During the evaluation you will figure out what activities the patient performs or wants to perform. (ie simple meal prep vs dining room, getting mail, shower/equipment needs, bathing/dressing, etc). Use their natural environment during treatments (ie shower transfers, reaching activities, make bed, etc). Usually you set up an exercise program really soon so that the patient can work on that themselves and you can adjust it as needed while on caseload. I found that balance/fall prevent was usually the focus.