Enabling occupation at the end of life

Background: End of life care is current and pertinent in today’s international socio-political climate. The drive for high-quality treatment, choice, and control, emphasized in the British Department of Health agendas (NICE... [ view full abstract ]

Background: End of life care is current and pertinent in today’s international socio-political climate. The drive for high-quality treatment, choice, and control, emphasized in the British Department of Health agendas (NICE 2004, 2011) is mirrored and reflected in the World Health Organisation’s European conveyance on palliative care (2004). Encompassing every aspect of intervention, people wish to be treated with dignity and have a good quality of life. Occupation is recognized as contributing to quality of life for all individuals (Wilcock 2007). The premise that occupation should be enabled for those at end of life is therefore intuitively a philosophical tautology.

Method: A literature review was conducted and published exploring occupation at end of life across multiple environments.

Results: Universally there appeared a dearth of therapists working in palliative care. Provision in hospitals was found to be compensatory or rehabilitative. Hospice therapy emerged as occupational, though the number of hospice places disappointingly few. In the community promising research refracted light on occupation at home, yet also revealed stretched domiciliary services, wherein clients were ill-informed about occupational therapy.

Conclusion: A ‘good death’ involving a quality end of life experience is the goal overarching all palliative care. Arguably, an occupation-focused approach provided by Occupational Therapists, can meet client need to enable meaningful experiences in the time available. Current practice environments are not necessarily commensurate in achieving these goals.

Application to Practice: Further research and promotion of the role and scope of occupational therapy, across all palliative care environments, is required for future practice.