In occupational therapy each senior is unique. It’s crucial to address how the client ended up in the hospital or nursing home. If we don’t address the how or the why, the senior may fall or have the same medical problem and readmit again.

I don’t believe in a cookie cutter approach to therapy because treatment needs to address the root of the problem instead of the typical diagnosis protocol. I believe in engaging the senior in setting their own goals and ultimately their healing.


  • Establish rapport.
  • Evaluation.
  • Honest questions like, “How did you get in this pickle?”
  • Set goals.
  • Use diverse techniques depending on their needs.
  • Work with the senior to help them remember the change in lifestyle or safety in their own words.

This type of approach takes longer because I choose to look at the root problem — and resolve it. As a result, seniors aren’t re-admitted to the hospital, have fewer surgeries, and reduce recurrence of infection.

An example of getting to the root problem involves a fall and subsequent fracture of any of these bones: hip, femur, pelvis, humerus, clavicle, and compression fracture in the back. A Comprehensive Fall Assessment by the Rehab team is essential for preventing more falls. Start with asking how many falls in the past year and what were the details and circumstances of the fall.  Environment, medical issues, balance test scores; range of motion, strength and sensory measurements and a footwear test are some of the items looked at. Personal habits are also pertinent like “I always walk fast”.  After the Rehab team assessment is done a treatment plan is done to those specific Fall Prevention issues. As always, senior involvement and empathy using motivational interview techniques etc. elicits a “buy in” by the senior with a good Rehab outcome and less hospitalizations! If balance is the issue, there is a multitude of balance treatment programs available including using a custom therapy Rehab Game that is of interest to the client!

With over thirty years of experience in geriatric rehabilitation, I’ve come to believe that seniors are more than their test scores and deserve independence and enjoyment of life.

Denise Kean, OTR/L