Occupational Therapy and Hospice

With April being National Occupational Therapy Month, we thought it timely to touch on the importance of occupational therapy as it relates to hospice in San Francisco and elsewhere. First, let’s go over what occupational therapy is. This is a form of therapy to help those who are recuperating from physical or mental illness, designed to encourage rehabilitation through the performance of activities necessary in daily life. According to the American Occupational Therapy Association, occupational therapy practitioners help people live life to the fullest by promoting health while at the same time preventing or lessening the effects of injury, illness or disability.

Occupational therapy is a vital part of hospice. Therapists play an integral role in hospice care teams through the identification of life roles and activities that provide some meaning to patients, all while addressing barriers that may exist when performing such activities. They take into account the behavioral and psychosocial health needs of the patient in addition to the physical. They’ll talk to the patient to find out what they want to accomplish and what’s most important to them, while also considering the available support systems and resources to achieve those goals. Ability level and the environment in which the patient is in will also play into the occupational therapy routine suggested.

Activities of Daily Living

Occupational therapy with an emphasis on hospice care can be offered in a variety of settings, such as within a hospital, nursing home, hospice facility, outpatient clinic or the individual’s home. Occupational therapy practitioners will first evaluate the needs of the patient, then identify current and potential abilities to determine barriers that may crop up in terms of engagement in occupations, including activities of daily living, rest and sleep, social life, and leisure.

Here are some examples of OT interventions that have been known to be effective in hospice care.

• Dressing: Using adaptive equipment, modified techniques and proper body mechanics to reduce fatigue, over-exertion, and pain.
• Bathing and showering: Using adaptive equipment to optimize safety in the tub or shower, such as benches or grab bars.
• Functional mobility: Using fall prevention strategies, such as removal of hazards like throw rugs and improved lighting.
• Meal preparation: Using activity modifications such as wheeled carts and reorganized kitchen storage for better access, as well as encouraging a healthy diet with resources for nutrition management.
• Home management: Assessing activity tolerance and body mechanics related to tasks such as laundry or cleaning.

The Process

Occupational therapists are typically part of the palliative and hospice care team. The first meeting will involve the therapist listening to the patient’s story, observing what they are able to do, and discussing what they consider important on a physical, social, emotional, and spiritual level, says CareSearch. Once these factors are established, the OT will set goals with the patient and family that are centered around what they want to continue doing and what they want to achieve before dying.

Goals may involve anything from showering by themselves to getting in and out of bed independently. Interventions may also focus on reducing anxiety and stress, and addressing pain management. Whatever the case, goals should be revisited, reassessed and modified as needed to meet the changing needs of the patient, their disease progression and their current physical abilities. One patient’s priority may be to continue spending time with family and friends, with modifications that allow them to continue to do so even when fatigued, such as changing the length of the meeting time or the location.

As the disease progresses, interventions may shift to focus on making practical preparations as death comes closer. This could involve packing up their homes and giving away items and belongings to loved ones. It could involve getting closure through reflection and reconciliation, or saying a final good-bye to loved ones.

Benefits of Occupational Therapy

 

There are many benefits to occupational therapy — in the hospice setting or otherwise. The main advantage is the mastery of skills needed to help patients recover or maintain daily living skills to provide them with the best and most comfortable life possible. The goal is to ensure independent, productive and satisfying lives. Over time, those goals will change as the patient’s health declines. Hospice patients aren’t the only ones who can benefit from OT.

Occupational therapy can greatly enhance the lives of people living with Parkinson’s, Alzheimer’s, or other chronic diseases:

• Multiple sclerosis: Can reduce the severity of symptoms of the disease and improve the ability to complete activities of daily living, as well as improve attention, executive functioning, memory and information processing.
• Parkinson’s Disease: Repetitive physical exercises can boost diachronic motor and sensory-perceptual performance skills.
• Post-Stroke Recovery: Specialized therapy plans help people meet their personal recovery goals, with exercises that work on task-related parameters rather than specific movements.

Contact Pathways Home Health and Hospice

We have occupational therapists on staff who can help your loved one in hospice. Contact us to learn more today.