#4A - Self and Client Assessment When working with clients, it is important to determine their readiness for change and identify appropriate motivational strategies they can use to increase or maintai
Sally Bio
Age 65, full -time administrative assistant . Barriers to activity: Sally works full time as an administrative
assistant at a local college. She spends the majority of her day sitting at a desk, answering phones,
greeting students and doing tasks for the profes sors in her department. Her husband is disabled and
cannot work. To make ends meet, Sally works part time (10 -15 hours per week) working at a local chain
retail store. She often works late shifts and weekends and spends most of the shift on her feet which
makes her very tired. She and her husband are also the primary caregivers of their 9-year -old grandson
as his mother is in the Army and is currently deployed overseas. Between her two jobs, grandson, and
caring for her husband, when she has “free time” all she wants to do is relax with her knitting projects or
attend church functions. Lifestyle and Risks: Sally is sedentary much of the day except when she works
her retail job which involves stocking shelves or working the cash register. Sally has never consis tently
exercised. When she was growing -up, sports were seen as something boys did, except for cheerleading
and dance, which never interested her because she was so much taller than the other girls. She does not
like to get sweaty or out of breath. Sally t ried an exercise class that was offered at her church in the
past, but she quit after a few weeks because it wasn’t enjoyable and took time out of her day. She does
not look forward to beginning a new program, but she knows “she’ll hate it. ”Sally has type 2 diabetes
which is poorly controlled. She takes the medication Metformin, but at her most recent doctor’s visit,
her physician informed her that if she does not take immediate steps to lose weight and begin an
exercise program, she will need to begin insul in therapy to control her blood sugar. Sally really does not
want to take insulin because she’s scared of needles and the expense associated with testing and daily
injections would be a financial burden to her family. Sally also had recent blood pressure r eadings of
135/85 and her physician warned her that if she does not make improvements, he will prescribe a
hypertensive medication in 3 months.
Goals : While Sally does not want to exercise, her top priority is avoiding being prescribed insulin and an
additi onal medication for high blood pressure. She is willing to consider making healthy changes to
achieve these goals, but she doesn’t know where to start and she doesn’t want to be miserable and
exercise all the time.
Additional information
Howdy, my name is Sally, and I’m a 61 -year -old administrative assistant and a grandmother of a 9 -year -
old boy. He lives full time with me and my husband. For a couple of years now my doctor encouraged
me to lose weight through diet and exercise. The doctor really started getting on my case last year when
I was diagnosed with type 2 diabetes. I’m on oral medication now to keep my blood sugar under control,
but at my last two checkups my doctor told me my sugars are not well controlled, and I will need to
begin insulin therapy if I don’t make changes on my diet and exercise routine. Well, to be hone st, I
shouldn’t say diet and exercise routine, since I don’t watch my diet or exercise at all. I really hate
exercise. Even as a child I never wanted to get hot or sweaty, and I never wanted to play outside. I
primarily worked on sewing and crafts and thing s like that. Why do all that running around when it’s so
much easier to just sit outside. Down here in Georgia it’s just too hot to be outside most of the year.
Plus, I don’t have time to exercise. In addition to my full -time job, I work part time several ev enings a
week, plus weekends to help make ends meet. My husband is disabled and can’t work. The last thing I
want to do after working two jobs is to find the time to exercise. I just want to sit down, work on my knitting projects and watch some TV. Wow, it sounds like I’m making a lot of excuses! Now don’t get me
wrong, I really want to start an exercise program. I want to lose weight, so I don’t have to start this
insulin therapy for my diabetes. The cost associated with these medications is very high, and I would
hate to do that. We are already on a tight budget. I want to do everything I can to avoid taking insulin. I
just don’t know anything about exercise or how to fit it into my schedule. Plus, I don’t want to start a
program I’m going to hate. I need so me direction. I know there is a gym on the college campus where I
work. Several of my coworker’s exercise at lunch, but I’m intimidated by the gym, and my coworkers are
in much better shape than I am. I really do want to improve my health, but I am just as lost on how to
get started.
