A MODEL TO PROMOTE ACTIVITY COMPETENCE IN ELDERS

This paper describes an occupational therapy home-based intervention in which purposeful activities were used to promote adaptation and competence in older adults with chronic disabilities Seven home care therapists visited 17 randomly selected, community-living elders who were chronically disabled and who volunteered to participate in the program. The number of visits ranged from 3 to 10 and occurred over a 3-month period according to clients' needs and wishes Therapists enhanced their ability to enter the client's social and cultural system by using participant-observation techniques and collaboratively identified activities. Therapists documented each home visit with a structured field note form. An analysis of 112 field-notes indicated that therapists were able to under stand a client's needs; this understanding resulted in small qualitative gains in areas identified as important by the client. Reilly's concept of an activity continuum was a useful framework from which to work with this population The implications for program-development, treatment outcomes, and accountability with this approach promote improved future treatment planning with the elderly with chronic disability.