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Examples of Barriers

1. Physical environment: an elevated home with no ramp or elevator for the wheelchair user

2. Social environment: living alone with no family or friends to help with transfers as needed

3. Cultural context: inability to speak the same language, including body language

4. Personal context: lacking high school education and/or living without insurance

5. Temporal context: Alzheimer’s disease at the end of a long day (“sundowning”)

6. Virtual context: lacking internet access necessary to view one’s electronic health record

RELATED ICE VIDEOS

Search the ICE Video Library for the titles below, or for keywords such as: environment, social interaction, function, ADL, etc.

• Participation: Expanding Therapy into the Community

• Multiple Sclerosis, Problems Observed in the Home: Parts 1-5

• Femur Fracture, 5 Weeks Post Surgery: Safety During Meal Preparation, Parts 1-3

• Femur Fracture, 5 Weeks Post Surgery: Advanced Practice Skills During IADLs

QUESTIONS 

Ask these questions when watching the related videos.

1. How does social interaction improve one’s pain tolerance, endurance, and participation in ADLs?

2. How can the physical environment be altered to promote safety, endurance, and independence during activities, such as cooking, cleaning, and gardening?

3. Why is it important to understand an individual’s stage of life and/or preferred rhythm of activity when facilitating rehabilitation?

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Amanda K. Giles, OTD, OTR/L
Assistant Professor
Division of Occupational Therapy
College of Health Professions
Medical University of South Carolina