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The Lived Environment Life Quality Model (LELQ) aims to explicate the ecological complexities in using occupations to optimize quality of life of institutionalized people with dementia. This model focuses on factors that affect clients’ opportunity in occupational engagement, mainly on the social and physical environmental supports and barriers. It has two main domains, including the lived-environment domain (specifically for assessment and intervention) and the Quality of Life (QoL) domain (specifically for intervention goals and outcome).

This integrative framework mainly consists of two elements: (1) the factors influencing clinical reasoning (CR), and (2) the evolving CR process underlying the choice of teaching strategies. First, both internal factors (relate to occupational therapists, such as knowledge and experience, personal habits) and external factors (relate to client, environment, task, and interaction of them, such as emotional/cognitive/physical availability, previous knowledge) influence CR of therapists.