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Nicaragua Leisure Activities with PALs Modification Levels

1 January 2013



Each year an interprofessional team of health professional students and faculty from the College of Health Professions, Pacific University Oregon, travel to Nicaragua to promote the health and wellness of older adults living in hogars (charity homes). The work presented here, describes and illustrates the experience and contributions of the Occupational Therapy (OT) students who participated in the project this year.


Four students from the School of Occupational Therapy were chosen to participate in the Nicaragua Project, a team composed of 22 students and 6 faculty from 5 health profession disciplines. To prepare for the 10-day service-learning trip, team members participated in 4 meetings where they performed team rapport building, fundraising and donation collection, and Nicaragua culture exploration. The students participated in two large fundraising events: the Warrior Dash and a donation drive for needed supplies at the annual Occupational Therapy Association of Oregon conference.

During Trip:

The interdisciplinary team was divided into two groups, performing service learning in hogars for older adults in Granada and Estelí. Two OT students were placed in Granada, and two in Estelí. Service was provided in the hogars for five days. The students began with interdisciplinary screenings, followed by individual treatments sessions, co-treatment when possible, caregiver training, group leisure and movement activities, and use of the Pool Activity Level Instrument for Occupational Profiling (PALS) for assessment of residents.

PALS assessments were administered with 8 individuals spanning the four cognitive levels. In Estelí, caregiver guides were placed in the individuals' medical records to guide caregivers in activity modification. Spanish caregiver education manuals were also left with each facility.

In addition to care of residents, each facility hosted a community education seminar with information provided by all disciplines. Occupational Therapy focused on providing information about working with vision, hearing and cognitive loss from the caregiver manual.

After Trip:

After piloting the PALS in Nicaragua, we found it to be a culturally relevant assessment, which provided the opportunity to facilitate caregiver training in activity modification. Students created a leisure activity modification tool, based on the PALS cognitive assessment, to train caregivers in Nicaragua to meet the varied ability levels of the older adults with whom they work. This assessment allows the caregiver to best work with the residents at their level for leisure activities and is included in this document. A PowerPoint presentation delivered that the Pacific University School of Occupational Therapy’s annual Research and Practice Symposium in April 2012 is also included.

Additionally, the occupational therapy students wrote a journal article titled “Navigating Cultural Differences in Interprofessional, International Service-Learning”. The article has been submitted for publication in Health and Interprofessional Practice, and for this reason it is not included within this document.


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