Occupational Therapy Can Help Even During End of Life Care

Occupational therapy isn’t just for young, otherwise healthy people. It can be a tremendous help for those in end of life care in San Mateo and elsewhere, too. April is Occupational Therapy Month, a time to pay homage to occupational therapy workers and the benefits they bring. According to the Bureau of Labor Statistics, occupational therapists treat patients who have illnesses, injuries or disabilities through the therapeutic use of everyday activities, with half of these professionals working in offices or in hospitals and the other half working in schools, nursing homes, and home health services.

The Role of Occupational Therapists in Hospice Care

Occupational therapy practitioners play a vital role in hospice care teams through the identification of life roles and activities that are meaningful to patients, while addressing barriers to performing those activities, says the American Occupational Therapy Association. Unlike other types of health care providers, they consider both the physical and psychosocial/behavioral health requirements of the patient, to focus on what is most important to them to accomplish. They also connect them with available resources and support systems, to the extent they want to participate.

Particularly in the hospice setting, occupational therapy provides a holistic and client-centered approach fostering a sense of independence while facing challenges of living with life-threatening symptoms. Occupational therapy with an emphasis on end of life may be offered within a hospital setting, hospice facility, an individual’s home, or an outpatient setting. Occupational therapists will first evaluate of the needs of the patient, identify current and potential abilities, and take a look at barriers to engaging in anything from activities of daily living (ADLs) and sleep to leisure and social participation. Therapists can also help prevent contractures and maintain high levels of joint integrity by introducing stretching routines or splints designed not to interfere with daily activities.

How Interventions Can be Effective

Activities of Daily Living (ADLs)

Dressing: Using adaptive equipment, energy conservation principles, modified techniques, and correct body mechanics to reduce overexertion, fatigue, and pain.
Bathing and showering: Use specialized equipment to maximize safety in the bathroom, such as grab bars and shower benches.
Functional mobility: Incorporate fall prevention strategies, such as removal of hazards such as scatter rugs, and improving adequate lighting. Foster awareness of safety issues and limitations while promoting capabilities and confidence.
Meal prep: Incorporate activity modifications for easier access, such as using wheeled carts and improving kitchen storage organization, while promoting a healthy diet with resources for good nutrition management.
Home management: Assess body mechanics and activity tolerance with tasks such as laundry and house cleaning.
Health management: Provide strategies on how to best manage symptoms of pain, fatigue, anxiety, or shortness of breath.
Religious or spiritual activities: Modify activities to better develop and maintain spiritual involvement, if requested.

Rest and Sleep

Assess sleeping habits to develop pre-sleep routines that lead to longer periods of restorative sleep.
Provide relaxation techniques and position alternatives to boost comfort, enhance ability to rest, and prevent skin breakdown due to pressure.
Leisure Participation: Identify ways the patient can safely participate in leisure and community activities despite illness or mobility issues.
Use relaxation techniques, anxiety and time management, coping strategies, and activity pacing.
Identify ways to maintain cognitive function, such as memory and concentration, so the patient can better participate in meaningful activities.

Psychosocial/Behavioral Health

Engage patients and family members in discussions about their fears, anxieties, and feelings, providing support and resources when appropriate to create an end-of-life plan.
Encourage communication and family involvement in an effort to support the patient’s wishes, and with the purpose of promoting continued social connections.
Support the caregiver, communicating about realistic expectations, as well as education on safe body techniques and mechanics during ADLs and transfers. Also, provide resources to caregivers to prevent burnout, such as through support groups.

There are several benefits to occupational therapy, mostly having to do with mastery of skills needed to help patients remain as comfortable as possible during this time. The goal here is to ensure productive, independent, and satisfying lives.

What Occupational Therapists Can Offer Patients and Families

They can:

Support and educate clients, families, caregivers, health care professionals, and policy makers.
Work with individuals to address ADLs, psychological issues, and emotional issues, splinting and positioning, energy conservation, and comfort.
Connect patients with community services and supports.
Conduct home assessments.
Be advocates for patients to die with dignity, free of pain, in a setting of their choice, surrounded by loved ones.

In a nutshell, occupational therapists are just as important during end of life care as any other member of the team.

Contact Pathways Home Health and Hospice

Here at Pathways, an occupational therapist can be part of your loved one’s hospice care team. To learn more about this invaluable resource, please contact us at 888-978-1306.