Date implemented:

Clients Initials and Age: XX, 64 yrs Time allotted for session: 60 minutes
09/20/2017
Diagnosis and any Precautions: Muscular dystrophy, moderate cognitive impairment, acute renal failure,
major depressive disorder (suicidal ideations), malnutrition. Pt is on fall precaution d/t decreased balance.
Goals being addressed: Pt will improve UE dressing performance from min A to mod I. Pt will increase grooming/hygiene skills from min
A to mod I. Pt will demonstrate functional mobility when performing ADL and IADL tasks Ily.
Other impairments being addressed: Decreased balance (static and dynamic), moderate cognitive impairment
Results (link to activity
Activity Demands
Specific Objectives for objectives; include Modifications (provided
Intervention Activities (setting, materials, and
this activity objective measures of during the activity and
social requirements)
performance when planned for next session)
possible)
Performing a morning
routine requires
(preferably) a bathroom for
the pt to wash along with a Pt performed making her
1. Assess pts decent sized space to bed with set up of clean
functional mobility allow room for pt to dress linens at bedside. Pt
when moving from comfortably. A morning demonstrated improved
bed to bathroom to routine requires materials functional mobility while
brush teeth including a toothbrush, ambulating around bed and
2. Assess pts ability to toothpaste, washcloths, increased dynamic
demonstrate UE and shampoo, soap, towels, standing balance while Pt was met in room already
LE dressing clean clothing, and any securing fitted sheet on dressed and brushing her
3. Assess pts dynamic necessary adaptive mattress. teeth. To improvise, pt
Perform morning routine
standing balance equipment. It is a social made her bed and put on
(25 minutes): ADL tasks
while brushing teeth requirement that someone Pt sat at bedside and her shoes and socks. I was
including brushing teeth,
and washing face be neat and clean before demonstrated putting on pleased with my quick
washing face, showering,
taking on their day. For this shoes and socks Ily. Pt improvisation. I would plan
dressing, etc.
It is imperative that OT be reason a morning routine is demonstrated increased to evaluate pts full
able to asses a pts ADL important! dynamic sitting balance dressing routine next
performance in an inpatient when bending at the waist session before d/c.
setting to determine Grade down this to don socks and shoes. Pt
precautions and assistance intervention by having pt verbalized that she was
required for pt to be perform morning routine in much better at donning her
successful in a morning bed with bedpan. socks and shoes and that
routine once they are she was no longer getting
discharged. Grade up this intervention dizzy when standing after
by having pt stand while donning them.
brushing teeth to increase
dynamic standing balance.

1. Pts cognitive ability
to efficiently count
an amount of money
Money management (10
that is presented to
minutes): Student will
them.
utilize money
2. Pts cognitive ability
management kit and
to return the correct
simulate purchasing
amount of change
situations. Pt will be asked
back to customer.
to provide the correct
amount of change. For
This intervention works to
example student will
exercise higher-level
purchase an apple for
cognition while also
$1.25 and will pay with $5.
increasing I in money
Pt would then be
management required to
expected to give student
purchase items at a store
$3.75 back in change.
(assuming pt uses cash).
*See Gibson abstract
Preparing a hot meal (25 1. Pts safety
minutes): Pt will prepare a awareness in the
simple hot meal (ie. mac kitchen.
& cheese or oatmeal) in 2. Pts functional
the kitchen utilizing the mobility in the
stovetop. Pt will access kitchen.
kitchen tools and 3. Pts ability to follow a
ingredients needed and recipe/directions as
will cook the simple meal. stated on the
This activity requires a
tabletop, mock money ($1,
$5, $10, $20 bills, and
coins), and grocery items if
simulating purchases at a
store (not required but
preferred). To be able to
make purchases with cash,
it is required that a person
know how to manage their
money so that they pay
enough for items but also
Did not utilize money
so that they know they get
management activity in
their correct amount of
session because
change back.
Results for this intervention supervising therapist had
activity were not obtained just used money
Grade down this activity by
(see modifications). management intervention
simply asking pt to present
with pt the previous day. It
a certain amount of money
was suggested we move
(Can you show me
onto another intervention.
$3.25?).
Grade up this activity by
simulating a purchase
situation that requires the
pt to calculate change
(This apple is $1.25. If I
give you this $10 bill, how
much change do you owe
me?).
This activity requires a pot, Pt ambulated Ily to
boxed macaroni and dayroom to complete D/t time restriction, we did
cheese (ingredients include safety awareness activity not have time to go down
butter, milk, noodles, and and required skilled to the kitchen. We walked
cheese powder), water, a instruction on how to push to the dayroom down the
stovetop, a large mixing herself up on arm rests hall from pts room and
spoon, and a pot when moving from sit to used a safety awareness
holder/oven mitt. This stand. Pt participated in picture book to identify
activity does not have any safety awareness task of hazardous situations. If
 oatmeal or mac &
cheese box.
This intervention assesses
many things including
functional mobility, dynamic
standing balance, safety
awareness, and ability to
follow directions all within
the occupation of cooking.
Along with this, cooking a
meal safely and Ily is an
important skill for pt to have
before moving back home.
*See Gibson abstract
social requirements unless
you may be cooking for
company.
Grade down this activity by
cooking with a microwave
rather than a stove.
Grade up this activity by
making a recipe from
scratch rather than using
provided ingredients.
recognizing hazardous
situations in pictures with
mod I required for
increased time once every
four pictures. Pt
demonstrated increased
safety awareness
throughout safety
awareness activity.
time permitted, to grade
this up I would have had pt
cook oatmeal in the kitchen
like originally planned to
assess safety awareness
in a real life situation. I
would try to utilize this
cooking intervention next
session if time allowed.

S/OT name: Stephanie Janecek

Citation: Robert W. Gibson, Mariana DAmico, Lynn Jaffe, Marian Arbesman; Occupational Therapy Interventions for Recovery in the Areas of
Community Integration and Normative Life Roles for Adults With Serious Mental Illness: A Systematic Review. Am J Occup Ther 2011;65(3):247-
256. doi: 10.5014/ajot.2011.001297.

Abstract: This systematic review investigated research literature evaluating the effectiveness of occupational therapy interventions focusing on
recovery in the areas of community integration and normative life roles for people with serious mental illness. The review included occupation- and
activity-based interventions and interventions addressing performance skills and performance patterns, aspects of context and environment, activity
demands, and client factors. The results indicated that the evidence of the effectiveness of social skills training is moderate to strong. The evidence
for the effectiveness of life skills and instrumental activities of daily living (IADLs) training to improve performance is moderate, as is the evidence for
neurocognitive training paired with skills training in the areas of work, social participation, and IADLs. The evidence for client-centered intervention
and increased intensity and duration of treatment is limited but positive, and the evidence that providing intervention in the natural context is more
beneficial than in the clinic setting is inconclusive.

Reasoning: Occupation based intervention has been proven to have better outcomes than non-occupation based intervention. This article
researches this idea with adult patients with mental illness and relates to this specific patient due to their struggle with depression and suicidal
ideation. Gibsons article states that several studies identified experiential participation in occupations related to self-management, home
management, cooking, and community integration tasks related to obtaining education and work, managing money, and maintaining healthier
behaviorsImprovement was noted in these occupation-based programs (Gibson, DAmico, Jaffe, Arbesman 2011). For this reason, I chose to
focus on all occupation based interventions in my treatment plan.