Elderly

The Value and Meaning in Occupations (ValMO) aims to address the absence of theoretical structures to aspects of value and meaning in existing models of occupations. It adopts a person-task-environment triad, where occupation is viewed as the result of the transaction. It includes the role narrative in structuring an individual’s experiences embedded in daily occupation, which contributes to an ongoing personal story.

The Meaning Perspectives Transformation Model is characterised by three phases: the trigger phase, the changing phase, and the outcome phase. These three phases move the process of meaning perspective transformation in the physical, emotional, cognitive, or spiritual dimensions. Critical self-reflection acts as a catalyst and represents as a moment of “readiness of change”. This allows clients to identify their assumptions, question meaning, and develop alternative ways of performing.

This framework places spirituality as the core of the person. It regards an individual’s spirit as one’s being, unharmed by injury or illness, rather than as a component. In this framework, spirituality is depicted as two concentric circles surrounding the center. The first circle depicts human center and the second circle depicts personal worldview. The center is defined as the core, the heart, or what is means to be human.

The compensatory frame of reference (FOR) aims to increase occupational performance and facilitate independence by utilizing compensatory techniques. It is used to compensate dysfunction in desired occupations, e.g., using assistive device or equipment such as Ergonon/Reflex knife during meal preparation, to compensate difficulty with using traditional knife. This FOR also includes environmental change, e.g., altering layout of living environment or using splints.

Rehabilitative frame of reference (FOR) considers rehabilitation as the process of facilitating patients in fulfilling daily activities and social roles with competence. This FOR is used with clients whose underlying impairments are unlikely to remediate and be considerable permanent, or the clients who lack motivation to participate in remediation. The theoretical basis of this FOR is that the client must focus on the remaining abilities, despite of any disabilities, to attain his/her highest level of functioning in the desired occupational performance.

The theoretical base of biomechanical frame of reference (FOR) is considered as a remedial approach focusing on impairments that limit occupational performance. This FOR assumes clients are able to acquire the voluntary motor skills necessary to perform the desired human occupation, meaning that the underlying impairment is amenable to remediation. It also assumes that engaging in occupation and therapeutic activities has the potential to remediate the underlying impairment, and results in improvement in occupational performance.

The psychoanalytic frame of reference (FOR) emphasizes on the unconscious aspect of what is done and said, and it is embedded in an occupational therapy relationship model of practice - the Vivaio model (MOVI). The central element of the MOVI is the recognition of constant emotions that exist in the interdependent relationship between the three elements of patient, therapist and ‘doing’.

The developmental frame of reference (FOR) suggests that development is sequential, and behaviors are primarily influenced by the extent to which an individual has mastered and integrated the previous stages. This FOR views people as dynamic, developing, and people’s lives go through stages of growth and decline, which require necessitate adaptation by the individual. People develop at different rate, but each stage of development can only proceed normally if the preceding stages have been completed successfully.

The behavioral frame of reference (FOR) emphasizes on the use of behavioral modification to shape behaviors, which purports to increase the tendency of adaptive behaviors or to decrease the probability of maladaptive learned behaviors. The key concepts in this FOR include:

The cognitive-behavioral frame of reference (FOR) emphasizes five aspects of life experience: thoughts, behaviors, emotion/mood, physiological responses, and the environment. These aspects are interrelated, meaning that changes in one factor can lead to improvement or deterioration in other(s). Each is influenced by the social and physical environments. One key theoretical component in this FOR is the hierarchical levels of cognition. Automatic thoughts is the most accessible, which are uninvited and immediate thoughts. Beliefs are conditional beliefs we hold about ourselves.