The Rehabilitative Frame of Reference
At the skilled nursing facility, I used the rehabilitative frame of reference daily. The rehabilitative frame of reference focuses on making the individual as functional as possible despite their impairment. This could involve coming up with compensatory strategies so the individual can perform their occupations more independently. It could also include modifying the task or the environment so the client can be more successful when performing their occupations. I incorporated the rehabilitative frame of reference at the skilled nursing facility with an individual who was in the early stages of dementia. She had also had a recent fall that resulted in a hip injury. While screening and evaluating the client, I learned that she loved to cook. She had been a homemaker all of her life, and her children were her whole world. She was also really close with her grandchildren who were now in college, and only came home on weekends and holidays. One of her main concerns was being unable to cook for her family whenever she returned home. She said that she is becoming more and more forgetful, and now she is afraid that if she tries to cook it would not be good, because she would forget an ingredient. She is also now afraid of maneuvering around her kitchen, because that is where she fell while she was at home. In order to help her become more confident and engage in her meaningful occupations, I had her write down all of her favorite recipes that her family loved. This way, she would not have to remember all of the recipes as her dementia progressed, she could just follow the instructions that she had written down. The one attached below is a red velvet cake recipe that her granddaughter would request every time she came home from school. Also, to decrease her fear of falling we performed a lot of cooking tasks in the ADL suite at the facility. We had a meeting with her and her family where we discussed easy ways to adapt the environment to prevent falls. We also went over strategies to help the client remember kitchen safety, such as setting a timer to remind her to turn off the oven after she uses it. By using the rehabilitative frame of reference and implementing client- centered interventions, I believe I established a great therapeutic relationship with my client.
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