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Washington University in St. Louis Program in Occupational Therapy
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is a direct result of their environments ability to support their needs which inspires competence,
self sufficiency, and connections with others (Eakman, 2015). Adults are driven to gain a sense
of self worth and autonomy from their daily occupations. They hand pick occupations they feel
will optimize their life path at that point in time.
The occupations of older adults can be understood through the lens of the Selective
Optimization with Compensation (SOC) theory. Older adults choose meaningful goals
(selection) that give them a feeling of success (optimization) while responding to losses in ability
(compensation) (Baltes, Staudinger, & Lindenberger, 1999). Selecting, optimizing, and
compensating allows older adults to participate in occupations that give their life meaning.
When they are able to choose and maximize the benefit of the activities they do everyday, they
reduce feelings of loss and increase feelings of reward after accomplishing a task successfully.
Lloyd is a ninety-four year old retired farmer who resides in Garden City, Kansas. He
has four children, nine grandchildren, and six great-grandchildren who are the main priority in
his life. His wife, Pauline, passed away in 2008. Lloyd has many characteristics that make him
exceptional. Research shows that education level has a strong positive impact on health status
into old age and life expectancy (Eriksson, Lilja, & Petersson, 2015). Though Lloyd is extremely
intelligent, he left school after eighth grade to work on the family farm. Despite this, he lives
alone at age ninety-four, and is able to complete nearly every activity of daily living and
instrumental activity of daily living independently. Furthermore, though research shows less than
half of older individuals perform outdoor housekeeping, Lloyd still plants flowers and tidies his
yard, which he finds valuable (Fortuijn et al., 2006). While Lloyd is remarkable in many ways,
he does fit many of the developmental norms of his age group. He has chronic heart disease
which causes occasional fatigue that hinders his ability to complete daily tasks on occasion.
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Lloyd also reported in his interview that his participation in organizations like the American
Legion and The Elks Club has decreased as he has gotten older. Now he spends more time doing
leisure activities that require a low level of exertion than he used to. According to Eriksson et al.
(2015), this is typical as individuals reach further into older adulthood.
Discovering the roles and activities of individuals across the lifespan made it clear to me
that occupational identity is dynamic. Individuals adjust their occupational participation day-byday in response to their environment and social interactions (Phelan & Kinsella, 2013). Without a
firm grasp on what occupations will give clients a sense of fulfillment, joy, and efficacy at the
stage of life they are in, therapy would be ineffective. It would simply be going through motions
without the invaluable tailored fit that gives occupational therapy true and relevant meaning. I
will use my knowledge of life-stage occupations when interacting with clients as well as their
family and friends. It will be important to have an understanding of the occupational identity of
those around my client in order to understand how he or she relates to others. If these
relationships are unhealthy, it may be wise to assume it will take additional effort to gain my
clients trust, which will allow us to successfully proceed in therapy. In addition, gaining a
perspective on the environment that surrounds my client will allow realistic goal formation and
understanding of how their environment enhances or restricts occupational progression. Asking
the right questions will allow me to understand how my clients identity has changed if they have
loss of function due to aging, a new disease, injury, or disability and what they need to regain
autonomy, competence, and a sense of meaning. It will help me understand the meanings they
assign to their occupations. The ability to knowledgably analyze my clients past and present
combined with an understanding of the universal occupations of their life stage will allow me to
optimize client goal choices. As a result, client centered care will naturally emerge as a priority.
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References
Baltes, P. B., Staudinger, U. M., & Lindenberger, U. (1999). Lifespan psychology: Theory and
application to intellectual functioning. Annual review of psychology., 50, 471-507.
Eakman, A.M. (2015) Person Factors in Christiansen, C.H., Baum, C.M., & Bass, J.D.
Occupational Therapy: Performance, Participation, and Well-Being, Fourth Edition
(pp 317-318). Thorofare: SLACK Incorporated.
Eriksson, G, Lilja, M.& Petersson, I. (2015) Occupations of Elderhood in Christiansen,
C.H., Baum, C.M., & Bass, J.D. Occupational Therapy: Performance,
Participation, and Well-Being, Fourth Edition (pp 169-183). Thorofare: SLACK
Incorporated.
Fortuijn, J. D., van der Meer, M., Burholt, V., Ferring, D., Quattrini, S., Hallberg, I. R., ... &
Wenger, G. C. (2006). The activity patterns of older adults: a crosssectional study in
six European countries. Population, Space and Place, 12(5), 353-369.
Phelan, S. K., & Kinsella, E. A. (2013). Occupation and Identity: Perspectives of Children
with Disabilities and their Parents. Journal of Occupational Science, (ahead-ofprint), 1-23.
Rodger, S., Ziviani, J., & Lim, S.M. (2015) Occupations of Childhood and Adolescence in
Christiansen, C.H., Baum, C.M., & Bass, J.D. Occupational Therapy: Performance,
Participation, and Well-Being, Fourth Edition (pp 129-155). Thorofare: SLACK
Incorporated.
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