Abstract:

Discusses the universal need for control of one's personal environment and suggests ways in which physical and occupational therapists can promote a sense of control among persons in an institutional environment. Nursing homes often fail to support individuality and autonomy, but there is an increasing demand for more humane environments that support and promote individual autonomy. Nursing home residents can be given choices regarding food, clothing, activities, bedtimes, and other daily routines. When it is not possible to grant complete control, residents can be given the illusion of control if they are allowed to make decisions about seemingly unimportant activities. Predictability of events is as important as actual control over a situation. Physical and occupational therapists should review the opportunities for control in their programs and services and should assess patients' perceptions of the extent to which they feel a sense of control. Patients can be given opportunities for three types of control: behavioral control, such as locking a door to ensure privacy; cognitive control, such as educating patients about their conditions; and decisional control, which provides a choice among a number of options