by Bri Giruzzi, OTR/L MS
As OT practitioners, we try to have our sessions and occupational therapy treatment ideas be as individualized as possible. Best practice calls for using the client’s own interests and roles. With a full caseload, and especially with patients who are harder to motivate, it is sometimes easy to get stuck in a therapy rut or a routine.
We know that, as clinicians, we are encouraged to step away from the repetitive pegboards and exercise. But in a busy SNF, you can feel limited by what materials are available and the set up/clean up time required.
One activity that covers a lot of ground is coupon clipping. This is a real-life task, and can even be a prior leisure activity for some.
Elderly patients may enjoy looking at old advertisements or favorite products. Patients who go shopping may need to get back to doing this chore after discharge from rehab.
The list of functional skills this activity would address goes on and on, including:
- fine motor
- working memory
- visual search and scan
- IADLs and even
- community reintegration
Coupon Treatment Idea Supplies
The supplies are relatively easy and cheap to get.
All you need are:
- coupons, and a
- coupon organizer or index card holder - local newspapers and ads are great, too!
I like to use plastic organizers with labels that have separate slots. These would open like a book or an accordion. The slots can be labeled by month, grocery item, or whatever makes sense to divide up a client’s coupons by. I will use “month” for this example.
How Do I Use Coupons in an Occupational Therapy Treatment?
In a typical session, I would start by writing down month categories and a corresponding shopping list for each one. This may look like: June needs ice cream, July needs canned goods, August needs dry good products, etc. The list can be specific or very broad - below is a free coupon organization shopping list and some coupons to get you going or if you are a member of the Learning Lab, download the coupon list and coupon examples in the Treatment Idea Section under the Resource Section of the Lab.
Your patient will then search through the coupons using fine motor shift and pinch. They will use scissor skills and hand-eye coordination to accurately cut out the square.
Have them transport the coupon into the proper month’s slot. They will need to use appropriate force and strength so as to not crinkle the paper.
Bilateral coordination comes into play when having to hold the slots open and keep the container still. Have them continue down the list until the organizer is all filled up!
Grading the Activity
To Grade Down
It is also simple to grade this challenge up or down. For patients that are low-level functioning, you can have the coupons precut and spaced out on the table. Limit the amount to organize, such as placing only 1 item in each slot or using color-coded visual cues. All of the non-edible items could be highlighted in red, and the matching plastic label for the month would also be red.
Hand-over-hand guidance is always a good option for CVA patients. You could find modified scissors or just help them tear the coupons out by hand.
For social skills and stimulation, patients may simply enjoy looking at the pictures and discussing how to use each item (think Q-tips, wrapping paper, small appliances).
To Grade Up
For a higher-level challenge, we can have them create the shopping list themselves. This will encourage recall, judgement, following a recipe, or even budgeting money.
To Use this Activity Focusing on Hand Therapy
If using this to focus on hand therapy, direct skills are grasp, in-hand manipulation, tool use, lateral key pinch, and forearm supination/pronation when turning the pages. As a mental intervention this involves planning, following directions, and sequencing.
To Use this Activity to Assess Safety
As a way to assess safety, you can see if they are able to find all of the frozen foods. Making errors in this might suggest they’ll return home and leave meat out of the fridge or boxed TV dinners on the counter.
You could also have them identify items they would need in a natural disaster or loss of power- batteries, coolers, canned goods, flashlights, etc.
This activity can be stretched to last a few sessions or can be done in 15 minutes. It has been helpful with patients who don’t particularly like tabletop games or puzzles.
Your patients may respond better to using “real” community objects. Incorporating familiar household items is generally a good idea, especially in dementia care.