Patients in in-patient rehabilitation are often discharged with adaptive equipment in order to be safe and independent in their homes, as is the case for patients at ManorCare, a skilled nursing facility in Tacoma, Washington. However, if adaptive equipment that is functionally necessary is not being used by the patient, it can lead to reduced independence and safety, potentially resulting in incidents that result in injury and re-admittance. Therefore, Rehabilitation Director Joette Jindra, OTR/L requested research to understand the factors that contribute to continued use or non-use after discharge to assist therapists in their clinical decision-making when making equipment provisions and recommendations. The research showed that approximately ⅔ of patients continue to use their equipment based on client, equipment, training, and environmental factors.

The findings of this research were presented at an in-service presentation at ManorCare to the occupational therapy staff. Additionally, a clinical decision-making tool was developed and disseminated for clinical use, outlining the factors that affect continued use. Two surveys were disseminated to the in-service participants; one at the end of the presentation and another two weeks later, giving them time to trial the decision-making tool. The results of the first survey indicated that the information presented was clear and useful. The results of the second survey indicated that the decision-making tool had a moderate impact of their approach to equipment prescription. It is recommended that the facility consider conducting follow-up with discharged patients to track continued equipment use and suitability.

Publication Place

Tacoma, Washington


University of Puget Sound

Faculty Advisor

Kirsten Wilbur, EdD, OTR/L

Project Chairperson

Publication Date



Capstone Project





Degree Program

Occupational Therapy

Degree Level

Master of Science


Occupational Therapy


University of Puget Sound