Steve is a 55-year-old divorced white male who has quadriplegia, following a work-related accident 5 years ago; he settled his case with the...

Steve is a 55-year-old divorced white male who has quadriplegia, following a work-related accident 5 years ago; he settled his case with the insurance company. Up until his accident, Steve worked as a heavy equipment operator at a mine for 20 years. Steve does have a bachelor's degree in mechanical engineering. He is unable to walk; has regular arm and hand function, but with some weakness; is able to transfer himself; and is independent with self-care, but does require assistance at times. He uses an electric wheelchair for mobility. Steve was diagnosed with major depression 3 years ago. He also has chronic pain and muscle spasms in his legs and lower back. Steve is prescribed the following medications for pain management, muscle spasticity, and depression: oxycodone, baclofen and Paxil. He recently returned home from a stay in the hospital for decubitus ulcers.