention session. The sudden increase in Anthonys blood pressure is
significant because his medical records indicate that he has autonomic dysreflexia, therefore the
OT did not want to further exacerbate his symptoms. Nevertheless, the 20-minute session that
Anthony completed was still a big accomplishment. During previous session, Anthony was only
able to handle 15 to 18-minutes of therapy. It is still clearly obvious that the exercises were very
taxing on Anthony since his movements looked weak and had little control. The OT often had to
provide minimal assistance and verbal cues in order to accomplish the task. However,
Anthonys mental functions have always remained intact. Specifically, Anthony was able to
make eye contact whenever the OT spoke to him and appeared alert and oriented during the
treatment; the only thing is that Anthony seems to lack motivation due to his depression.
Significant Impacts
Due to the traumatic loss of another wife and sustaining a sudden life changing
impairment, it has greatly affected Anthonys client factor of emotional regulation (AOTA,
2014). As a result, Anthonys inability to regulate his depress emotions has often interfered with
his ability to successfully engage in the occupation based interventions during OT services.
Particularly, Anthony would sometime refuse to work with the OT regarding his bathing,
dressing and personal hygiene and grooming because he was not able to motivate himself to get
out of his depress state. Consequently, as a form of avoidance Anthony will try to sleep all day in
his dark room, which slows down the recovery process. Another domain of the Occupational
Therapy Practice Framework (OTPF) that is impacting Anthonys engagement in meaningful

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occupations is his performance skill. The specific performance skill that Anthony has trouble
performing is implementing proper calibration during feeding (AOTA, 2014). While attempting
to feed himself, Anthony is unable to use the appropriate force and speed when bring his eating
utensil to his mouth. This usually causes Anthony to over shoot the movement, resulting in him
hitting his face and making a mess. Lastly, the third subdomain of the OTPF that is affected is
his role of being a parent, which is under the domain of performance patterns (AOTA, 2014).
This had led to Anthonys occupation of child rearing being negatively impacted. Since Anthony
spend most of his time in the hospital and focusing on his ability to improve his functional
performance of his ADLs, this has resulted in Anthony unintentionally neglecting his two
daughters. Anthony has expressed to the OT how terrible he feels for putting his children through
this difficult situation. This is another main cause of depression for him because he feels that he
has failed as a father since he sees himself unable to protect and provide for his daughters.
Problem List
Problems
1) Client requires TA in self-grooming & bathing due to a lack of motivation to take care of his
appearance because of his depression.
2) Client is unable to perform UB & LB dressing due to his inconsistency of using his tenodesis
grasp.
3) Client is unable to participate in play with his daughters due to his inability to verbally
communicate & use of fine & gross motor skills.
4) Client demonstrates in safety techniques during functional mobility due to unanticipated
autonomic dysreflexia incidents.

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5) Client is unable to perform physical activities on his UE for long periods of time due to his
in endurance.
Problem Priorities and Justification
The top priority for Anthony is for him to build confidence in himself by successfully
completing ADL activities in self-grooming and bathing. Specifically, Anthony lacks
motivations to do anything because of his depression. Therefore, by having him take care of his
appearance with as much autonomy as possible it will create momentum for him to want to
attempt other occupational activity. In addition, it will be one of the first steps towards regaining
his independence, through the practice of using his tenodesis grasp.
The other top priority (can be interchangeable with the first problem priority) is for
Anthony to be able to perform upper and lower body dressing due to his inconsistency of using
his tenodesis grasp. Similar to the first priority, this problem is important because it will work on
Anthonys appearance in order to motivate him, while also working on his tenodesis grasp to
reclaim his independence. However, this is different from the first problem priority in that it will
allow Anthony to include his lower body (which will increase his ROM in his arms and trunk)
and use more trunk stability when sitting up to put a shirt over the his head and when pulling his
pants up to his waist. Ultimately, resolving this problem will provide Anthony the basic tools to
get him towards performing his main occupational duties of being a father.
The third problem priority will be Anthonys inability to participate in play with his
daughters due to his inability to communicate with them verbally or through the use of fine or
gross motor skills. Due to the loss of his wife, Anthonys daughters are now his only priority in
which he feels that he must provide for and protect. However, in order for Anthony to play he
must first be able to move. This is why this problem was not at the top of the list.

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The fourth problem priority is Anthonys decrease safety in functional mobility due to his
unanticipated autonomic dysreflexia incidents. This is significant because in order for Anthony
to increase his independence through his functional mobility, he will need to know the proper
procedures to take when he has an autonomic dysreflexia attack. However, this was not one of
the top problems in the list because the procedures in dealing with autonomic dysreflexia can be
taught later on once Anthony is comfortable with his tenodesis grasp.
The last problem priority is Anthonys inability to perform long periods of physical
activities with his upper extremities due to a decrease in his endurance. Unfortunately, after
sustaining a complete C6 spinal cord injury, Anthony is left relying a lot of his occupational
performance with his upper extremities. Therefore, by building up Anthonys endurance in his
upper extremities, it will allow him to enhance his functional performance in different
occupations. This problem was put last because, the main priority is to just get Anthony moving
and spending time with his daughters, instead of focusing on Anthony becoming stronger.
Intervention Plan and Outcomes
Long-Term Goal 1: Client will choose all OT activities to engage in during session c 1 VC to
depression & social interaction by 4 wks.
Short-term goal. Client will engage in 2 OT activities chosen by OT 95% of the time c 2
VC & minimal HOH by 2 wks.
Intervention. OT will initiate client to participate in therapy by first explaining the entire
therapy session agenda to client and then asking him if he has any questions or concerns.
Afterwards, client will voluntarily participate in doing ADL activities such as grooming and
bathing or therapeutic exercises. The type of intervention approach that will be utilized is
prevention because it will prevent social isolation of the client by promoting interaction with the

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OT and participation in therapy session (AOTA, 2014). When working on brushing clients
teeth, OT will provide minimal assistance by setting up all essential equipment and helping the
client brush his teeth using no more than two verbal cues and minimal hand over hand. Similarly
during bathing, OT will set up sponge bath and examine the client wipe his entire front UB by
himself. OT will then assist by wiping the clients back and lower body. In a study, the
researcher examined clients living in a skilled nursing facility (very similar to a long-term acute
care facility), and discussed how providing clients with perceived autonomy and control in their
environment when performing self-care ADLs have shown to enhance the clients motivational
behavior and self-esteem (Blair, 1999). The outcome of the intervention is participation in
desired occupation of grooming and bathing (AOTA, 2014).
Short-term goal 2. Client will engage in supervised 15 min guided imagery training to
manage back pain within 2 wks.
Intervention. Client will be introduced to guided imagery in which the OT will educate
the client in the concept that the body and mind are connected. The OT will initiate the guided
imagery session by having the client in a relax position with or without his eyes closed, while the
OT reads off of a script or plays an audio recording and relaxing music to evoke positive
imagination. By having the client listen, it should help guide him into a more relax state, which
will temporarily distracting him from his back pain. Again, this intervention is designed to be a
prevention intervention approach that not only prevents social isolation of the client, but also to
prevent occurrence of barriers (in this case his back pain) that decrease his occupational
performance (AOTA, 2014). Therefore, the target outcome of the intervention is improvement
(AOTA, 2014). Particularly, because it will help the client find a non-pharmacological method
towards helping the client regain focus of accomplishing his ADLs. In a research study it

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indicates that the majority of subjects that used guided imagery to help alleviate their pain,
reported back with positive results (Burhenn, Villegas, & Kravits, 2014).
Long-Term Goal 2: Client will complete UB and LB dressing min (A) using compensatory
strategies within 4 wks.
Short-term goal 1. Client will snap large buttons on 1 shirt & zip up 1 jacket 1 VC
within 2 wks.
Intervention. The clients impairments has somewhat regressed his motor skills to that of
a child. Therefore, a modified intervention approach that the client can do (that is commonly
used in the pediatric setting) to address the visual perceptions and control the voluntary
movements associated in dressing is to utilize a button board (Barnes & Beck, 2011, p. 149).
This is a modified approach because it is teaching the client compensatory techniques to help
support him with dressing when he returns back home (AOTA, 2014). Specifically, client will be
instructed and trained on techniques for tenodesis grasp to button and unbutton large buttons on
the button board. Button board will have five large buttons in total, which the client will be
expected to button all the away up and unbutton downwards. In addition, the client will perform
a similar activity of zipping up and zipping down a zipper board (zipper board will be
approximately one foot in length). Due to the tenodesis grasp still being a relatively new skill for
the client, they will only be expected to preform each activity once. Afterwards, the OT will
then record the amount of time it took the client to complete each activity separately. Dressing
interventions should focus on ways to modify the performance patterns or activity demands of
dressing and that therapist may modify the actions or time required for dressing (Barnes & Beck,
2011, p. 151). The expected outcome for this intervention is improvement in his hands fine

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motor skill in order to increase occupational performance in the ADL of upper body dressing
(AOTA, 2014).
Short-term goal 2. Client will demonstrate LB dressing mod (A) using compensatory
strategies within 2 wks.
Intervention. Client would first be reminded of his spinal cord precautions and then be
educated on simple wardrobe or closet arrangements such as, moving all his cloths at a lower
storage space to make it more convenient for the client to access. Afterwards, client will be
guided through a step-by-step remediation approach intervention on how to don pants using
compensatory strategies, while on his bed (AOTA, 2014). Due to the new introduction of this
compensatory strategy, client will utilize putting on loose sweat pants first to make the task
easier to establish and to build confidence. A study examined the energy coast of lower body
dressing for individuals with SCI and it showed that they tend to require more energy to perform
lower body dressing compared to their able-body counterparts (Lynch, Hornby, & Roth, 2015).
With that said, Client will first be instructed to sit up in which the OT will demonstrate the initial
step of weave the clients folly cater through on of the pant leg first. Next, client will be helped
crossing one leg as high up the opposite thigh as possible in order to insert it through on of the
pant legs. The same procedure will be done for the other leg. Client will then pull their pants up
until it reaches near their buttocks area. From there the client will position himself into a sidelying position (by doing a log roll) on each side to complete pulling his pants up to his waist. The
client will be provided moderate assistance throughout the session. Researchers suggests that
rehabilitation professional need to keep energy cost in mind because other medical conditions
might be triggered due to physical exertion (Lynch, Hornby, & Roth, 2015). This is why it is
important to teach clients to use appropriate compensatory strategies in order to convers as much

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energy as possible. The expected outcome is again improvement in occupational performance,

but this time it is for the client to be able to dress his lower body (AOTA, 2014).
Precautions and Contraindications
As mentioned earlier, due to a motor vehicle accident that caused the loss of the clients
wife and his SCI, it is a very traumatic experience. Therefore, the first precaution for the client
should focus on his psychosocial. Client has often express feeling depress and frustrated,
therefore the therapist needs to build a good rapport with the client so that the client will trust the
therapist in helping him reanalyze his life in a positive light. As a result his will help the client
fully engage in his therapy to regain his independence. Furthermore, another precaution to keep
in mind is the clients autonomic dysreflexia, so a constant monitoring of the clients vitals is
crucial. Frequent breaks should be implemented to avoid triggering the symptoms of autonomic
dysreflexia; this will keep the client safe and avoid cutting the time with therapy to short. Lastly,
it is always good to remind the client to follow SCI precaution to avoid reinjures until the
physician has said so otherwise.
Frequency and Duration
The relatively small number of clients that stay at Progressive Hospital is often a benefit
for all of the clients because they are able to receive extra care throughout the day. Anthony for
example is able to receive OT services anywhere between three to four times a day, just depends
on his tolerance level (on average Anthony is able to tolerate 20 minutes of therapy). Keep in
mind that he can also receive the same amount of service from other members of the
interdisciplinary team. In addition, in Anthonys plan of care it indicates that he is able to work
with an OT three to five days out of the week (could possibly have been more days, but

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Progressive Hospital does not provide OT services during the weekend) until his discharge date.
At the end, Anthony will have received six weeks of skilled OT services.
Grading Up and Down
The upper body dressing intervention can be graded up by having the client button two
buttons of a polo shirt while wearing it. Having the client button a shirt while he is wearing it
will increase the requirement because he will not be able to visually see the button as he fastens
it. In addition, wearing the shirt is relatively more difficult because it requires the client to have
more trunk stability when buttoning a shirt compared to accomplishing the activity on a button
board. Grading down the activity can be accomplished by having the client button larger and
fewer buttons on the button board. Specifically, this task will be easier because it involves less
effort and time from the client.
Primary Framework
For the interventions that I chose for my second long-term goal, it was based on the
rehabilitation frame of reference. Specifically, the interventions were designed to restore
Anthonys ability to participate in functional activities, since his abilities had been disrupted by a
physical impairment. Therefore, Compensatory and adaptation approaches were used to allow
the client to complete upper body and lower body dressing.
Client Training and Education
Education on spinal cord precautions will be address to the client to ensure safety during
functional activities. The use of compensatory strategies when Anthony engages in activities of
daily living will be explained to both the client and his family. Specifically, education and
demonstration will be provided on safe transfer techniques and how to functionally use a
tenodesis grasp throughout Anthonys daily occupations. It will also be important to educate and

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provide the client and the family members about necessary durable medical equipment (DME)
and A/E that will ensure safety and independence in Anthonys home and in community
accessibility. In addition, essential training and education will be provided on the benefits of
maintaining a healthy lifestyle, such as Anthony changing positions every two hours in order to
prevent bedsores. Lastly, education on autonomic dysreflexia will also be provided so that
Anthony can take the necessary steps to alleviate the symptoms.
Client Response
Anthonys progress toward his goals will be monitored and assessed through daily
progress notes that will be written after every session and weekly progress notes that will be
written every Monday. What is unique about Progressive Hospital is that because it is a small
hospital with only 17 rooms, OTs can provide up to 3 sessions a day with the client. Therefore,
Anthonys daily progress could be assessed up to 3 times a day in several different occupational
activities. Although daily progress notes is a good source to monitor a clients progression, it can
often be difficult to evaluate improvement because it will often be small. As a result, is it also
essential to write weekly progress notes to gain a better understanding on Anthonys overall
progression during the week. In addition, weekly progress notes are also shared within the
hospitals interdisciplinary team. Therefore, Anthonys weekly progress notes from other
disciplines can also be used as a source to assess his goal achievements.

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References

American Occupational Therapy Association [AOTA]. (2014). Occupational therapy practice

framework: Domain and process (3rd ed.). American Journal of Occupational Therapy,
68(Supp.1), S1-S48. doi:10.5014.ajot.2014.682006
Barnes, J.K., & Beck, A.J. (2011). Enabling performance and participation for children with
developmental disabilities. In C.H. Christiansen & K.M. Matuska (Eds.), Ways of living:
Intervention strategies to enable participation (4th ed., pp. 149-151). Bethesda, MD:
AOTA Press.
Blair, C. (1999). Effect of self-care ADLs on self-esteem of intact nursing home residents. Issues
In Mental Health Nursing, 20(6), 559-570.
Burhenn, P., Olausson, J., Villegas, G., & Kravits, K. (2014). Guided Imagery for Pain Control.
Clinical Journal Of Oncology Nursing, 18(5), 501-503. doi:10.1188/14.CJON.501-503
Lynch, M. M., Hornby, T. G., & Roth, E. J. (2015). Energy Cost of Lower Body Dressing, PopOver Transfers, and Manual Wheelchair Propulsion in People with Paraplegia Due to
Motor-Complete Spinal Cord Injury. Topics In Spinal Cord Injury Rehabilitation, 21(2),
140-148. doi:10.1310/sci2102-140.