Date of Award


Document Type

Scholarly Project

Degree Name

Master of Occupational Therapy (MOT)


Occupational Therapy

First Advisor

Breann Lamborn


Occupational Therapy; Patient Advocacy; Poverty -- North Dakota; Transporation -- North Dakota; Aged; Aged, 80 and over


Between the ages of 65 and 74, 9% of elderly individuals live in poverty in the United States (Forum, 2010). This poverty rate increases to 11% in elderly individuals who are 75 years of age or older (Forum, 2010). In rural areas, the effects of poverty may be even more pronounced than in urban areas secondary to the societal limitations that exist within some small rural communities; rural areas in North Dakota routinely face both the effects of poverty and the societal limitations. These limitations may include a lack of public transportation or services available to the general public. Due to limited urban areas and a low population, North Dakota has experienced rural depopulation over the past few decades (North Dakota State Data Center, 2012). With more of North Dakota’s younger citizen moving to urban areas, the state has had to cut funding to the rural communities, resulting in greater difficulties for the elderly individuals who continue to reside in those areas (North Dakota State Data Center, 2012). With the growing trend of rural depopulation, the low occurrence of elderly individuals relocating to urban areas, and the increasing elderly population in North Dakota, further research needs to be conducted regarding the elderly living in poverty in North Dakota (North Dakota State Data Center, 2012). In addition, occupational therapists who work in rural areas with limited community resources may experience a greater demand for services and requests to provide services outside traditional areas of expertise [i.e. advocating for transportation in rural areas] (Payne, 2005; Vissing, 1996). The overall goal of the resource manual is to provide a practical, user-friendly, theoretical model-driven occupational approach using the Occupational Adaptation model for occupational therapists who must advocate for transportation related services for elderly individuals who live in poverty in North Dakota.