Occupation and Client-Centered Practitioner
1. Appreciates the influence of socio-cultural, socioeconomic, political, diversity factors, and lifestyle choices on engagement in occupation throughout the lifespan.
During my home health rotation, I was fortunate to see a variety of people and homes ranging from an apartment located in the heart of a major city to a cabin in the woods of a rural small town. Some homes were more functional than others, so there were a number of contexts to consider when planning interventions for clients. One client was unable to transfer in and out of the tub and had been sponge bathing. While instruction in safe tub transfer techniques was a common intervention for this setting, learning how to safely complete tub transfers was not a priority for this client, who stated that their goal was to regain independence in cooking in their kitchen. I appreciated their preference and set meal planning and household management goals accordingly.
During my home health rotation, I was fortunate to see a variety of people and homes ranging from an apartment located in the heart of a major city to a cabin in the woods of a rural small town. Some homes were more functional than others, so there were a number of contexts to consider when planning interventions for clients. One client was unable to transfer in and out of the tub and had been sponge bathing. While instruction in safe tub transfer techniques was a common intervention for this setting, learning how to safely complete tub transfers was not a priority for this client, who stated that their goal was to regain independence in cooking in their kitchen. I appreciated their preference and set meal planning and household management goals accordingly.
2. Communicates effectively with a wide range of clients, peers, and professionals both verbally and non-verbally.
Many clients I encountered in home health had visual impairments, such as glaucoma, macular degeneration, or diabetic retinopathy. Many clients also had age-related hearing loss, so verbal communication was sometimes challenging. It was always important for me to communicate with clients clearly, both verbally and non-verbally. For those with visual impairments, I would use tactile or audio cues, such as gently tapping on their body to facilitate movement or tapping on objects to alert the client of its location. For those with hearing impairments, I would amplify my voice or write on a dry erase board, as seen in the example below:
Many clients I encountered in home health had visual impairments, such as glaucoma, macular degeneration, or diabetic retinopathy. Many clients also had age-related hearing loss, so verbal communication was sometimes challenging. It was always important for me to communicate with clients clearly, both verbally and non-verbally. For those with visual impairments, I would use tactile or audio cues, such as gently tapping on their body to facilitate movement or tapping on objects to alert the client of its location. For those with hearing impairments, I would amplify my voice or write on a dry erase board, as seen in the example below:
3. Collaborates with clients and caregivers in establishing and maintain a balance of pleasurable, productive, and restful occupations to promote health and prevent disease and disability.
While the primary focus of home health was to help clients return to the highest possible level of independence with activities of daily living (ADLs), it was equally important to help clients return to occupations they loved, such as gardening, painting, or doing projects in their workshops. One client mentioned that gardening brought them joy, but the client had been unable to go outside safely because of their condition causing increased fatigue and decreased strength and endurance. I believed it would be motivating for the client to be able to return to this hobby. In creating a holistic plan of care, I included a goal for household management. The occupational therapy assistant would then be able to instruct the client in areas like dynamic standing balance on unlevel surfaces and functional reach to address their gardening goals.
While the primary focus of home health was to help clients return to the highest possible level of independence with activities of daily living (ADLs), it was equally important to help clients return to occupations they loved, such as gardening, painting, or doing projects in their workshops. One client mentioned that gardening brought them joy, but the client had been unable to go outside safely because of their condition causing increased fatigue and decreased strength and endurance. I believed it would be motivating for the client to be able to return to this hobby. In creating a holistic plan of care, I included a goal for household management. The occupational therapy assistant would then be able to instruct the client in areas like dynamic standing balance on unlevel surfaces and functional reach to address their gardening goals.
4. Inspires confidence in clients and team members.
Many clients were discouraged by their conditions, especially when they were unable to take care of themselves or others. It is disheartening to not be able to complete tasks as intended, but task training and modifications can make it possible again. I encouraged clients to acknowledge their feelings while focusing on the positive to promote recovery. I celebrated small victories with them, such as initiating tiny movements in a finger following a cerebral vascular accident (CVA), or increasing range of motion in a shoulder by a few degrees following a replacement. Uplifting clients played a critical role in guiding them to reaching their goals.
Many clients were discouraged by their conditions, especially when they were unable to take care of themselves or others. It is disheartening to not be able to complete tasks as intended, but task training and modifications can make it possible again. I encouraged clients to acknowledge their feelings while focusing on the positive to promote recovery. I celebrated small victories with them, such as initiating tiny movements in a finger following a cerebral vascular accident (CVA), or increasing range of motion in a shoulder by a few degrees following a replacement. Uplifting clients played a critical role in guiding them to reaching their goals.
5. Considers client motivation when using occupation based intervention to maximize functional independence.
The tasks involved to achieve functional independence vary for each individual. Some clients are able to feed themselves by ordering food or warming up prepared meals, while others prefer to cook their own meals. It would not have been appropriate to assign meal preparation goals for clients who were content to have prepared meals; functionally, they were able to feed themselves. I provided education on the benefits of preparing meals and ensured they could complete the necessary tasks from set-up to clean up. Then, I chose to focus on goals that were more motivating and meaningful to the clients, such as being able to transfer into and out of the shower as safely and independently as possible.
The tasks involved to achieve functional independence vary for each individual. Some clients are able to feed themselves by ordering food or warming up prepared meals, while others prefer to cook their own meals. It would not have been appropriate to assign meal preparation goals for clients who were content to have prepared meals; functionally, they were able to feed themselves. I provided education on the benefits of preparing meals and ensured they could complete the necessary tasks from set-up to clean up. Then, I chose to focus on goals that were more motivating and meaningful to the clients, such as being able to transfer into and out of the shower as safely and independently as possible.
6. Applies theory regarding the therapeutic use of occupation and adaptation to screen and evaluate, plan, and implement intervention, while establishing and maintaining a therapeutic relationship with the client.
I had many opportunities during my fieldwork rotations to apply the theories I had learned in my classes and implement them through evaluations and interventions practically and therapeutically. While the methods are driven by science and evidence, the practice must remain client-centered and motivational. During my rotation at the behavioral health center, I often used the Model of Human Occupation theory to address the youths’ motivation to complete necessary and desired tasks, habits and routines essential to their well-being in a highly structured setting, and assess their ability to perform these tasks. In the screenshot below, I discussed the tools and strategies I learned through direct experience:
I had many opportunities during my fieldwork rotations to apply the theories I had learned in my classes and implement them through evaluations and interventions practically and therapeutically. While the methods are driven by science and evidence, the practice must remain client-centered and motivational. During my rotation at the behavioral health center, I often used the Model of Human Occupation theory to address the youths’ motivation to complete necessary and desired tasks, habits and routines essential to their well-being in a highly structured setting, and assess their ability to perform these tasks. In the screenshot below, I discussed the tools and strategies I learned through direct experience: