This qualitative study sought to discover and compare the perceptions of well elders and their families regarding the impact of the elder's cessation of driving. Similar themes emerged from both groups regarding the sense of burden, the decision process, and the meaning of driving to the elder. Congruent and divergent perceptions between family members and elders are illustrated in the text. These provide insight to occupational therapists and others working with the elderly regarding the meaning of the occupation of driving.

The emergence of managed care has resulted in a practice environment buffeted by rapid and sweeping changes. Shifts in philosophy and approach to payment for health care affect the nature of the service and the method of its delivery. The occupational adaptation frame of reference is used to illustrate the challenges imposed by the physical, social, and cultural components of the changing occupational environment. Perceptions, observations, and concerns of middle level occupational therapy, physical therapy, social work, and nursing managers illustrate the impact of this new environment. Therapists are challenged to understand their own changing work setting and to apply the same effort to mastering its challenges as they would to examining the context of their patient's occupational performance and to designing and implementing an appropriate clinical intervention.

No abstract

This document contains four sections that direct the delivery of occupational therapy services. These sections are General Supervision, Supervision of Occupational Therapists and Occupational Therapy Assistants, Roles and Responsibilities of Occupational Therapists and Occupational Therapy Assistants During the Delivery of Occupational Therapy Services, and Supervision of Occupational Therapy Aides. General Supervision These guidelines provide a definition of supervision and outline parameters regarding effective supervision as it relates to the delivery of occupational therapy services. These supervision guidelines are to assist in the appropriate and effective provision of occupational therapy services. The guidelines themselves cannot be interpreted to constitute a standard of supervision in any particular locality. Occupational therapists, occupational therapy assistants, and occupational therapy aides are expected to meet applicable state and federal regulations, adhere to relevant workplace policies and the Occupational Therapy Code of Ethics (AOTA, 2005) and participate in ongoing professional development activities to maintain continuing competency.

This study suggests the validity of the ACL-90 as an assessment to use for screening the cognitive functional performance of adolescents.