Practice in shelters for people who are homeless is an exciting and challenging opportunity for occupational therapists. However, there is a paucity of knowledge about the occupational performance needs of this population. In the present study, 25 persons at a shelter were interviewed using the Canadian Occupational Performance Measure (COPM). Data were analysed using both qualitative and quantitative methods. Several major themes emerged including spirituality, “we want what everyone wants”, choosing satisfaction, diverse health concerns, power of relationships, the importance of environment to well-being, and poverty. Altruism in the midst of adversity and individuality were minor themes. Instrumental activities of daily living, such as access to employment, financial management, housing, and recreation, were reported as more important than basic activities of daily living. Participants and interviewers also responded to general questions regarding the use of the COPM in the assessment process. The COPM was found to be useful for assessing the occupational performance needs of this population, but should be augmented by inquiry about environmental concerns, relationships, housing, and spirituality
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