Ayessa Escandar

Occupational Profile
1. Client name: Epinaida Mendiola
2. Age: 56
3. Sex: Female
Briefly discuss each of the following:
4. Who is the client?
Epinaida Mendiola is a 56 year old woman who is currently working as an
accountant and who is also a mother.
5. Why is the client seeking services and/or what are the clients concerns relative
to engaging in occupations and in daily life activities?
The client is seeking occupational therapy services because she is experiencing
lower back, neck, and hip pain while engaging in her occupations of financial
management, home management, and while also working as an accountant. She
is concerned on how to alleviate the pain or how to stop the pain from
progressing.
6. In what occupations does the client feel successful and what barriers are
affecting his or her success?
The client is successful in performing her occupations of working, home
management, financial management and while participating in leisure activities.
She is able to perform all her occupations thoroughly and never fails to complete
a task. However, she feels that often when she performs her occupations the
main barrier that affects her from completing the activities in a faster manner is
the pain she receives from her lower back, neck, and hips. Therefore due to
these pains, she often will work in a slower manner because the pain is a
nuisance to her. The specific event where the pain is most prominent is when
she performs the occupation of work. Specifically, when she is in a seated
position in front of a computer typing for long hours.
7. What apsects of his or her environments or contexts does the client see as
supporting engagement in desired occupations and what aspects are inhibiting
engagement?
When the client engages in the occupation of financial management some
aspects in the environment that supports her engagement in the activity is
having a space where the client can lay out all her materials and have access to
the necessary tools and equipment that is needed to pay her bills, such as her
office space. It was also important that the client work in an environment where
she can function her best in, such as bright lighting, have room temperature,
and a noise level that is minimum.

8. What is the clients occupational history?

The clients occupational history is that she has been working as an accountant
for 36 years; therefore her occupational history is employment interests and
pursuits, employment seeking and acquisition, and job performance. She has
also been a mother for 25 years; therefore some of her occupations for the past
25 years are child rearing, home establishment and management, and shopping.
9. What are the clients values and interests?
The clients interests are maintaining her financial management, performing the
requirements of her job as an accountant, providing care for her child,
maintenance of health management, and meal prepping more nutritious meals.
The clients value is to maintain a healthy and satisfying life by eating healthier
and participating in leisure and social participation with family and friends, so
that she can live a better and more balanced life style.
10.What are the clients daily life roles?
The clients daily life roles are working as an accountant, performing home and
health maintenance and management, meal prepping nutritious and healthier
meals, and performing her ADLs such as showering, toileting, dressing, eating,
functional mobility, and personal hygiene.
11.What are the clients patterns of engagement in occupations?
The clients daily pattern of engagement in occupation is performing her
activities of daily living by showering, dressing, eating, and performing personal
hygiene before going to work. In order for the client to get to work she drives to
her destination using her vehicle. Once the client arrives to work she performs
the requirements of a job by performing her duties as an accountant. Once the
client comes home from work she prepares herself a healthy meal and
participates in a leisure activity, such as enjoying her daily television shows.
Also, before going to bed, the client participates in her occupation of health
management by doing yoga or walking on the treadmill.
12.What are the clients priorities and desired targeted outcomes related to
occupational performance?
The clients priority is to improve her physical health by decreasing her pain in
her back, hips, and neck so that she can perform her occupations in a faster,
pain free manner. She would also like to enhance her skills in her performance
by increasing her strength and stamina so that she does not get easily fatigued
when engaging in her occupations.

Occupational Analysis
1. Occupation: Paying bills
Categorization of occupation for the client:
Subcategory:
1. Activities of daily living
2. Instrumental activities of daily living Financial Management
3. Education
4. Work
5. Play
6. Leisure
7. Social participation
2. Values, beliefs, spirituality associated with participation:
Values: As a single mother her acquired beliefs and commitments are towards
providing and caring for her children. Therefore, financial management is an
important priority because in order for her to maintain her household, provide a
safe environment, and provide the necessities for herself and her children it is
important for her to balance her finances. Especially because she is a single
mother, her finances are more limited; therefore it is more of a necessity to
manage her income and expenditures.
Beliefs: The clients belief is if she stays organize in her budgeting and finances,
she will be able to save more money, raise her credit score, and it will help her
make wiser finance choices for the future. Also, because almost everything in life
comes with a price, the client believes if she continues to make wise financial
decisions today, she will be able to afford things she wants in the future.
Spirituality: Was not applicable when the client performed her activity of paying
her bills.

3. Contexts:
Context
Physical/space
demands

Supports
The clients office and
office desk serves as a
place where she can
properly work on her
budgeting and where she
can pay her bills. This is a
place where all her
materials for paying her
bills are present, such as
her receipts, paperwork,
computer, and

Inhibits
The client did not have any
physical or space demands
that inhibited her from
performing her activity of
paying her bills.

checkbook.
Social

Through the clients

activity of paying her bills,
her sister was present in
the clients office and
would help clarify some of
the expenses that were
stated on the clients
bank statements and on
the receipts. Therefore,
the client would receive
aid when a problem
appeared.

Cultural

In the clients household

there are roles that are
taken place between her
and her sister. The clients
role is to balance the
budget between
groceries, cable, and the
electricity bills, while the
sisters role is to take care
of other financial
management. This
activity pattern was made
so that there is
organization within the
household and so that
every bill gets paid for.
The client is a 56-year-old
single mother who
engages in the occupation
of paying her bills.
The client engaged in the
activity of paying her bills
for one hour.

Personal

Temporal

Virtual

When the client pays her

bills online, the bill is set

Although the clients sister

would help clarify some
information that were
stated on the clients
receipts, there would be
some instances where the
clients sister would
converse with her about
other issues or events that
did not relate to the
activity of financial
management. Therefore, it
could have been a little
distracting for the client.
The client and her sister
have to trust one another
that they are both doing
their duties. If one of them
does not do their duties in
financial management,
bills will be paid late and it
will affect both of their
credits.

There are no inhibitory

factors to her personal
context.
The client engaged in the
activity of paying her bills
for one hour, however
could of possibly done it in
a faster manner if she did
not hold conversations
with others not regarding
her task at hand.
One problem that could
occur if the client pays her

on a specific date to make

sure that she does not
pay her bills late. Also,
when she logs into her
account where it states
her bill, it displays the
most current bill.

bills online, is if the

payment does not get sent
through or if the internet
gets shut down, her
payments could be
possibly sent late.

4. Objects and their properties used:

Tools: Calculator and cellphone
Supplies: Pen, receipts, bank statements, and checkbook
Equipment: Computer and shredder

5. Social demands:
Social Environment: The client converses with her sister regarding information
that is stated on her receipts or on her bank statements.
Cultural and virtual context: The client reads information that is stated on the
website that she logs in to. She also follows directions that are stated on the
website regarding how to pay her bills and whether or not her payment was
processed.
Rules and norms: The client follows the rules and norms of paying her bills on
time. The client looks at the dates and determines how far in advance she would
like to pay for her bills to ensure that her payments are not late.
6. Sequence and timing:
1. The client walks towards her office.
2. The client opens the door to her office.
3. The client walks towards her computer desk.
4. The client opens the first drawer.
5. The client takes out her black folder.
6. The client places the black folder on her desk.
7. The client takes out her cell phone.
8. The client places her cell phone on her desk.
9. The client takes out a pen.
10. The client places the pen on her desk.
11. The client closes the first drawer.
12. The client goes to the top shelf of her desk.
13. The client opens the box.
14. The client takes out her past receipts from that month from the box.

15. The client takes out her past envelopes with bank statements from the box.
14. The client places the receipts and envelopes on her desk.
15. The client sits down on her computer chair.
16. The client sits in front of her computer desk.
17. The client turns on the computer.
18. The client opens her excel file.
19. The client opens the black folder and takes out her checkbook.
20. The client places in receipts in chronological order.
21. The client checks if her receipts match her bank statements.
22. As the client matches her receipts to her bank statements, she places check
marks on them once they match.
23. The client uses her old cell phone to calculate some numbers.
24. The client opens her second drawers and takes out the calculator.
25. The client uses the calculator instead to calculate.
26. Once the client goes through each of her bank statements she looks at each
bank statement and checks the due date.
27. The client then looks at her other bills and checks when those are due.
28. The client types in her excel sheet the amount of each bank statement.
29. The client sums up all the amounts for that month that she typed on the
excel sheet.
30. The client goes to her banks website and logs in.
31. The client goes to the clicks on the tab that states, pay for credit card.
32. The client types in the amount she owes for the credit card.
33. The client presses the pay button on the website.
34. The client logs out of her banks website.
35. The client goes to her homes Internet website.
36. The client logs into the Internet website.
37. The client clicks on a tap that states, pay bill.
38. The client places an amount into the box.
39. The client presses the send button.
40. The client logs out of her account on the Internet website.
41. The client opens her checkbook.
42. The client picks up her pen and writes a check.
43. The client tears out the check from the checkbook.
44. The client stands up from her desk and walks to her sister.
45. The client gives the check to her sister.
46. The client walks back to her computer chair.
47. The client sits down.
48. The client grabs her old bank statements and shreds them.
49. The client grabs her old receipts and throws them away in the trashcan.
50. The client closes her checkbook and places it back into her black folder.
51. The client opens the first drawer and puts her black folder, pen, and old
cellphone back in.
52. The client closes the first drawer.
53. The client opens the second drawer and puts back her calculator.
54. The client closes the second drawer.
55. The client closes all the windows that are open on her computer desk.
56. The client turns off the computer by logging off.

7. Body functions required: (financial management)

Function

How It Is Used

Judgment

The client has to

determine what
bills she should
pay first, taking
into
consideration
the due dates of
each bill. She
also has to
determine which
bills have
already been
paid and
whether or not
she should put
those receipts
away or place
them in a nice
pile to the side
of her.
The client
understands the
dates of each
receipt and
places them in a
numerical
formation where
the most current
receipt is placed
on the bottom
of the stacked
receipts. She
also divides the
receipts into
separate piles
based on the
locations where
the receipts
were obtained.
If a problem
occurs with the
bill, such as the
bill stating a

Concept formation

Metacognition

None

Minimally
Challenged

Greatly
Challenged

Cognitive flexibility

charge that the

client could not
recall
purchasing, she
analyzes the
problem by
recalling
purchases shes
made on that
day and makes
a solution by
looking through
all her receipts
to check if it
matches the bill.
When the client
was calculating
her expenses by
using the
calculator on
her IPhone, one
problem that
would typically
occur would be
pressing the
wrong numbers.
This problem
occurred due to
the fact that it
was a touch
screen and she
could not feel
the buttons she
was pressing.
Therefore, when
she recognized
that this was a
continuous
problem she
changed her
strategy by
using an actual
calculator where
she could feel
the buttons that
were being

Insight/awareness

Concentration

pressed.
The client is
aware of her
knowledge and
ability to
calculate her
expenses by
using a
calculator and
an excel
worksheet on
the computer to
organize and
compute her
bills instead of
just using a pen
and paper to do
so. She is also
aware that this
process of using
a computer and
calculator to
calculating and
organizing her
bills will only
benefit her by
saving her time
and eliminating
mistakes.
Concentration is
needed when
she is paying
her bills
because she has
to organize her
materials, such
as her receipts
and envelopes
with bills, she
has to
chronologically
place all her
receipts in
order, and do
checks and
balances

Sustained attention

Selective attention

between the
amount of
money she has
spent
throughout the
month versus
how much
money is left in
her account.
The client
sustains her
attention for a
long period of
time by
concentrating
on what receipt
matches with
what bills, if the
amount on the
receipt matches
that statement
of her credit
cards, which
bills she has
already paid for,
and overall she
concentrates on
whether or not
her
computations
are correct.
While the client
is at her desk
paying bills,
there are other
several events
that are
simultaneously
occurring
around her,
such as her
sister folding
clothes and her
nephew
watching
television.

Divided attention

Short-term memory

Therefore, to be
able to finish
her tasks of
paying her bills,
she uses
selective
attention so that
she may
concentrate
only on her
activity for the
majority of the
time.
Through the
activity of
paying her bills,
the client
showed the
ability to focus
on typing the
amount of the
receipts onto an
excel sheet
while also
conversing with
her sister and
nephew. As she
continued to
converse with
them, she still
remained to
stay
concentrated on
her activity by
checking her
statements
online.
As the client
checks her
receipts by
looking at the
location she
bought the item
and how much
she paid for it,
she looks at the

Working memory

Long-term memory

amount and
memorizes it for
a short period of
time in order to
type the amount
on an excel
sheet. She
continued to do
this process
with all her
receipts and
would recall the
amount that
was stated on it
in order to
calculate the
amount and
have it in a
sequential
manner.
While the client
was in the
process of doing
her activity of
paying her bills,
she had to use
working
memory in order
to go through
the steps. She
had to actively
use her working
memory in order
to read her
statements,
write checks,
through away
receipts she was
done with, and
categorize bills
on her excel
sheet.
Before doing the
activity of
paying her bills,
the client had to

Discrimination of senses:
Auditory

Discrimination of senses:
Tactile

first organize
her environment
it order for it to
be a smooth
and easy
process. To be
able to do this,
the client first
had to have all
her materials
ready and in the
process she had
to use long-term
memory to
recall where she
had placed her
materials from
weeks ago. She
had to recall
where she
placed all her
receipts,
calculator, mails
with bills, and
writing utensils.
The clients
auditory sense
did not have to
be used in order
to complete the
occupation of
financial
management.
When the client
had to write
checks to pay
for her bills, she
had to touch
and rub the
front of the
check in order
to distinguish
that she is
tearing out only
one check from
her checkbook.

Discrimination of senses:
Visual

Discrimination of senses:
Olfactory

Also, when she

typed on the
keyboard she
had to
differentiate the
texture between
the buttons and
the hard surface
of the keyboard
in order to
ensure that she
was pressing a
button rather
than pressing on
another part of
the computer.
The client uses
her visual sense
throughout the
process of
paying her bills.
She uses it to
find the
materials she
needs and
places it in
areas where she
can stay
organized. While
she also uses it
to physically
look at the
information on
her receipts and
statements in
order to
interpret the
information.
The clients
olfactory sense
did not have to
be used in order
to complete the
occupation of
financial
management.

Discrimination of senses:
Vestibular-proprioception

Multisensory processing

The client
positioned
herself in a
distance that is
fairly close to
her computer
desk in order to
reach the
keyboard where
she would be
typing, while
also having
access to
additional
materials such
as her receipts,
calculator,
checkbook, and
writing
materials within
arms reach. She
was also
conscious of her
body position by
placing herself
in a distance
that was fairly
close to the
shredder
because she
would often turn
and shred bills
that were no
longer needed.
In order for the
client to pay for
her bills, she
uses a check as
a method of
payment.
Therefore, she
uses her tactile
sense to rip the
check out of the
checkbook while
using her visual

Sensory Memory

Spatial relationships

sense to see
whether the
check is
physically
getting torn out.
In order for the
client to perform
the activity of
paying her bills,
she must
process what is
being shown,
such as the
amount that are
being shown on
receipts or on
her statements;
than using that
information to
logically think
and recall the
event she made
that purchase in
order to
reassure that
there are no
mistakes on her
credit card
statements.
The client
understood that
in order to work
proficiently her
working
materials had to
be within arms
length.
Therefore, she
placed all her
receipts and
credit card
statements in
one pile near
the computer
and calculator in
order to easily

Temporal relationships

Recognition

view the items

as she typed in
into the
computer. She
also positioned
the shredder
close to her
desk so that it
could be within
arms reach
when she
shredded her
old credit card
statements.
The client had
knowledge
about what time
she started the
task of paying
her bills and
understood the
allotted time
she had to
complete it in
order for her to
still cook dinner
after.
The client was
able to
recognize which
receipts she had
already looked
over because
she was able to
distinguish
which piles were
for the ones that
have been
completed and
the ones that
have not. She
also was able to
recognize that
she was typing
on the keyboard
and pressing a

Categorization

Generalization

Awareness of reality

button through
her touch and
hearing
sensations. She
was able to
physically feel
the keys being
pressed while
also hearing a
clicking noise.
Before the client
actually began
to pay her bills,
she would place
her items in a
categorical
method. She
would place all
her receipts in
one pile while
her credit card
statements
were in another.
Another
occupation that
the client
performs is
being an
accountant.
Therefore, the
excel skills that
she uses within
her work is also
used when she
organizes and
calculates her
bill through
excel. She uses
her skill of
preparing
financial records
for her work the
same way to
organize her
bills at home.
The client was

Logical/coherent thought

Appropriate thought
content

aware that she

had performed
her activity of
paying her bill in
her home,
specifically in
her office on her
computer desk.
The client
recognized in
order to
proficiently pay
her bills; she
had to first
organize her
materials in
order for it to be
accessible in a
timely manner.
Also, she
understood by
placing her
receipts in
chronological
order it would
be easier to
match the
receipts to the
credit card
statement
based on the
dates and the
items that were
purchased.
As the client
looked at the
credit card
statements and
looked at the
amount that
was purchased
at each location,
she would think
out loud stating
that she
remembered

Mental functions of
sequencing complex
movement

Regulation and range of

emotion

going those
places and
stating what she
bought. Also, if
there is an
unfamiliar item
on the credit
card statement,
she would go
through her
receipts to
check on
whether or not
she actually
made those
purchases.
The activity of
paying bills for
the client was a
long process
and required
much time
sitting on a
chair. Therefore,
the client would
often tap her
feet or shake
her leg in order
to have blood
flow to her feet.
She often would
switch seating
positions in
order for her
legs to not fall
asleep.
The client would
compute and
use excel on a
fairly old
computer.
Therefore, the
client would
have to retain
frustration when
the computer

Appropriateness of
emotion

Coping

Behavioral regulation

would often take

long or display
action in a slow
manner.
The client
remained in a
calm manner as
she completed
that activity of
paying her bills.
In order to not
make
calculation
mistakes, she
had to regulate
any negative
emotions so
that it would not
distract her at
the task as
hand.
When there
appeared to be
a mistake on the
clients credit
card statement
by stating a
charge that she
felt she made
not make, she
handled the
crisis by trying
to recall the day
she made that
purchase and
than she looked
through her past
receipts to
check if she
really did make
that purchase.
When the client
was confused
about the
amount she
spent on a

Body image

Self-concept

Self-esteem

Arousal

certain location
that was stated
on her credit
card bill, she
expresses the
confusion by
making a facial
expression that
showed that she
was puzzled.
While the client
performed the
activity of
paying her bills,
she did not
need to be
aware of her
own body
image.
This was not
needed for the
client to perform
her activity of
paying her bills.
The client
displayed
confidence in
the ability to
pay for her bills,
by
demonstrating
efficiency on
how she
conducted the
process. She
had developed a
system of what
steps are
needed to be
taken in order to
pay her bills in
an organized
and fast
manner.
The client
displayed

Consciousness

Orientation to self

Orientation to place

alertness of her
environment by
listening to her
sister converse
with her, while
also
continuously
doing her
activity of
paying her bills.
The client
displayed the
ability to stay
alert and aware
of the task at
hand by
constantly
paying
attention.
Although she
would converse
with her sister
and nephew,
she continued to
focus on her
calculations and
which bills were
already paid for.
The client
understood
what her name
is which was an
important factor
when paying
bills because
she had to login
to her online
accounts using
her name and
password in
order to check
her online credit
card
statements.
The client
understood the

Orientation to time

Orientation to others

Energy level

location she was

in, specifically
her home in the
office where she
always does the
task of paying
her bills.
The client
understood
what month and
date it is in
order to
determine when
to pay her bills
and what dates
are stated on
her receipts and
statements. The
client has to be
conscious of the
date in order to
not pay her bills
late.
The client did
not display this
or this would
have not
affected her
activity of
paying her bills.
The energy level
needed for the
client to
complete the
activity of
paying her bills
is minimal,
however she
needed enough
energy so that
she could
concentrate on
making
calculations and
recalling past
purchases she

had made.
Function

How It Is Used

Motivation

The client
displayed
internal
incentive by
showing her
concentration
and focus on
finishing her
activity of
paying her bills.
She did not let
other stimulus
that were
occurring in the
environment to
distract her
because she
knew that if she
did not pay the
bills on time her
credit would get
ruined.
The client
contained the
impulse to do
other activities,
by only staying
concentrated on
the activity of
paying her bills.
Also, the client
frequently used
the computer to
look at online
bank
statements,
however she
would never got
distracted and
did not look at
other websites
that did not
relate to her

Impulse control

None

Minimally
Challenged

Greatly
Challenged

Appetite

Sleep

Detection/registration

Visual modulation

current task at
hand.
The client did
not display this,
nor was it
necessary for
her to complete
the task.
The client did
not need to
partake in this
in order to
complete that
task of paying
her bills.
The client
detects the light
that the
computer
displays in order
to view the
colors, pictures,
and numbers
that the online
website was
showing, Also,
the client uses a
red pen to make
check marks on
her credit card
statements she
has checked,
therefore she
detects the
color of her red
pen in order to
distinguish that
she has already
checked those
statements.
The client
showed
concentration of
only looking at

Integration of senses

Awareness at distances

one line at a
time on her
bank statement
in order to
isolate it so that
she would not
lose track on
what items she
has already
looked or did
not look at. By
following this
process, the
client was able
to keep herself
organize and
not get over
stimulated by
looking at too
many items at
once.
The client
integrated the
senses of using
sight and touch
in order to
check her bank
statement. She
would simply
place her finger
on each line of
her bank
statement so
that she could
isolate a
particular item
while blocking
the others,
while also using
her sight to view
the item.
The client is
near sighted;
therefore she
would place
herself in a

Tolerance of ambient
sounds

Location and distance of

sounds

Moving against gravity

distance that is
close enough to
what is being
looked at in
order to have
the best visual
acuity. She also
placed items
close to her so
that she did not
have to look far
to detect it.
The client
worked in an
environment
where her sister
and nephew are
present;
therefore other
noises were
taken place
around her.
However, the
client displayed
the ability to
drown out the
noises and
voices around
her as she did
the activity of
paying her bills.
The client would
locate her
sisters voice
when she would
talk to her, as
the client
continued to do
her activity of
paying her bills.
When the client
is in a seated
position and
grabs her
receipts and
other paper

Taste

Smell

Body in space

Comfort with touch

work from the

top of the shelf
on her desk, she
moves her arm
against gravity
in order to reach
her materials.
The client did
not need to use
her sense of
taste in order to
complete the
activity of
paying her bills.
The client did
not need to use
her sense of
smell in order to
complete the
activity of
paying her bills.
When the client
is in a seated
position in front
of her computer
on her desk, she
moves towards
the direction of
the shredder
when she is
done looking at
her bank
statements and
shreds them.
She than moves
back to her desk
in order to
return to her
workspace.
The client
displays comfort
with touch,
when she is in
contact with
various that is
needed to pay

Localizing pain

Thermal awareness

her bills, such as

a pen, pressing
buttons on the
keyboard,
tearing out a
check from the
checkbook,
pressing the
bottom from the
mouse, and
touching the
receipts and
statements.
The client
expresses pain
in her hips when
she is sitting
down too long
while she is
doing the
activity of
paying her bills.
This pain occurs
because the
client currently
has the
condition of
osteoporosis in
her hipbones.
The client is
able to perform
the activity of
paying her bills
in the most
optimal level as
long as the
temperature in
the room was
room
temperature. As
she currently
performed her
activity she was
able to
acknowledge
that the

Joint mobility

Joint stability/alignment

temperature
was cool due to
the air
conditioning
that was on in
her home.
The client
needed to reach
forward in order
to grab
materials that
were needed.
She also needed
to move
towards the
shredder when
she needed to
shred old bank
statements.
Lastly, she
would than
move towards
back her desk in
order to
continue doing
the rest of her
payments.
The client
displays joint
stability and
alignment when
writing in her
checkbook and
tearing out a
check. The
client has to
stabilize her
wrist so that she
can write, and
when tearing
out a check she
has to use a
certain force so
that she can
tear it out while
also being

Muscle power

Muscle tone

Muscle endurance

conscious of not
exerting too
much force or
the check could
possibly rip.
The client used
minimal muscle
power when
performing the
activity of
paying her bills
because not
much effort or
force needed to
be exerted
when writing,
tearing, or
typing.
The clients
muscle tone is
increased in her
hands when she
has to tear out a
check from the
checkbook.
Also, when the
client is typing
on the
keyboard, she
has to exert a
little more effort
so that the
button will be
pressed down.
The client
displayed
minimal muscle
endurance,
however she
used it as she
would grab
items that were
on the top shelf
of her desk,
such as past
paper work,

Stretch reflex

ATNR

STNR

Righting and supporting

reflex

Eye-hand coordination

check booklet,
and past
receipts.
Not applicable
to the clients
activity. The
client did not
physically move
that often,
therefore it did
not occur.
No infants will
be participating
in the activity.
No infants will
be participating
in the activity.
When the client
slightly bent
backwards to
reach the
shredder, she
would use
balance so that
she would not
fall backwards.
After slightly
bending
backwards to
reach for the
shredder, the
clients body
would position
itself to the
proper position,
which is facing
the computer
and in front of
her desk.
When the client
looks through
her credit card
statement she
places her index
finger on a
specific item on

Bilateral coordination

Crossing midline

Fine motor control

the paper in
order to isolate
it while she is
looking at the
amount that
was charged on
her credit card.
She also uses
eye-hand
coordination
when she is
typing on the
keyboard while
also looking at
her receipts.
The client uses
one hand to
write on a paper
while the other
hand is holding
the receipt in
front of her
face.
The client
reaches across
her computer
desk (using her
right hand and
moving toward
her left side) in
order to reach
an envelope
that was placed
there.
The client
utilizes fine
motor skill when
she uses her
fingers to push
on buttons that
are on the
keyboard and
the calculator.
She also uses it
when she writes
in her

Gross motor control

Occulomotor control

Gait patterns

checkbook or
makes
checkmarks on
her receipts.
The client
utilizes this
when she has to
reach for items
that are on the
top shelf of her
computer desk,
such as
grabbing her
receipts and
envelopes.
Additionally, the
client also uses
her lower
extremities
when she has to
stand up from
her chair and
walk towards
the shredder.
The client uses
this when she
has to search
for materials
that are in
different places
in her office.
She looks
through
different
drawers and
files to search
for her receipts,
calculator, pen,
and envelopes.
Gait patterns
are utilized
when the client
had to walk to
materials that
were not within
arms reach,

Blood pressure

Heart rate

Respiratory rate

Respiratory rhythm

Respiratory depth

such as receipts
she forgot to
bring to her
desk, old credit
card statements
that needed to
be shredded,
and grabbing
additional
materials such
as her wallet.
The clients
blood pressure
remained
steady
throughout the
activity, due to
minimal
endurance.
The clients
heart rate
remains at a
constant level
throughout the
activity of
paying her bills.
Respiration rate
of the client
remained
constant, due to
little endurance.
The client
displayed a
normal rhythm,
because the
activity of
paying her bills
required little
endurance,
therefore her
breathing was a
constant rate.
The amount of
respiration for
the client is
minimal due to

Physical endurance,
aerobic capacity

Voice functions

Voice rhythm and fluency

Alternative vocalization

little physical
movement that
was done
throughout the
activity of
paying her bills.
Physical
endurance of
the client is
minimal
because activity
of paying her
bills was mostly
spent in the
seated position.
Although voice
functions were
not required for
the client to
complete the
activity of
paying her bills,
she did speak
with her sister
during the
activity about
various other
topics in her life.
The client did
not need to use
this in order to
complete her
activity of
paying her bills.
The only
vocalization that
the client
expressed was
when she would
speak to herself
when she would
try to remember
the specific date
she had bought
an item in order
to make sure

Digestive system

Metabolic system

Endocrine system

that the credit

card statement
was stating the
correct
information.
Although the
clients
digestive
function is
currently
working
throughout the
activity, it is not
necessary for
the completion
of her paying
her bills.
Although the
clients
metabolic
system is
currently
working
throughout the
activity, it is not
necessary for
the completion
of her paying
her bills.
Although the
clients
endocrine
system is
currently
working
throughout the
activity, it is not
necessary for
the completion
of the paying
her bills

Function

How It Is Used

None

Urinary functions

Although the
clients urinary
functions are

Minimally
Challenged

Greatly
Challenged

Genital and reproductive

function

Protective functions of
the skin

Repair functions of the

skin

currently
working
throughout the
activity, it is not
necessary for
the completion
of paying her
bills.
Although the
genital and
reproductive
functions are
currently
working on the
client,
throughout the
activity, it is not
necessary for
the completion
of paying her
bills.
No protective
equipment was
used for the
client in order
for her to finish
the task of
paying her bills.
There were no
materials used
by the client
that would
cause any
hazards on her
skin.
Although there
was no damage
to the clients
skin, there could
have been a
possibility of a
paper cut due to
the receipts and
envelopes the
client remained
in contact with

throughout the
activity of
paying her bills.
8. Muscular analysis of movements required:
Muscle
Shoulder flexion
Shoulder extension
Shoulder abduction
Shoulder adduction
Shoulder internal
rotation
Shoulder external
rotation
Elbow flexion
Elbow extension
Wrist supination
Wrist pronation
Wrist flexion
Wrist extension
Thumb flexion
Thumb abduction
Finger flexion
Finger extension
Trunk flexion
Trunk extension
Trunk rotation
Lower extremities

Not used

Minimally
challenged
X
X
X
X
X

Greatly
challenged

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

9. Performance skills required:

Skill- Motor

How It Is
Used

Aligns

The client
sits in front
of her
computer in
a fair
distance
without
displaying
persistent
leaning so
that she

None

Minimally
Challenged

Greatly
Challenged

Stabilizes

Positions

could view
the
computer
screen.
Also, when
the client is
sitting in her
chair her
posture is
aligned and
straight in
order to
have proper
body
mechanics
when she
write or
types.
When the
client is
seated in
her chair
and leans
backwards
to reach the
shredder,
she displays
proper
balance so
that she
does not fall
backwards.
The client
positions
herself close
to her
computer
desk and to
other
various
materials on
her desk in
order to not
have to
reach far
when she

Reaches

Bends

Grips

needs to
use
materials
such as the
keyboard,
computer
mouse, and
pens.
The client
extends her
arm in order
to reach
objects that
are far,
especially
when she
has to reach
for items
such as her
receipts that
are placed
on the top
shelf of her
computer
desk.
The client
flexes her
trunk in
order to
write on her
check or to
look at her
bank
statements.
The client
also extends
her trunk as
she shreds a
few old
bank
statements
because the
shredder is
located
behind her.
The client

Manipulates

Coordinates

grips her
pen in order
for her to be
able to
stabilize it
as she
writes
checkmarks
on her
receipts and
as she
writes in her
checkbook.
The client
used
dexterous
finger
movements
in order to
type on the
keyboard of
the
computer,
press
buttons that
are on the
calculator,
and write in
her
checkbook.
While the
client
crosses out
some items
that were
stated in
her bank
statement,
she utilizes
one hand to
write on it
while the
other hand
is used to
hold down
the paper so

Moves

Lifts

Walks

that it does
not slip.
The client
pulls
drawers
open in
order to
take out
materials,
such as
receipts,
checkbook,
pens, and
bank
statements.
When the
materials
are on her
office desk
she pulls
objects from
the desk in
order to
hold it and
look at it.
When the
client was
done with
paying her
bills, she
lifts all the
materials,
such as her
receipts,
checkbook,
and bank
statements
off of her
desk
without
showing any
sign of
fatigue.
When the
client is
walking

Transports

Calibrates

about her
office
looking for
various
materials
needed for
her to pay
her bills,
she walks
swiftly with
balance and
does not
demonstrat
e any
instability.
When the
client
gathers
materials
from various
places in
her office
she
transfers
those
materials,
such as a
calculator to
the
designated
area where
she will
work (her
office desk).
When the
client opens
her drawers
to access
various
materials
such as a
calculator
and pen,
she opens
the drawer
with limited

Flows

Endures

Paces

force where
she exerts
just enough
effort for
the drawer
to open
slowly
where it
does not get
pulled out of
its railing.
When the
client is
typing of
the
keyboard,
she
demonstrat
es a fluid
motion with
her wrist
and fingers
in order to
type in an
efficient and
fast manner.
Throughout
the clients
activity of
paying her
bills, she
continuousl
y did the
tasks
without
showing any
sign of
fatigue or
persistent
stopping.
Throughout
the activity
the client
paces
herself with
her body

movements
so that she
does not
rush
through the
tasks and
fumbles
materials
that are
needed to
pay her
bills.
Skill- Process

How It Is
Used

Paces

Throughout
the activity
the client
paced
herself and
remained in
a steady
tempo as
she
completed
paying her
bills. She
did not
show any
sign that
she was
trying to
rush
because she
did not want
to make any
mistakes on
her
calculations.
Although
the clients
sister talks
to her while
she pays
her bills,
she often
stays

Attends

None

Minimally
Challenged

Greatly
Challenged

Heeds

Chooses

concentrate
d and looks
at the task
at hand
while
speaking to
her sister.
Once the
client began
to do the
activity of
paying her
bills, she
continued to
follow
through
with the
activity and
did not stop
until the
task was
done. For
example,
when the
client is
calculating
various
numbers
she
continues to
do it until
the list is
done.
When the
client was
looking for
various
materials
needed to
pay her
bills, she
chose items
that would
assist her so
that she
could do her

Uses

Handles

task in a
faster
manner,
such as a
calculator.
When the
client needs
to calculate
many
numbers at
once, she
choses to
use her
calculator to
calculate
the amount
on various
receipts.
However, to
organize the
items per
month by
categories
the client
uses an
excel sheet
to input the
information.
When the
client
placed the
calculator,
receipts,
and
checkbook
on her desk,
she placed
them
towards the
middle of
the desk so
that the
materials
are securely
placed
where it will

Inquires

Initiates

Continues

not
accidentally
fall from the
table.
When the
client is
reading the
information
on her bank
statement
she reads
each line
out loud and
checks
whether the
information
is correct or
not.
After the
client
reviews
each item
on the
receipt, she
then goes
on to the
following
step and
looks for the
same item
on her bank
statement.
Once she is
done with
that step,
she then
inputs the
data into
her excel
sheet.
Once the
client began
to input
various
numbers
and

Sequences

Terminates

information
onto her
excel sheet,
she
continued to
do the
process
until all the
items were
finished,
because if
she were to
pause for a
while she
could
possibly
forget
where she
stopped.
When the
client is
going
through the
various
tasks of
paying her
bills she
follows the
same
sequence
throughout
the activity
in order to
stay
organized
and stay
efficient.
Once the
client has
paid all her
bills and
reviewed all
her bank
statements
and
receipts,

Searches/locates

Gathers

she
terminates
the activity
by turning
off the
computer
and returns
all her
materials
back to its
designated
area.
Before the
activity, the
client looks
for her
materials
needed to
assist her to
pay her bills
so that she
does not
have to
locate them
in the
middle of
her tasks. In
order for the
activity to
go in a fast
and efficient
manner, the
client
wanted to
have all her
materials
prepared.
Before the
activity
began, the
client
gathered all
her receipts
from the
past month
and placed

Organizes

Restores

them on her
desk in
chronologic
al order so
that it
remained
organized
and easier
to find.
Before the
activity
began, the
client
placed all
her receipts
in one pile
while the
envelopes
filled with
bank
statements
were all in
another pile,
so that it
was easier
to
distinguish
where each
item was
located.
Once the
client
finished
reviewing all
the items
needed to
pay her
bills, she
returned the
various
materials,
such as her
calculator,
checkbook,
pen, and
bank

Navigates

Notices/responds

Adjusts

statements
back to its
original
location.
When the
client is
reaching for
items that
are needed
to pay her
bills, such
as her
calculator,
she moves
and reaches
for her
calculator
without
hitting other
items that is
on her desk,
like her
computer or
lamp.
When the
client is
looking for
her past
excel file
that has the
information
of various
other bill
amounts,
she notices
what file it
is under in
the
computer in
order to
open it and
add
additional
information.
When the
client is

Accommodates

Benefits

done using
her
calculator to
pay her
bills, she
moves her
calculator
from the
current
location,
such as her
desk, to a
drawer that
is located in
the other
side of the
room.
The client
organizes all
her receipts,
bank
statements
and other
various
materials in
order to
eliminate
looking for
the
materials
while
performing
the activity
of paying
her bills.
When the
client was
first
calculating
her bills,
she was
using her
phone
calculator.
However,
due to

several
mistakes
the client
kept making
while using
her phone,
she decided
to just use
her
calculator
instead and
prevented
the problem
from
reoccurring.
Skill- Social interaction

How It Is
Used

Approaches/starts

When the
client was
trying to
recall a past
purchase
she had
made she
would
initiate a
conversatio
n with her
sister and
ask her if
she
remembers
where they
went on a
certain
date.
When the
clients
sister
converses
with her she
produces
speech in
order to
answer her
question.

Produces speech

None

Minimally
Challenged

Greatly
Challenged

Gesticulates

Speaks fluently

Turns Toward

She also
produces
speech
when she
talks to
herself
about trying
to recall a
purchase
she made.
When the
client is
trying to
recall a
purchase
that she had
made with
her sister,
she will tell
her sister to
come to
her, using a
arm motion
displaying
come
here.
The client
speaks to
her sister in
a fluent
manner in
order to be
understood
and get the
message
across
about any
information
regarding
paying her
bills.
When the
client has to
shred past
credit card
statements,

Looks

Places self

she has to
turn her
body
towards the
back in
order to
reach it.
Also, when
she speaks
to her sister
she will
slightly turn
her chair to
face her,
but will also
be faced
towards her
paper work.
The client
will make
eye contact
with her
sister while
communicat
ing about
past
purchases
they had
made
together so
that they
can double
check if the
amount
stated on
her credit
card is
correct.
The client
positioned
herself close
to her
computer
desk so that
she was
able to

Touches

Regulates

Questions

reach her
keyboard
and
paperwork,
while also
being
conscious of
the distance
she was
from the
shredder.
The client
did not
display the
sense of
touch, nor is
touch
needed
when
completing
the activity
of paying
her bills.
The client
did not
demonstrat
e any
irrelevant or
impulsive
behaviors
that are not
part of
social
interactions
when
communicat
ing with her
sister or
nephew.
When the
client was
not sure
whether the
amount
stated on
her credit

Replies

Discloses

card was
correct,
when she
purchased
an item with
her sister,
she would
ask her
sister if she
had the
receipt or if
she
remembere
d the
amount
stated.
When the
clients
sister asks
her various
questions
that does
not pertain
to the
activity of
paying her
bills, the
client will
still reply by
answering
with
appropriate
answers.
When the
client would
converse
with her
sister about
a purchase
they had
made
together,
she
discloses
the
information

Expresses emotion

Disagrees

Thanks

by stating
the location
of where
they bought
the product
and the
amount of
it.
Throughout
the clients
activity of
the paying
her bills,
she would
mostly
express a
neutral
emotion;
however
occasionally
she would
express an
emotion of
confusion
when she
calculates
an amount
wrong.
The client
did not
display any
differences
of opinion
when
communicat
ing to those
around her
throughout
the activity.
Throughout
the clients
activity of
paying her
bills, she did
not display
any

Transitions

Times response

Times duration

gestures
displaying
gratitude,
nor did she
receive any
compliment
s.
When the
clients
sister
communicat
es to her
about other
topics not
regarding
the
payment of
bills, the
client allows
her sister to
finish what
she is
stating then
transitions
the
conversatio
n to the
activity of
paying her
bills.
No social
messages
were used
by the client
in her
activity.
When the
client talks
to her sister
about a
problem
that is on a
bank
statement,
she talks to
her sister

Takes turns

Matches language

Clarifies

about it
until a
solution is
made.
The client
was
performing
the activity
of paying
her bills by
herself,
therefore
did not have
to take
turns.
When the
client
speaks to
her sister
about bills
that she has
to pay, she
speaks to
her sister in
their native
language
because it is
easier for
both of
them to
converse
that way.
When the
client is
trying to
balance her
checkbook,
however is
missing
some
payments
from her
sister, she
talks to her
sister about
the issues

Acknowledges and
encourages

Empathizes

Heeds

Accommodates

and checks
if her sister
understands
the
problem.
The client
did not
demonstrat
e this action
during her
activity.
The client
did not
demonstrat
e this action
during her
activity.
When the
client was
asking her
sister about
various
products
that are
stated on
the receipts
they
completed
there
conversatio
n once a
solution or
answer was
made.
When the
client would
speak to her
sister, she
would try to
steer away
from
conversatio
ns that did
not relate to
her task at
hand in

order to
finish in a
timely
manner.
The client
did not
experience
any socially
inappropriat
e
interaction;
therefore it
was not
necessary
to prevent
the
problem.

Benefits

10.Performance patterns:
Parts of this occupation has elements of which of the following: (check all that
apply)

Pattern
Useful habit

Describe
The client gathers all her materials before she engages in the
occupation of paying her bills, so that she can do the activity
is a faster and more proficient manner.
I did not observe the client perform a dominating habit.

Dominating
habit
Routine

Ritual

The client did not perform a ritual during her occupation.

Role

The client is a single mother and her role aside from caring
for her child is to provide for her family, which is making sure
that they are financially stable. Therefore, she must engage
in the occupation of financial management.

The client follows a routine when paying her bills, such as

reviewing over old receipts than matching it to her bank
statements, and lastly imputing it in her excel sheet.

Intervention Plan
1. Identify 1 objective and measurable goal of the intervention:
Objective goal: Epinaida will pay her bills independently while taking frequent
breaks to stand up for at least 5 minutes.
Measurable goal: Epinaida will do weight bearing exercises to increase
strength in her lower back so that her back pains will be decreased while she
is in a seated position.
a. According to OTPF what type of outcome is this?
The outcome of this intervention is to address health and wellness and
also improvement.

2. Intervention approach:

Approach
Create/promote

Describe
Provide information to the client about ways to improve
posture, importance of taking breaks, and adaptive
equipment that can be used to provide better performance in
her occupation.

Establish/restore

Develop a schedule where the client takes breaks throughout

her activity of paying her bills so that she is not in a seated
position for a long period of time.

Maintain

Provide the client with an ongoing intervention where she

can maintain her strength by doing exercises that are weigh
bearing and can strengthen her hips, back, and neck.

Modify

When the client uses her computer to input information for

paying her bills, the client can raise her computer screen to
improve her posture so that she can decrease the pain in her
lower back.

Prevent

The client can use a laptop when paying her bills so that she
can stand up while doing her activity, since her pain in her
hips, back, and neck are most frequently felt in a seated
position.

3. Activity selection
a. Activity selection: Identify 1 example of each for the intervention plan

Activity
Occupation

Describe
The client can input her receipt information on her excel
sheet as soon as she makes a purchase, in order to lessen
her time when she has to pay her bills at the end of the
month. This will also allow her to not have to sit for a long
period of time causing her to decrease her pain in her hips.

Activity

The client should set a timer so that when she reaches a

certain amount of time she has to take a break by standing
up and walking around so that she can reduce the pressure
on her hips, which is caused by sitting for a long period of
time.

Preparatory
method

Provide the client with an item that can elevate her computer
screen and keyboard so that she can have a better posture
and decrease pain in her hips and back.

Preparatory task

Provide the client with weight bearing exercises, such as

wearing a vest with weights in order to strengthen her back
so that her back pain can be decreased.

b. Discuss how activity selection relates back to occupational profile and occupational
analysis
As I look through the clients occupational profile where it states her history,
experiences, patterns of daily living, interest, values, and needs, it is apparent that
the clients activity of paying her bills is present throughout all of the occupational
profile categories. The client places value on this activity by prioritizing her time so
that she can accomplish the task and also has a designated area in her home for
the activity to take place. Also due to the clients daily life role, which is a mother
and an accountant, much of her life is revolved around maintaining the household
and providing for her family. Therefore it is important for the client to maintain her
finances by using methods that allows her to perform in the most optimal level
without feeling any strains and pains.
Also, because the occupation of financial management plays a great importance in
the clients life, it was best to synthesize and observe an activity the client felt was
significant. Through the analysis of the clients activity of paying her bills, I was able
to observe what interventions needed to take place in order for the client to reach
her goals.
c. Discuss how activity selection will support achievement of client identified goals and
goal of the intervention plan.
The activity selection will allow the client to decrease her pain in her hips,
back, and neck by increasing exercises that will strengthen those areas. Also,
by having the client perform the tasks of paying her bills in different days,

she will decrease the time she will be sitting compared to if she were to do
the whole activity in one sitting. Therefore, this will allow her to not sit for a
long period of time, which will decrease her pain in her hips and back.
However, if she chooses to do the activity of paying her bills all at one sitting,
by taking frequent breaks she will be able to reduce the pain in her hips as
she continuously stands up. Lastly, by increasing the height of her computer
screen and keyboard, this will allow the client to maintain a proper body
position that will also decrease the pain in her neck.

4. Describe how intervention can be graded or adapted and why

Graded up: The activity of paying bill can be graded up by including more
receipts to be placed in chronological order.
Graded down: The activity of paying bills can be graded down by having the
receipts already placed in chronological order so that the client does not have
to sort them herself. This will allow the client to focus on the other tasks of
paying her bills.
Adaptation: The client could use adaptive equipment to help assist her in the
activity of paying her bills by using a calculator that is greater in size so that
it is easier to view and press the buttons. She could also use a pen with a
wider grip, so that it is easier for her to write on her receipts. It would be best
for the client to use these various adaptive equipment so that she can
perform her activity of paying her bills in a faster and easier manner.
5. Discuss any safety concerns and/or precautions
Since the client feels pain in her lower back, hips, and neck when in a seated
position for a long period of time, it is best to take into consideration the
clients posture when she is in a seated position while paying her bills.
Therefore, she should raise the height of her computer screen and keyboard
so that she is not slouched over when she typing and viewing the screen,
because this could possibly lead to more back problems.
6. Discuss the role of the occupational therapy practitioner during the
intervention
The role of the occupational therapist during intervention is to determine
whether or not the activities during the intervention are a just right
challenge, or whether the tasks needs to be upgraded, down graded, or
needs the use of adaptation. Also, they need to analyze and watch whether
the client is applying proper body mechanics and movements that are
suppose to be associated with the activity. Lastly, the role of the therapists is
also to encourage, motivate, and educate the client on why they need to

complete their intervention, how it is affecting them, and what will be their
outcomes.
7. Discuss what is expected of the client during the intervention
During the intervention the client is expected to try there hardest, stay
motivated and focused, and perform the activities that occupational therapist
has for them. Although the activities wont always be right for each client, it is
important for the client to express the importance of their occupations so that
the therapist can create an intervention plan that is a just right challenge. It
is also important for the clients to be engaged in the activity by asking
questions regarding the treatment and expressing any concerns that they
may feel.